Recognition and repair of communicative failures: the interaction between Theory of Mind and cognitive complexity in schizophrenic patients.

UNLABELLED: The aim of the present research is to perform a detailed and empirical investigation of schizophrenia patients' deficits in recognizing and recovering a communicative failure. In particular, this paper investigates the role of Theory of Mind (ToM) and of the complexity of the mental representations involved in explaining patients' deficits in recognizing and recovering different kinds of communicative failures, i.e. failure of the expressive act, failure of communicative meaning and failure of the communicative effect. Twenty-two patients with schizophrenia and an equal number of healthy controls took part in the experiment. The experimental protocol consisted of videotaped stories in which two agents interact, showing a communicative failure; the participants were asked to recognize and repair the observed failure. Some classical ToM tests (Sally and Ann, Modified Smarties and a selection of six Strange Stories) were also administered. Our results revealed a deficit in patients, when compared with healthy controls, in recognizing and recovering communicative failures. Furthermore, focusing on schizophrenia patients' performance per se, we observed a trend with regard to the increasing difficulty of understanding and recognizing different kinds of communicative failures, i.e. failure of expression act, failure of communicative meaning, and failure of the communicative effect. LEARNING OUTCOMES: The reader becomes aware that schizophrenic patients perform less well than healthy controls in recognizing and recovering different kinds of communicative failures, and of the role played by Theory of Mind, and representational complexity involved in such different kinds of failures, in explaining patients' performance.

Th.o.m.a.s.: an exploratory assessment of Theory of Mind in schizophrenic subjects.

A large body of literature agrees that persons with schizophrenia suffer from a Theory of Mind (ToM) deficit. However, most empirical studies have focused on third-person, egocentric ToM, underestimating other facets of this complex cognitive skill. Aim of this research is to examine the ToM of schizophrenic persons considering its various aspects (first- vs. second-order, first- vs. third-person, egocentric vs. allocentric, beliefs vs. desires vs. positive emotions vs. negative emotions and how each of these mental state types may be dealt with), to determine whether some components are more impaired than others. We developed a Theory of Mind Assessment Scale (Th.o.m.a.s.) and administered it to 22 persons with a DSM-IV diagnosis of schizophrenia and a matching control group. Th.o.m.a.s. is a semi-structured interview which allows a multi-component measurement of ToM. Both groups were also administered a few existing ToM tasks and the schizophrenic subjects were administered the Positive and Negative Symptoms Scale and the WAIS-R. The schizophrenic persons performed worse than control at all the ToM measurements; however, these deficits appeared to be differently distributed among different components of ToM. Our conclusion is that ToM deficits are not unitary in schizophrenia, which also testifies to the importance of a complete and articulated investigation of ToM.