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Introduction: Deficits in theory of mind (ToM) can vary depending on the predominant schizophrenia symptoms, and though most neurocognitive functions are involved in ToM, all may not be associated with the same symptoms. With consideration to the relationships between symptoms, neurocognition and ToM, the aim of the present study is to identify the neurocognitive functions influencing ToM capacities according to symptomatic profile., Methods: The study is based on a sample of 124 adults with schizophrenia from a French national cohort. Patients were divided into two groups according to their scores on the five Wallwork factors of the Positive and Negative Syndrome Scale using hierarchical clustering before carrying out multivariable analyses., Results: The "disorganised group" ( n  = 89) showed high scores on the disorganised factor, and had a ToM associated with reasoning , visual recognition and speed of processing . The "positive group" ( n  = 35) showed high scores on the positive and depressive factors, and had a ToM associated with working memory ., Conclusions: These results suggest that neurocognitive predictors of ToM in schizophrenia are different according to the predominant clinical dimension, thus refining our knowledge of the relationship between symptoms, neurocognition and ToM, and acknowledging their status as important predictors of patients' functional status.

It is now largely accepted that patients with schizophrenia have a deficit to attribute mental states to others, such as intentions, needs and motivations but also to perform memory tasks. According to one hypothesis, these impairments may be due to an early visual attention deficit during the encounter of social stimuli. Another hypothesis posits a robust correlation between intention attribution and autobiographical memory that results in impaired recollection of past events making it difficult to infer others' intentions. In sum, the link between intention attribution and encoding process is yet to be explored in patients with schizophrenia. The objective of the present study is to contribute to this debate by investigating whether schizophrenic patients' recollection can be boosted by an attentional cueing on relevant information and to determine the influence of two different situational contexts: attribution of intentions or physical causality scripts. By using a supraliminal attentional cue, we made relevant areas of our material more salient across two conditions: attribution of intentions (AI) and physical causality with human characters (PCCH). The results confirmed expected deficit of explicit memory in schizophrenia patients while attentional cueing on relevant areas for intentions attribution or physical causality had no effect on recollection in any group. However, it seems that the recollection performances are highly influenced by the nature of intentions attribution. Also, it is the first time that the material used for the assessment of theory of mind performances has been tested with a recognition test., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The debilitating effects of social dysfunction in many psychiatric disorders prompt the need for systems-level biomarkers of social abilities that can be applied in clinical populations and longitudinal studies. A promising neuroimaging approach is the animated shapes paradigm based on so-called Frith-Happé animations (FHAs) which trigger spontaneous mentalizing with minimal cognitive demands. Here, we presented FHAs during functional magnetic resonance imaging to 46 subjects and examined the specificity and sensitivity of the elicited social brain responses. Test-retest reliability was additionally assessed in 28 subjects within a two-week interval. Specific responses to spontaneous mentalizing were observed in key areas of the social brain with high sensitivity and independently from the variant low-level kinematics of the FHAs. Mentalizing-specific responses were well replicable on the group level, suggesting good-to-excellent cross-sectional reliability [intraclass correlation coefficients (ICCs): 0.40-0.99; dice overlap at P uncorr <0.001: 0.26-1.0]. Longitudinal reliability on the single-subject level was more heterogeneous (ICCs of 0.40-0.79; dice overlap at P uncorr <0.001: 0.05-0.43). Posterior temporal sulcus activation was most reliable, including a robust differentiation between subjects across sessions (72% of voxels with ICC>0.40). These findings encourage the use of FHAs in neuroimaging research across developmental stages and psychiatric conditions, including the identification of biomarkers and pharmacological interventions., (© The Author (2016). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.)

Schizophrenia has been characterized by an impaired mentalizing. It has been suggested that distinguishing implicit from explicit processes is crucial in social cognition, and only the latter might be affected in schizophrenia. Two other questions remain open: (1) Is schizophrenia characterized by an hypo- or hyper attribution of intentions? (2) Is it characterized by a deficit in the attribution of intention or of contingency? To test these three questions, spontaneous mentalizing was tested in 29 individuals with schizophrenia and 29 control subjects using the Frith-Happé animations, while eye movements were recorded. Explicit mentalizing was measured from participants' verbal descriptions and was contrasted with implicit mentalizing measured through eye tracking. As a group, patients made less accurate and less intentional descriptions of the goal-directed and theory of mind animations. No group differences were found in the attribution of contingency. Eye tracking results revealed that patients and controls showed a similar modulation of eye movements in response to the mental states displayed in the Frith-Happé animations. To conclude, in this paradigm, participants with schizophrenia showed a dissociation between explicit and implicit mentalizing, with a decrease in the explicit attribution of intentions, whereas their eye movements suggested a preserved implicit perception of intentions.

Background: Schizophrenia is associated with poor theory of mind (ToM), particularly in the attribution of intentions to others. It is also associated with abnormal gaze behaviours and contextual processing. This study investigated to what extent impaired ToM in patients with schizophrenia is related to abnormal processing of social context., Methods: We evaluated ToM using a nonverbal intention attribution task based on comic strips depicting social/nonsocial and contextual/noncontextual events while eye movements were recorded. Eye-tracking was used to assess processing time dedicated to visual cues contained in regions of interest identified in a pilot study. We measured cognitive contextual control on a separate task., Results: We tested 29 patients with schizophrenia and 29 controls. Compared with controls, patients were slower in intention attribution but not in physical reasoning. They looked longer than controls at contextual cues displayed in the first 2 context pictures of the comic strips, and this difference was greater for intention attribution than for physical reasoning. We found no group difference in time spent looking at noncontextual cues. Patients' impairment in contextual control did not explain their increased reaction time and gaze duration on contextual cues during intention attribution., Limitations: Difficulty may not have been equivalent between intention attribution and physical reasoning conditions., Conclusion: Overall, schizophrenia was characterized by a delay in intention attribution related to a slowdown of social context processing that was not explained by worse executive contextual control.

Schizophrenia is associated with poor Theory of Mind (ToM), particularly in goal and belief attribution to others. It is also associated with abnormal gaze behaviors toward others: individuals with schizophrenia usually look less to others' face and gaze, which are crucial epistemic cues that contribute to correct mental states inferences. This study tests the hypothesis that impaired ToM in schizophrenia might be related to a deficit in visual attention toward gaze orientation. We adapted a previous non-verbal ToM paradigm consisting of animated cartoons allowing the assessment of goal and belief attribution. In the true and false belief conditions, an object was displaced while an agent was either looking at it or away, respectively. Eye movements were recorded to quantify visual attention to gaze orientation (proportion of time participants spent looking at the head of the agent while the target object changed locations). 29 patients with schizophrenia and 29 matched controls were tested. Compared to controls, patients looked significantly less at the agent's head and had lower performance in belief and goal attribution. Performance in belief and goal attribution significantly increased with the head looking percentage. When the head looking percentage was entered as a covariate, the group effect on belief and goal attribution performance was not significant anymore. Patients' deficit on this visual ToM paradigm is thus entirely explained by a decreased visual attention toward gaze., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Eye movements have been recently recorded in participants watching animated triangles in short movies that normally evoke mentalizing (Frith-Happé animations). Authors have found systematic differences in oculomotor behaviour according to the degree of mental state attribution to these triangles: Participants made longer fixations and looked longer at intentional triangles than at triangles moving randomly. However, no study has yet explored kinematic characteristics of Frith-Happé animations and their influence on eye movements. In a first experiment, we have run a quantitative kinematic analysis of Frith-Happé animations and found that the time triangles spent moving and the distance between them decreased with the mentalistic complexity of their movements. In a second experiment, we have recorded eye movements in 17 participants watching Frith-Happé animations and found that some differences in fixation durations and in the proportion of gaze allocated to triangles between the different kinds of animations were entirely explained by low-level kinematic confounds. We finally present a new eye-tracking measure of visual attention, triangle pursuit duration, which does differentiate the different types of animations even after taking into account kinematic cofounds. However, some idiosyncratic kinematic properties of the Frith-Happé animations prevent an entirely satisfactory interpretation of these results. The different eye-tracking measures are interpreted as implicit and line measures of the processing of animate movements.

Purpose: We have developed a new scale that assesses disability caused by cognitive impairments in schizophrenia, in order to evaluate the functional impact of schizophrenia and help the prescription of rehabilitation interventions. The aim of the study was to assess its psychometrical properties. Materials and methods: Mental healthcare professionals and relatives of individuals with schizophrenia developed and rated the evaluation of cognitive processes involved in disability in schizophrenia scale, which included 13 items. Its construct validity was assessed through a factorial analysis; its concurrent validity was evaluated based on ecological outcomes, its convergent validity was tested against the World Health Organization Disability Assessment Schedule (WHODAS II), and its reliability was estimated based on internal consistency and inter-rater reliability. Results: Overall, 215 patients were included. Our findings supported a two-factor structure which accounted for 46% of the variance. The internal consistency and inter-rater reliability were good. The convergent validity showed a strong correlation with the WHODAS II. The concurrent validity showed strong relationships with work status, independent living, level and adequacy of institutional care. Conclusions: The good psychometric properties of the scale suggest a role for this tool in assessing schizophrenia-related disability and evaluating the need for cognitive remediation. Implication for Rehabilitation: Schizophrenia is a chronic disorder leading to a severe psychiatric handicap. The scale showed good psychometric properties in individuals with schizophrenia and severe psychiatric disability. The scale is easy and quick to administer (about 15 min). The scale may help to identify targets for rehabilitation interventions in individuals with schizophrenia. [ABSTRACT FROM AUTHOR]

Le but de cette communication était de résumer l'état des connaissances sur les liens entre fonctionnement psychosocial et cognition sociale dans la schizophrénie. La cognition sociale, et en particulier la Théorie de l'Esprit, est perturbée dans la schizophrénie. La littérature retrouve une plus forte association entre fonctionnement psychosocial et les performances en Théorie de l'Esprit qu'entre fonctionnement et mesures de la cognition dite froide (définie comme l'ensemble des processus de traitement de l'information de nature non sociale, par opposition à la cognition sociale). Cette influence serait médiée par les compétences sociales. Des études longitudinales ont montré que, dans ces associations, la direction de causalité était unique et partait des troubles de la cognition froide vers les troubles de la cognition sociale, ces derniers entraînant les déficits fonctionnels. Dans une étude utilisant des modèles d'équations structurales, les niveaux de symptômes positifs, de désorganisation et de symptômes négatifs étaient tous les trois fortement liés à une altération du fonctionnement. L'effet de la désorganisation et les symptômes négatifs sur le fonctionnement étaient en partie médiés par la cognition sociale, contrairement aux symptômes positifs. Cette revue de littérature suggère que l'amélioration de la cognition sociale pourrait permettre d'améliorer le fonctionnement psychosocial dans la schizophrénie. This literature review aimed to summarize the scientific knowledge concerning the links between psychosocial functioning and social cognition. Social cognition, and particularly Theory of Mind, is strongly disturbed in patients with schizophrenia. There were strong arguments that psychosocial functioning was more strongly associated with Theory of Mind than with neurocognition (defined as nonsocial information processing in contrast to social cognition). The functional capacity mediated this influence. Moreover, longitudinal studies suggested a unidirectional causal pathway with primary neurocognitive disorders leading to secondary deficits in social cognition, which in turn led to disturbances in psychosocial functioning. Studies using structural equation modelling showed that positive, negative and disorganization symptoms were associated with disturbances in psychosocial functioning. Regarding negative symptoms and disorganization, the influences were mediated by social cognition. The influence of positive symptoms on psychosocial functioning was independent of social cognition. This literature review suggests that social cognitive remediation in patients with should improve the psychosocial functioning in patients with schizophrenia. [ABSTRACT FROM AUTHOR]

Individuals with schizophrenia are impaired in their neurocognition and present cognitive biases. These impairments may lead to a deficit in recognizing helping intentions of others. To investigate recognition of help, we designed a card-guessing game (Virtual Help Recognition Paradigm) involving two successive virtual agents asking questions to the participant at different moments of the game. These questions were either empathetic (i.e. on the subject's feelings) or non-empathetic (i.e. on technical aspects of the game). We assessed how much the participant felt that the virtual agent had helped him and, her attitude and personality traits. We measured how much the participant trusted the virtual agent with a monetary allocation procedure. Twenty individuals with schizophrenia and twenty healthy controls were recruited. The controls’ ratings demonstrated that they interpreted empathetic questioning as helping and rewarded it positively with an increased monetary allocation. Participants with schizophrenia had a reduced perception of the differences between the two agents. Only the rating concerning the “interest/attention” of the agent toward these participants yielded significant differences among conditions. Hypothetically, individuals with schizophrenia take into account the fact they are the object of another's attention, but may fail to infer a helping intention and to behave accordingly. [ABSTRACT FROM AUTHOR]