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Theory of mind in a sample of men with schizophrenia detained in a special hospital: its relationship to symptom profiles and neuropsychological tests
Author(s) -
Murphy David
Publication year - 1998
Publication title -
criminal behaviour and mental health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 54
eISSN - 1471-2857
pISSN - 0957-9664
DOI - 10.1002/cbm.281
Subject(s) - neuropsychology , schizophrenia (object oriented programming) , psychology , psychiatry , clinical psychology , sample (material) , neuropsychological testing , cognition , chemistry , chromatography
Background The understanding that others can have beliefs or mental states different from our own is described as possessing a ‘Theory of Mind’ (ToM). ToM deficits may explain some symptoms of schizophrenia. As ToM is thought to be closely related to the ability to empathize and feel guilt, its examination may be particularly important in patients with schizophrenia who also commit offences. A relationship between ToM and other cognitive abilities remains to be established. Methods Thirty‐seven men with schizophrenia and 23 with personality disorder but no evidence of psychosis, all resident in Broadmoor Hospital, completed a set of ToM tasks and a range of neuropsychological tests. They were also rated on a symptom checklist. Results No significant differences were found between schizophrenia and personality disorder groups in their understanding that another person may have a false belief about the state of the world (first‐order representation), but the schizophrenia sample were significantly more impaired in their understanding that another may have a false belief about the mental state of another individual (second‐order representation) than the PD group. Within the schizophrenia group, patients with predominantly ‘behavioural signs’ symptoms performed significantly worse than the groups presenting most prominently with paranoid delusions or with passivity phenomena. Second‐order representation deficits were associated with significantly lower general intellectual functioning, delayed recall of prose and designs, and impaired ability to shift thinking from one concept to another. Conclusions The findings suggest that a sample of people with schizophrenia who have offended may have ToM deficits more specific to the mentalization of others' mental states than the deficits among non‐offenders with schizophrenia, but further study with direct comparisons between such samples is needed. Although it seems unlikely that offending per se is mediated by ToM deficits, within the context of schizophrenia, ToM assessment could further understanding of offending behaviour and improve risk assessments. Copyright © 1998 Whurr Publishers Ltd.