Research Of The Impairment Characteristics Of Theory Of Mind In Patients With Schizophrenia

Purpose:As a core component of social cognition,Theory of Mind(ToM)affects the quality of life and overall prognosis of patients with schizophrenia.A deeper understanding and research on the characteristics of theory of mind impairment in patients with schizophrenia will help to understand the psychopathology and cognitive impairment behind schizophrenia,and provide important theoretical reference for targeted rehabilitation intervention and improvement of patients’ social function.This study adopted the classic paradigm of theory of mind and makes relevant changes according to the experimental design requirements,aiming to measure different components of theory of mind in patients,and to explore the damage characteristics of different stages,components and error types of theory of mind in patients with schizophrenia combined with relevant demographic information and clinical scales.To reveal the correlation between the impairment of theory of mind and clinical symptoms,and to explore whether there is a specific effect of facial emotion recognition on the performance of theory of mind.Method:1.Investigation: A total of 32 inpatients with schizophrenia and 32 healthy controls were recruited.Descriptive statistics,independent sample t test and Mann-Whitney U test were used to analyze the basic demographic information and clinical data.2.Experimental study: Through two behavioral experiments(Yoni task and MASC-C task),Analysis of variance,independent sample t test,latent profile analysis,network analysis,Spearman correlation analysis and Mann-Whitney U test were used to analyze the characteristics of ToM impairment,clinical correlation and the possible effect of facial emotion recognition on theory of mind in schizophrenia.Results:1.Investigation: There were no significant differences in gender,age and years of education between schizophrenia patients and healthy controls(p > 0.05);The trail making test,symbol coding test and digit memory span of the subjects were significantly lower than those of the controls(p<0.001).2.Experimental study:(1)Experiment 1:(1)After controlling for physical conditions,there were significant differences in ToM between patients and healthy controls in all stages and components(p <0.05),except for affective b ToM(simple affective)(p = 0.063).(2)There were three latent categories of ToM performance within the schizophrenia group: intact type,second-order impairment type and global impairment type,and there were significant differences in positive symptoms(F = 4.390,p = 0.022)and negative symptoms(F = 3.5,p = 0.045)in these three categories.(3)Network analysis showed that first-order cognitive ToM was negatively correlated with positive symptoms;second-order affective a ToM was negatively correlated with negative symptoms.The symbol coding test,second-order cognitive ToM and second-order affective b ToM had high centrality.(2)Experiment 2:(1)In the two conditions of mask and display expression,the healthy control group performed better than the patient group in the correct number of ToM,less ToM and no ToM errors(p < 0.05),while the excessive ToM errors showed a significant difference between the two groups only in the display of expression(Z =-1.984,p = 0.047).The patient group showed a higher percentage of less ToM errors(t = 2.527,p = 0.015),while the healthy controls showed a higher percentage of excessive ToM errors(t =-2.247,p = 0.030).(2)The patient’s ToM deficit was significantly positively correlated with the severity of symptoms(rho = 0.5-0.7).(3)There was no significant difference between-group difference in the difference ToM performance with or without expression(p > 0.05).Conclusion:1.On the whole,the ToM impairment of schizophrenia patients is relatively comprehensive and profound,which is manifested in different stages,components and error damage tendency.The impairment of second-order affective ToM is mainly reflected in complex affective,and the less ToM errors is the wrong choice that patients are more likely to make.At the same time,there are also different types of ToM injuries and there are differences in symptoms within the patient group.2.There is a correlation between ToM impairment and clinical symptoms in patients with schizophrenia.Among them,positive symptoms are related to cognitive ToM performance,negative symptoms are related to affective ToM performance,and both negative and positive symptoms are related to less ToM.3.ToM impairment in schizophrenia is associated with neurocognitive performance such as processing speed and working memory.4.Whether to recognize facial expressions affects the specific performance of ToM to a certain extent and the relationship between ToM performance and clinical symptoms.However,in general,the patients’ ToM impairment and facial emotion recognition impairment may be relatively independent.