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Theory of mind and neurocognition in early psychosis: a quasi-experimental study.

Langdon R, Connors MH, Still M, Ward PB, Catts S - BMC Psychiatry (2014)

Bottom Line: In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms.Patients' deficits in theory of mind were evident even after adjusting for their deficits in neurocognition.Severity of negative symptoms, however, was a significant predictor of both outcomes.

View Article: PubMed Central - PubMed

Affiliation: ARC Centre of Excellence in Cognition and its Disorders, and Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia. robyn.langdon@mq.edu.au.

ABSTRACT

Background: People with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits. In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms. In young people with recent-onset psychosis, however, it is unclear the extent to which theory of mind impairment is independent of neurocognitive deficits. The primary aim of this study was to examine the evidence for specific theory of mind impairments in early psychosis. A secondary aim was to explore the relations between theory of mind, neurocognition, symptom severity, and functional outcomes.

Methods: Twenty-three patients who were within two years of their first psychotic episode and 19 healthy controls completed theory of mind and neurocognitive batteries. Social functioning, quality of life, and symptom severity were also assessed in patients.

Results: Patients demonstrated deficits in tasks assessing theory of mind and neurocognition relative to controls. Patients' deficits in theory of mind were evident even after adjusting for their deficits in neurocognition. Neither theory of mind nor neurocognition predicted social functioning or quality of life in this early psychosis sample. Severity of negative symptoms, however, was a significant predictor of both outcomes.

Conclusions: While a specific theory of mind impairment was evident in this early psychosis sample, severity of negative symptoms emerged as the best predictor of poor functional outcome. Further early psychosis research is needed to examine the longitudinal progression of theory of mind impairments - independent of neurocognitive deficits - and their impact on psychosocial function.

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Patients’ deficits in ToM and different neurocognitive domains relative to controls.
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Fig1: Patients’ deficits in ToM and different neurocognitive domains relative to controls.

Mentions: Patients performed worse than controls in ToM tasks and in all measures of neurocognition. These differences, however, did not reach statistical significance for set shifting and planning (see Table 2). Effect sizes are shown in Figure 1. Patients showed particularly large impairments in ToM, verbal memory, and semantic fluency relative to controls. To determine whether ToM deficits were evident when neurocognitive performance was accounted for, we compared patients and controls’ composite ToM scores using an ANCOVA with the composite score of neurocognition as a covariate. Patients still displayed a significant deficit in ToM compared to controls, F(1, 38) = 5.60, p = .02, ηp2 = .13. There was also a significant effect of neurocognition on ToM independent of group, F(1, 38) = 25.81, p < .01, ηp2 = .41. Levene’s test indicated that the assumption of equality of error variances was met for this analysis, F(1, 39) = 3.83, p = .06. Patients and controls did not differ on any of the control conditions in the ToM tasks (all ps > .05).Table 2


Theory of mind and neurocognition in early psychosis: a quasi-experimental study.

Langdon R, Connors MH, Still M, Ward PB, Catts S - BMC Psychiatry (2014)

Patients’ deficits in ToM and different neurocognitive domains relative to controls.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4263012&req=5

Fig1: Patients’ deficits in ToM and different neurocognitive domains relative to controls.
Mentions: Patients performed worse than controls in ToM tasks and in all measures of neurocognition. These differences, however, did not reach statistical significance for set shifting and planning (see Table 2). Effect sizes are shown in Figure 1. Patients showed particularly large impairments in ToM, verbal memory, and semantic fluency relative to controls. To determine whether ToM deficits were evident when neurocognitive performance was accounted for, we compared patients and controls’ composite ToM scores using an ANCOVA with the composite score of neurocognition as a covariate. Patients still displayed a significant deficit in ToM compared to controls, F(1, 38) = 5.60, p = .02, ηp2 = .13. There was also a significant effect of neurocognition on ToM independent of group, F(1, 38) = 25.81, p < .01, ηp2 = .41. Levene’s test indicated that the assumption of equality of error variances was met for this analysis, F(1, 39) = 3.83, p = .06. Patients and controls did not differ on any of the control conditions in the ToM tasks (all ps > .05).Table 2

Bottom Line: In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms.Patients' deficits in theory of mind were evident even after adjusting for their deficits in neurocognition.Severity of negative symptoms, however, was a significant predictor of both outcomes.

View Article: PubMed Central - PubMed

Affiliation: ARC Centre of Excellence in Cognition and its Disorders, and Department of Cognitive Science, Macquarie University, Sydney, NSW, Australia. robyn.langdon@mq.edu.au.

ABSTRACT

Background: People with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits. In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms. In young people with recent-onset psychosis, however, it is unclear the extent to which theory of mind impairment is independent of neurocognitive deficits. The primary aim of this study was to examine the evidence for specific theory of mind impairments in early psychosis. A secondary aim was to explore the relations between theory of mind, neurocognition, symptom severity, and functional outcomes.

Methods: Twenty-three patients who were within two years of their first psychotic episode and 19 healthy controls completed theory of mind and neurocognitive batteries. Social functioning, quality of life, and symptom severity were also assessed in patients.

Results: Patients demonstrated deficits in tasks assessing theory of mind and neurocognition relative to controls. Patients' deficits in theory of mind were evident even after adjusting for their deficits in neurocognition. Neither theory of mind nor neurocognition predicted social functioning or quality of life in this early psychosis sample. Severity of negative symptoms, however, was a significant predictor of both outcomes.

Conclusions: While a specific theory of mind impairment was evident in this early psychosis sample, severity of negative symptoms emerged as the best predictor of poor functional outcome. Further early psychosis research is needed to examine the longitudinal progression of theory of mind impairments - independent of neurocognitive deficits - and their impact on psychosocial function.

Show MeSH
Related in: MedlinePlus