OBJECTIVES : Theory of mind (ToM) is the ability to conceptualize other people's mental states in order to explain their behavior. This study compared the ToM ability of schizophrenia patients, their first-degree biological relatives, and healthy controls. METHODS : ToM animation test was administered to schizophrenia patients (N=28), their healthy first-degree relatives (N=26), and healthy controls (N=28). The Korean version of schizotypal personality questionnaire (SPQ) was used to assess the schizotypal personality trait of all three groups. RESULTS : Schizophrenia patients and their first-degree relatives showed decreased accuracy on ToM animation test compared to healthy controls [F(2,78)=29.75, p<.001]. Additionally, first-degree relatives performed worse than the control group and better than schizophrenia patients. First-degree relatives had similar SPQ scores compared to healthy controls but showed decreased ToM accuracy compared to healthy controls. CONCLUSION : ToM deficits in schizophrenia patients are apparent. The ToM deficit in first-degree relatives of schizophrenia patients raises the possibility that ToM deficit may be a endophenotype for schizophrenia pathology.
Endophenotypes ; Humans ; Surveys and Questionnaires ; Schizophrenia ; Theory of Mind

OBJECTIVE: It was proposed that the ability to recognize facial emotions is closely related to complex neurocognitive processes and/or skills related to theory of mind (ToM). This study examines whether ToM skills mediate the relationship between higher neurocognitive functions, such as reasoning ability, and facial emotion recognition. METHODS: A total of 200 healthy subjects (101 males, 99 females) were recruited. Facial emotion recognition was measured through the use of 64 facial emotional stimuli that were selected from photographs from the Korean Facial Expressions of Emotion (KOFEE). Participants were requested to complete the Theory of Mind Picture Stories task and Standard Progressive Matrices (SPM). RESULTS: Multiple regression analysis showed that the SPM score (t=3.19, p=0.002, beta=0.22) and the overall ToM score (t=2.56, p=0.011, beta=0.18) were primarily associated with a total hit rate (%) of the emotion recognition task. Hierarchical regression analysis through a three-step mediation model showed that ToM may partially mediate the relationship between SPM and performance on facial emotion recognition. CONCLUSION: These findings imply that higher neurocognitive functioning, inclusive of reasoning, may not only directly contribute towards facial emotion recognition but also influence ToM, which in turn, influences facial emotion recognition. These findings are particularly true for healthy young people.
Facial Expression ; Humans ; Male ; Negotiating ; Theory of Mind*

OBJECTIVE: The goal of the present study was to identify the brain mechanism involved in the attribution of person's attitude toward another person, using facial affective pictures and pictures displaying an affectively-loaded situation. METHODS: Twenty four right-handed healthy subjects volunteered for our study. We used functional magnetic resonance imaging (MRI) to examine brain activation during attitude attribution task as compared to gender matching tasks. RESULTS: We identified activation in the left inferior frontal cortex, left superior temporal sulcus, and left inferior parietal lobule during the attitude attribution task, compared to the gender matching task. CONCLUSION: This study suggests that mirror neuron system and ventrolateral inferior frontal cortex play a critical role in the attribution of a person's inner attitude towards another person in an emotional situation.
Brain ; Humans ; Magnetic Resonance Imaging ; Mirror Neurons ; Theory of Mind

Recently, social cognition is becoming a hot issue in field of schizophrenia research. There are increasing demands for more clear definition of terms and knowledge about neurobiology of social cognition in schizophrenia. One of the reasons why it receives so much attention would be its role of predicting the functional outcomes of schizophrenia patients. The purpose of this article is to review and summarize the concepts and neural correlates of social cognition in schizophrenia. Functional brain imaging studies as well as behavioral studies were reviewed.
Cognition* ; Functional Neuroimaging ; Humans ; Neurobiology* ; Schizophrenia* ; Theory of Mind

OBJECTIVES: The primary purpose of this study was to evaluate the therapeutic effects of sociodrama on inpatients with schizophrenia. METHODS: The sociodrama group was composed of 20 inpatients with schizophrenia and control group was matched with the sociodrama group. The sociodrama group received 10 sessions of sociodrama therapy over 10 weeks. Assessment was done at the beginning and end of this period. RESULTS: After 10 sessions of sociodrama, the patients showed a significant improvement in the BPRS total score, in the withdrawal-retardation and hostile-suspiciousness subscale scores and on the ToM Scale. There was also a significant improvement on the QoL Scale. There were no significant changes on the RCS or the Empowerment Scale. CONCLUSION: These results suggested that, for inpatients with schizophrenia, sociodrama can make a useful contribution in the improvement of withdrawal-retardation, hostile-suspiciousness, theory of mind, and subjective satisfaction with quality of life. We therefore expect that sociodrama can play a useful role in enhancing the psychosocial functioning of patients with schizophrenia. Future research to generalize of the results of this study is necessary.
Humans ; Inpatients ; Power (Psychology) ; Quality of Life ; Schizophrenia ; Theory of Mind

OBJECTIVES: The aim of this study was to investigate brain activation during a Korean language-based 'theory of mind (TOM)' task and fMRI in Korean schizophrenic patients. METHODS: Fourteen Korean schizophrenic patients and 15 normal controls participated in this study. For all participants, several clinical states and psychosocial functions were evaluated. The subjects were then scanned while performing Korean language-based fMRI tasks. The tasks were comprised of conditions-first order false belief (TOM task), physical causality, and unrelated situations. Imaging data were analyzed using SPM2 software (uncorrected p<0.005, extent threshold kappa=10). RESULTS: 1) Compared with the control group, the patient group showed significantly poorer performance on the TOM task, and no significant correlation between TOM and empathic abilitiesy. 2) In the patient group, there were no significantly activated brain regions associated with the TOM task as compared to the physical causality task. With respect to between-group differences, the patient group showed significantly less activation of the left medial frontal region (primarily BA 8) and signifcantly different activation of the left precuneus (BA 7) associated with the TOM task. CONCLUSION: These results suggest that Korean schizophreniac patients show different brain activity associated with TOM functions, especially with respect to the Korean language-based first order false belief tasks.
Brain ; Humans ; Magnetic Resonance Imaging ; Schizophrenia ; Theory of Mind

OBJECTIVE: The aim of this study is to investigate whether insight and mentalizing abilities are related to the severity of Obsessive Compulsive Disorder (OCD) in treatment resistant OCD. We look at the association between treatment resistance, insight, and mentalizing ability. METHODS: The study was conducted with 71 OCD patients; 30 of them met the criteria for treatment resistant OCD, whereas the other 41 (57.7%) were labeled as responder group. All patients were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Reading the Mind in the Eyes Test (RMET), Brown Assessment of Beliefs Scale (BABS), Mini International Neuropsychiatric Interview, Beck Depression Inventory, and Beck Anxiety Inventory. RESULTS: The resistant group received higher depression and anxiety mean scores and had significantly longer illness duration. The RMET score was significantly higher for responders. The Y-BOCS insight score and the BABS score were significantly higher for the resistant group. BABS scores were negatively correlated with RMET total scores. RMET scores were found to be significant predictor of insight even when other potential factors were controlled for. CONCLUSION: Results suggest that better mentalizing abilities may be a predictor of better treatment outcome in patients with OCD.
Anxiety ; Depression ; Humans ; Obsessive-Compulsive Disorder* ; Theory of Mind* ; Treatment Outcome

OBJECTIVE: The aims of this study were to evaluate differences in empathic abilities between patients with complex regional pain syndrome (CRPS) Type I and healthy control subjects (HCs) and to assess correlations between empathic abilities and multidimensional aspects of pain. METHODS: Empathic ability was measured in 32 patients with CRPS Type I and in 36 HCs using the Interpersonal Reactivity Index (IRI). A comprehensive assessment of pain was conducted in the patient group using the West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Psychiatric symptoms were assessed using the Beck Depression and Anxiety Inventories (BDI and BAI), and quality of life was evaluated using the WHO Quality of Life (WHOQOL-BREF) questionnaire. RESULTS: Patients with CRPS showed impaired cognitive and emotional empathic abilities compared with HCs. Significantly lower levels of perspective taking and empathic concern and higher levels of personal distress on the IRI were exhibited by the patient group. Perspective taking and personal distress were associated with affective distress and poor quality of life in social contexts (BDI, BAI, and WHOQOL). However, empathic concern was positively correlated with pain severity and social support from others (WHYMPI). CONCLUSION: A tendency toward self-oriented distress in social cognition was exhibited among patients with CRPS Type I. Impaired empathic ability was shown to have potentially negative effects on subjective emotional outcomes and social performance in the lives of patients. Interventions to improve emotional awareness and theory of mind would be beneficial for enhancing social functioning in patients with CRPS Type I.
Anxiety ; Chronic Pain ; Cognition ; Depression ; Equipment and Supplies ; Humans ; Quality of Life ; Theory of Mind

To understand developmental abnormalities including pervasive developmental disorders, it is essential to understand normal developmental process of children, especially from infancy to preschool years. Infancy refers to the time before the beginning of extensive verbal communication that occurs at about 18 months. Toddlerhood, from 18 months to 3 years, encompasses the most rapid and contextually transactional period of developmental change throughout the postpartum life. Preschool years are characterized by extensive development of language, cognition, and social ability including the blooming of theory of mind. Multiple areas of development are affected in pervasive developmental disorders (PDD), and assessments of various aspects of behavior and development are essential for diagnosis. This review provides the areas of assessment of core features of PDD, including abnormalities in communication, social interaction, and repetitive and stereotyped behavior in the context of deviation from the normal behavioral development from infancy to preschool years.
Child ; Cognition ; Humans ; Interpersonal Relations ; Postpartum Period ; Stereotyped Behavior ; Theory of Mind

OBJECTIVE: This study aimed to use data mining to explore the significantly contributing variables to good social functioning in schizophrenia patients. METHODS: The study cohort comprised 67 schizophrenia patients on stable medication. A total of 51 variables (6 demographic data, 3 illness history, 22 social cognition, 16 neurocognition, 4 psychiatric symptoms) were input into a data-mining decision tree using the Answer Tree program to find the pathway for the best social functioning. RESULTS: Several contributing factors for good social functioning were found. Continuous attention was the strongest contributing factor. Three variables involving best social functioning included good continuous attention, good theory of mind (TOM), and low sensitivity of disgust emotion. CONCLUSION: Our results confirmed the mediating roles of social cognition between neurocognition and functional outcomes, and suggested that social cognition can significantly predict social functioning in schizophrenia patients.
Cognition ; Cohort Studies ; Data Mining ; Decision Trees ; Humans ; Negotiating ; Schizophrenia ; Theory of Mind