J Psychiatry Neurosci 2016;41(2):E13-E21
Paul Roux, MD, PhD; Eric Brunet-Gouet, MD, PhD; Christine Passerieux, MD, PhD; Franck Ramus, PhD
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.
Submitted Feb. 14, 2015; Revised July 6, 2015; Accepted Sept. 13, 2015; Early-released Feb. 2, 2016
Acknowledgments: This work was supported by Agence Nationale de la Recherche (ANR-09-BLAN-0327, ANR-11-IDEX-0001-02 PSL* and ANR-10-LABX-0087) and Assistance Publique Hôpitaux de Paris–Centre National de la Recherche Scientifique. We thank the psychiatrists at Versailles hospital for their help in recruiting patients. We are also grateful to the members of the Laboratoire de Sciences Cognitives et Psycholinguistique for the recruitment of control participants and for their assistance with eye-tracking data collection and processing. The authors thank the Centre Hospitalier de Versailles for editorial assistance.
Affiliations: From the Laboratoire de Sciences Cognitives et Psycholinguistique, Département d’Etudes Cognitives, Ecole Normale Supérieure, PSL Research University, Paris, France (Roux, Ramus); the Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, Le Chesnay, France (Roux, Brunet-Gouet, Passerieux); the Laboratoire HandiRESP EA4047, Université Versailles Saint Quentin en Yvelines, Versailles, France (Roux, Brunet-Gouet); and the Fondation FondaMental, Réseau des Centres Experts, Créteil, France (Roux, Brunet-Gouet, Passerieux).
Competing interests: None declared.
Contributors: All authors designed the study. P. Roux acquired and analyzed the data, which E. Brunet-Gouet and F. Ramus also analyzed. E. Brunet-Gouet and F. Ramus wrote the article, which all authors reviewed and approved for publication.
Correspondence to: P. Roux, Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; firstname.lastname@example.org