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Cited by 86Schizophrenia research and treatmentMental Health and PsychiatryChild and Animal Learning Development

Theory of Mind (ToM) and counterfactuality deficits in schizophrenia: misperception or misinterpretation?

LEITMAN, DAVID I., ZIWICH, RACHEL, PASTERNAK, ROEY, JAVITT, DANIEL C.·2006·Psychological Medicine
DOI 10.1017/s0033291706007653
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Abstract

Background. Theory of Mind (ToM) refers to the ability to infer another person's mental state based upon interactional information. ToM deficits have been suggested to underlie crucial aspects of social interaction failure in disorders such as autism and schizophrenia, although the development of paradigms for demonstrating such deficits remains an ongoing area of research. Recent studies have explored the use of sarcasm perception, in which subjects must infer an individual's sincerity or lack thereof, as a ‘real-life’ index of ToM ability, and as an index of functioning of specific right hemispheric structures. Sarcastic detection ability has not previously been studied in schizophrenia, although patients have been shown to have deficits in ability to decode emotional information from speech (‘affective prosody’). Method. Twenty-two schizophrenia patients and 17 control subjects were tested on their ability to detect sarcasm from spoken speech as well as measures of affective prosody and basic pitch perception. Results. Despite normal overall intelligence, patients performed substantially worse than controls in ability to detect sarcasm (d=2·2), showing both decreased sensitivity (A′) in detection of sincerity versus sarcasm and an increased bias (B″) toward sincerity. Correlations across groups revealed significant relationships between impairments in sarcasm recognition, affective prosody and basic pitch perception. Conclusions. These findings demonstrate substantial deficits in ability to infer an internal subjective state based upon vocal modulation among subjects with schizophrenia. Deficits were related to, but were significantly more severe than, more general forms of prosodic and sensorial misperception, and are consistent with both right hemispheric and ‘bottom-up’ theories of the disorder.

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  • Deficits in tone matching contribute significantly to communications such as sarcasm that require patients to appreciate what another person may be thinking (theory of mind).

    “as well as to communications such as sarcasm that require patients to appreciate what another person may be thinking (76, 77), a trait called “theory of mind”, a form of empathy.”

    From Sensory Processing Dysfunction in the Personal Experience and Neuronal Machinery of Schizophrenia (2015) · cites this paper as [76]

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Authors
LEITMAN, D. I., ZIWICH, R., PASTERNAK, R., & JAVITT, D. C.
Affiliations
Nathan Kline Institute for Psychiatric Research (US)
ORCID
JAVITT, DANIEL C.
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
2006-05-15
Volume
36
Issue
8
Pages
1075-1083
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291706007653
OpenAlex
W2042585712
Cited by
86
References
44
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 4 · 2019: 4 · 2018: 6 · 2017: 1 · 2016: 3 · 2015: 3 · 2014: 7 · 2013: 12 · 2012: 5
FWCI
3.19
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (F1-MH-067339, K02-MH-01439, R01 MH49334, F31MH067339, R01MH049334, K02MH001439)
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, schizophrenia, sarcasm detection, counterfactual reasoning, emotional prosody, pitch perception, right hemisphere, social cognition, misunderstanding, misinterpretation, sincerity
MeSH terms
Adult, Affect, Aptitude, Discrimination Learning, Female, Humans, Male, Middle Aged, Music, Perceptual Distortion, Pitch Perception, Psychiatric Status Rating Scales, Psychotic Disorders, Schizophrenia, Schizophrenic Psychology, Semantics, Social Perception, Speech Acoustics, Speech Perception, Statistics as Topic, Truth Disclosure, Personal Construct Theory

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