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Hyper- and hypo-mentalizing in patients with first-episode schizophrenia: fMRI and behavioural studies

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posted on 2023-06-09, 12:10 authored by Vibeke Bliksted, Chris Frith, Poul Videbech, Birgitte Fagerlund, Charlotte Emborg, Arndis Simonsen, Andreas Roepstorff, Dan Campbell-MeiklejohnDan Campbell-Meiklejohn
Background: Historically, research investigating neural correlates of mentalizing deficits in schizophrenia has focused on patients who have been ill for several years with lengthy exposure to medication. Little is known about the neural and behavioural presentations of theory-of-mind deficits in schizophrenia, shortly after the first episode of psychosis. Methods: We investigated social cognition in seventeen recently diagnosed first-episode schizophrenia (FES) patients with little or no exposure to antipsychotic medication and 1:1 matched healthy controls. We recorded behavioural and neural responses to the Animated Triangles Task (ATT), which is a non-verbal validated mentalizing task that measures the ascription of intentionality to the movements of objects. Results: FES patients under-interpreted social cues and over-interpreted non-social cues. These effects were influenced by current intelligence (IQ). Control group and FES neural responses replicated earlier findings in healthy adults. However, a region of anterior medial prefrontal cortex (amPFC) of FES patients showed a different response pattern to that of controls. Unlike healthy controls, patients increased activity in this social cognition region while studying ‘random’ movements of shapes, as compared to the study of movements normally interpreted as ‘intentional’. Conclusions: Mentalizing deficits in FES consists of hypo- and hyper-mentalizing. The neural pattern of FES patients is consistent with deficits in the ability to switch off mentalizing processes in potentially social contexts, instead increasing them when intentionality is not forthcoming. Overall, results demonstrate complexities of theory of mind deficits in schizophrenia that should be considered when offering social cognitive training programs.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Schizophrenia Bulletin

ISSN

0586-7614

Publisher

Oxford University Press

Volume

sby027

Department affiliated with

  • Psychology Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2018-02-15

First Open Access (FOA) Date

2019-03-09

First Compliant Deposit (FCD) Date

2018-02-15

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