Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia
Abstract
Research on the relationship between insight and social cognition, in particular Theory of Mind (ToM), in schizophrenia has yielded mixed findings to date. Very few studies, however, have assessed both clinical insight and cognitive insight when examining their relationships with ToM in schizophrenia. The current study thus investigated the relationship between clinical insight, cognitive insight, and ToM in a sample of 56 patients with schizophrenia and 30 healthy controls. Twenty-seven patients were classified as low in clinical insight according to their scores on the 'insight' item (G12) of the Positive and Negative Syndrome Scale (PANSS). Moreover, cognitive insight and ToM were assessed with the Beck Cognitive Insight Scale (BCIS) and the Yoni task, respectively. The results indicated that patients with poor clinical insight performed worse on tasks of second-order cognitive and affective ToM, while the ToM performance of patients with high clinical insight was equivalent to that of healthy controls. Furthermore, while clinical insight was correlated with ToM and clinical symptoms, cognitive insight did not correlate with clinical insight, ToM, or clinical symptoms. Clinical insight thus appears to be an important factor related to ToM in schizophrenia.
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Some studies have not found an association among cognitive insight and symptoms.
“Other studies, however, have not found an association among cognitive insight and symptoms 64 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [64]
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“…general, ToM impairments in patients suffering from schizophrenia have been associated with slower reaction times [28] and a decelerated cognitive processing speed as compared to healthy controls [19], whereas others assume no correlation of non-ToM cognitive capabilities and ToM functions [29–31].”
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“The inclusion criteria were (1) International Classification of Diseases, 10th Revision (ICD-10) diagnosis of schizophrenia; (2) clinical stability and absence of aggressive or hostile behavior; (3) age 18 years or older; (4) ability to understand the survey instructions and willingness to provide written informed con…”
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“…school education or higher; (iii) There was partial insight, and the G12 score of positive and negative symptom scale (PANSS) was < 4 points (Zhang et al., 2016); (iv) Patients who have cognitive and understanding ability, can communicate effectively with researchers and can complete the…”
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“Among these, theory of mind (Bora et al., 2007; Zhang et al., 2016), emotion perception (Pijnenborg et al., 2013; Vaskinn et al., 2013), and attributional style (Langdon et al., 2006) have shown low to moderate associations with clinical insight.”
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“Patients with schizophrenia have been documented the impairments of perceiving social cues since the prodromal phase of illness, and these social impairments have been found associated with severity of disease, compliance, clinical insight, insufficient functioning and outcome of treatment [12,13].”
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“…primary school education or higher; (iii) There was partial insight, and the G12 score of positive and negative symptom scale (PANSS) was < 4 points (Zhang et al., 2016); (iv) Patients who have cognitive and understanding ability, can communicate effectively with researchers and can complete the…”
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“For instance, previous studies reported a moderate correlation of theory-of-mind with clinical insight (Beland and Lepage, 2017; Bora, 2017; Gan et al., 2022; Subotnik et al., 2020) but not cognitive insight (Zhang et al., 2016) in schizophrenia patients.”
Self-citationBesche‐Richard, C., Terrien, S., Rinaldi, R., Verhaegen, F., Lefèbvre, L., & Musiol, M. (2018) · Dunod eBooks · doi:10.3917/dunod.besce.2018.01.0153 · Cited by 2 · see citing works
Ceballos, L. A. S., Euse, J. A. R., & Jiménez, D. E. O. (2023) · Interdisciplinaria Revista de Psicología y Ciencias Afines · doi:10.16888/interd.2023.40.3.1 · Cited by 2 · see citing works
Levels and Correlates of Disability in Life Skills among Patients with Schizophrenia
Hamaideh, S. H., Hamdan‐Mansour, A. M., & ALhamdan, A. (2020) · Current Psychiatry Research and Reviews · doi:10.2174/2666082216999200905133918 · Cited by 2 · see citing works
Schizophrenia patients with poor clinical insight report less subjective memory problems
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Self-citationTheory of Mind bei Patienten mit Borderline-Persönlichkeitsstörung
Sprung, M. S. (2019) · Psychosomatik im Zentrum · doi:10.1007/978-3-662-58639-6_4 · Cited by 1 · see citing works
The Characteristic and Brain Mechanism of Theory of Mind in Schizophrenia
滕, 佳. (2016) · Advances in Psychology · doi:10.12677/ap.2016.610136
The complex interplay between schizotypy and emotional, cognitive and psychological factors
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EM-Theory as a minimalist program for global cognition: autism as case-study
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- Authors
- Zhang, Q., Li, X., Parker, G. J., Hong, X.-H., Wang, Y., Lui, S. S. Y., Neumann, D. L., Cheung, E. F. C., Shum, D. H. K., & Chan, R. C. K.
- Affiliations
- Chinese Academy of Sciences (CN)
- Griffith University (AU)
- Castle Peak Hospital (CN)
- Corresponding author
- Chan, Raymond C.K.
- ORCID
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2016-03
- Volume
- 237
- Pages
- 188-195
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2284675663
- Cited by
- 40
- References
- 56
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 5 · 2020: 8 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 1
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repository of Institute of Psychology, Chinese Academy of Sciences (Institute of Psychology, Chinese Academy of Sciences) (submittedVersion)
- Griffith Research Online (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
- Keywords
- theory of mind, clinical insight, cognitive insight, schizophrenia, social cognition, second-order theory of mind, affective theory of mind, Beck Cognitive Insight Scale, PANSS
- MeSH terms
- Metacognition, Adult, Awareness, Female, Humans, Male, Schizophrenia, Young Adult, Theory of Mind
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