Cited by 255Schizophrenia research and treatmentMental Health and PsychiatryAutism Spectrum Disorder Research

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Is Theory of Mind in Schizophrenia More Strongly Associated with Clinical and Social Functioning than with Neurocognitive Deficits?

Roncone, Rita, Falloon, Ian R.H., Mazza, Monica, De Risio, Alessandro, Pollice, Rocco, Necozione, Stefano, Morosini, PierLuigi, Casacchia, Massimo·2002·Psychopathology

DOI 10.1159/000067062

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Abstract

This paper examines the correlations between 'Theory of Mind' (ToM) and neurocognitive performance, together with clinical and social functioning, in out-patients with schizophrenic disorders. It was hypothesised that, since the ability to make inferences about the environment and about other peoples' mental states is a key ingredient of social competence, the assessment of ToM would correlate more strongly with current social functioning than with more traditional neurocognitive measures. 'Independent raters' assessed Theory of Mind, neurocognitive and clinical variables as well as community functioning in 44 subjects with schizophrenia. The neuropsychological measures were more closely associated with community functioning than with psychiatric symptoms. These associations remained evident when the effects of intelligence were controlled. Patients with a higher level of competence in making social inferences had better overall community functioning than those who showed less ability in this aspect of social cognition. In a regression model, the capacity to comprehend other people's mental states (ToM-2) was among the best predictors of global social functioning, together with recent onset of illness, good verbal fluency and low levels of negative and positive symptoms. These results are consistent with other recent findings. ToM measures of social cognition may be a useful addition to neuropsychological assessment when developing programmes for reducing clinical impairments…

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Lysaker, P. H., Erickson, M. A., Buck, B., Buck, K. D., Olesek, K. L., Grant, M. L. A., Salvatore, G., Popolo, R., & Dimaggio, G. (2010) · Cognitive Neuropsychiatry · doi:10.1080/13546805.2010.530470 · Cited by 79
“These deficits appear to be relatively stable over time and, although correlated with severity of psychopathology, cannot be explained simply as a reflection of symptoms or other features of schizophrenia (Abdel-Hamid et al., 2009; Bora, Yücel, & Pantelis, 2009; Langdon, Coltheart, Ward, & Catts, 2001; Roncone et al.,…”
Background
Enhancing sense of recovery and self‐reflectivity in people with schizophrenia: A pilot study of Metacognitive Narrative Psychotherapy
Bargenquast, R., & Schweitzer, R. (2013) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12019 · Cited by 80
Rehabilitation of theory of mind deficit in schizophrenia: a pilot study of metacognitive strategies in group treatment
Roncone, R., Mazza, M., Frangou, I., Risio, A. D., Ussorio, D., Tozzini, C., & CASACCHIA, M. (2004) · Neuropsychological Rehabilitation · doi:10.1080/09602010343000291 · Cited by 63
“The key score was the total for the complete scale and for a five-symptom cluster (Disorganisation, Negative Affect, Positive Symptoms, Elevated Affect, Negative Symptoms) (Roncone et al., 2002).”
BackgroundSelf-citation
Multi-level comparison of empathy in schizophrenia: An fMRI study of a cartoon task
Lee, S. J., Kang, D. H., Kim, C.-W., Gu, B.-M., Park, J., Choi, C., Shin, N. Y., Lee, J., & Kwon, J. S. (2010) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2009.08.003 · Cited by 76
“Empathydeficitsmight play a role in social dysfunction in schizophrenia (Roncone et al., 2002;Mazza et al., 2003), as empathy is an essential part of social functioning that allows us to infer others' thoughts and feelings.”
Background
Transportability and Feasibility of Social Cognition and Interaction Training (SCIT) in Community Settings
Roberts, D. L., Penn, D. L., Labate, D., Margolis, S. A., & Sterne, A. (2009) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465809990464 · Cited by 78
“Some evidence suggests that social cognition may be more strongly related to social functioning than is neurocognition (Pinkham and Penn, 2006; Pollice et al., 2002; Vauth, Rusch, Wirtz and Corrigan, 2004), while other research suggests that social cognition and neurocognition exert an interactive…”
Social cognition disorders in military police officers affected by posttraumatic stress disorder after the attack of An-Nasiriyah in Iraq 2006
Mazza, M., Giusti, L., Albanese, A., Mariano, M., Pino, M. C., & Roncone, R. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2011.11.027 · Cited by 66
“There is a rich literature on social cognition that mainly focuses on schizophrenia and autism disorders (Roncone et al., 2002; Brüne, 2003; Mazza et al., 2003; Abdi and Sharma, 2004; Brüne, 2005a,b; Achim et al., 2011).”
BackgroundSelf-citation
Social performance is more closely associated with theory of mind and autobiographical memory than with psychopathological symptoms in clinically stable patients with schizophrenia-spectrum disorders
Mehl, S., Rief, W., Mink, K., Lüllmann, E., & Lincoln, T. M. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2009.10.004 · Cited by 83
Exploring Predictors of Outcome in the Psychosis Prodrome: Implications for Early Identification and Intervention
Niendam, T. A., Jalbrzikowski, M., & Bearden, C. E. (2009) · Neuropsychology Review · doi:10.1007/s11065-009-9108-z · Cited by 64
“…measures of social cognition have been shown to be better predictors of community functioning (Pijnenborg et al. 2009), more closely associated with social functioning (Roncone et al. 2002), and stronger predictors of social behavioral problems in schizophrenia patients (Brune et al. 2007).”
Background
Reframing schizophrenia and autism as bodily self-consciousness disorders leading to a deficit of theory of mind and empathy with social communication impairments
Tordjman, S., Celume, M.-P., Denis, L., Motillon, T., & Keromnes, G. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.04.007 · Cited by 81
Deficits in Emotional Awareness in Schizophrenia and Their Relationship With Other Measures of Functioning
Baslet, G. C., Termini, L., & Herbener, E. S. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181b3b20f · Cited by 65
“Most studies have supported a relationship between theory of mind abilities and social functioning in schizophrenia (Roncone et al., 2002; Mazza et al., 2003, but also see Bâ et al., 2008).”
Background
Differential impairment of social cognition factors in bipolar disorder with and without psychotic features and schizophrenia
Thaler, N. S., Allen, D. N., Sutton, G. P., Vertinski, M., & Ringdahl, E. N. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.09.010 · Cited by 67
Social judgement in clinically stable patients with schizophrenia and healthy relatives: behavioural evidence of social brain dysfunction
Baas, D., Wout‐Frank, M. V. ‘., Aleman, A., & Kahn, R. S. (2007) · Psychological Medicine · doi:10.1017/s0033291707001729 · Cited by 65
“…the functional consequences of impaired trustworthiness evaluation in itself, there is substantial supportive evidence that demonstrates a relationship between social cognition and social functioning in schizophrenia (Ihnen et al. 1998 ; Hooker & Park, 2002 ; Roncone et al. 2002 ; Brune, 2005).”
Background
Integration of emotional and cognitive aspects of theory of mind in schizophrenia and its relation to prefrontal neurocognitive performance
Shur, S., Shamay‐Tsoory, S., & Levkovitz, Y. (2008) · Cognitive Neuropsychiatry · doi:10.1080/13546800802490034 · Cited by 64
“Patients with schizophrenia often exhibit social deterioration and flattened affect, misinterpret social situations, and fail to understand social cues (Allen, Frantom, Strauss, & van Kammen, 2005; Corrigan & Nelson, 1998; Frith & Corcoran, 1996; Roncone et al., 2002; Sperber & Wilson, 2002).”
Background
Childhood adversity and social functioning in psychosis: Exploring clinical and cognitive mediators
Palmier‐Claus, J. E., Berry, K., Darrell-Berry, H., Emsley, R., Parker, S., Drake, R., & Bucci, S. (2016) · Psychiatry Research · doi:10.1016/j.psychres.2016.02.004 · Cited by 63
Sex differences in theory of mind: A male advantage on Happé's “cartoon” task
Russell, T. A., Tchanturia, K., Rahman, Q., & Schmidt, U. (2007) · Cognition & Emotion · doi:10.1080/02699930601117096 · Cited by 125
Cognitive functions related to interpersonal problem-solving skills in schizophrenic patients compared with healthy subjects
Zanello, A., Perrig, L., & Huguelet, P. (2006) · Psychiatry Research · doi:10.1016/j.psychres.2003.07.009 · Cited by 60
Does employment promote the process of recovery from schizophrenia? A review of the existing evidence
Charzyńska, K., Kucharska, K., & Mortimer, A. M. (2015) · International Journal of Occupational Medicine and Environmental Health · doi:10.13075/ijomeh.1896.00341 · Cited by 65
Assessing Perspective Taking in Schizophrenia Using Relational Frame Theory
Villatte, M., Monestès, J., McHugh, L., Baqué, E. F. I., & Loas, G. (2010) · The Psychological Record · doi:10.1007/bf03395719 · Cited by 52
“…which constitutes one of the most dramatic features of this illness (Bora, Eryavuz, Kayahan, Sungu, & Veznedaroglu, 2006; Brüne, 2005b, 2006; Roncone et al., 2002; Schenkel, Spaulding, & Silverstein, 2005). according to Hyronemus, Penn, Corrigan, and Martin (1998), inaccurate social…”
Background
Social-Cognitive Deficits in Schizophrenia
Mier, D. U., & Kirsch, P. (2015) · Current topics in behavioral neurosciences · doi:10.1007/7854_2015_427 · Cited by 67
Addressing Metacognitive Capacity in the Psychotherapy for Schizophrenia: A Case Study
Buck, K., & Lysaker, P. (2009) · Clinical Case Studies · doi:10.1177/1534650109352005 · Cited by 59
“…to hereafter as metacognitive capacity (Semerari et al., 2003), is not reducible to the result of a single symptom or neurocognitive deficit and is a central source of dysfunction (Brüne, Abdel-Hamid, Lehmkämper, & Sonntag, 2007; Langdon, Coltheart, Ward, & Catts, 2002; Roncone et al., 2002).”
Background
The relative contribution of neurocognition and social cognition to 6-month vocational outcomes following Individual Placement and Support in first-episode psychosis
Allott, K., Cotton, S., Chinnery, G. L., Baksheev, G., Massey, J., Sun, P., Collins, Z., Barlow, E., Broussard, C., Wahid, T., et al. (2013) · Schizophrenia Research · doi:10.1016/j.schres.2013.07.047 · Cited by 57
Fearful Faces in Schizophrenia
Wout‐Frank, M. V. ‘., van Dijke, A., Aleman, A., Kessels, R. P. C., Pijpers, W., & Kahn, R. S. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318142cc31 · Cited by 52
“In addition, Pollice et al. (2002) demonstrated that comprehension of other people’s mental states, recent illness onset, good verbal fluency, and low levels of schizophrenia symptomatology were among the best predictors of global social functioning.”
Background
What Is It like to Be a Person with Schizophrenia in the Social World? A First-Person Perspective Study on Schizophrenic Dissociality – Part 1: State of the Art
Stanghellini, G., & Ballerini, M. (2011) · Psychopathology · doi:10.1159/000322637 · Cited by 48
Insight and theory of mind in schizophrenia
Ng, R., Fish, S. C., & Granholm, E. L. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.11.010 · Cited by 65
“ToM task performance and cognitive and clinical insight have all been found to be associated with neurocognitive impairment (Smith et al., 2000; Roncone et al., 2002; Drake and Lewis, 2003; Rossell et al., 2003; Sergi et al., 2007; Lepage et al., 2008; Bora et al., 2009; Nair et al., 2014),…”
BackgroundInfluential
Functional Impairments and Theory of Mind Deficits in Schizophrenia: A Meta-analysis of the Associations
Thibaudeau, É., Cellard, C., Turcotte, M., & Achim, A. M. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa182 · Cited by 51
Oxytocin and social cognition in affective and psychotic disorders
Pérez-Rodríguez, M. M., Mahon, K., Russo, M., Ungar, A. K., & Burdick, K. E. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2014.07.012 · Cited by 58
“Indeed, they are a critical obstacle to recovery and function (Brune et al., 2007) (Couture et al., 2006; Harvey and Bowie, 2012; Roncone et al., 2002), may cause more disability than http://dx.doi.org/10.1016/j.euroneuro.2014.07.012 0924-977X/& 2014 Elsevier B.V. and ECNP.”
BackgroundInfluential
New evidence in theory of mind deficits in subjects with chronic schizophrenia and first episode: correlation with symptoms, neurocognition and social function.
Mazza, M., Pollice, R., Pacitti, F., Pino, M., Mariano, M., Tripaldi, S., Casacchia, M., & Roncone, R. (2012) · Rivista di psichiatria · doi:10.1708/1139.12561 · Cited by 52
“We also obtained a correlation between ToM and social function in both groups: few studies have directly investigated the relationship between ToM deficits and social functioning (49) in schizophrenia (46, 50).”
Self-citation
Irony comprehension and context processing in schizophrenia during remission – A functional MRI study
Varga, E., Simon, M., Tényi, T., Schnell, Z., Hajnal, A. S., Orsi, G., Doczi, T. P., Komoly, S., Janszky, J., Füredi, R., et al. (2013) · Brain and Language · doi:10.1016/j.bandl.2013.05.017 · Cited by 55
“…to the poor overall community functioning (Brüne, 2005; Brüne, Abdel-Hamid, Lehmkämper, & Sonntag, 2007; Lysaker et al., 2005; Pinkham & Penn, 2006; Roncone et al., 2002; Sprong, Schothorst, Vos, Hox, & van Engeland, 2007); and they are superior to neurocognition or clinical symptoms in predicting…”
Metacognitive training for young subjects ( MCT young version) in the early stages of psychosis: Is the duration of untreated psychosis a limiting factor?
Ussorio, D., Giusti, L., Wittekind, C. E., Bianchini, V., Malavolta, M., Pollice, R., Casacchia, M., & Roncone, R. (2016) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12059 · Cited by 51
Self-citation
Adaptación al español de la prueba de teoría de la mente Hinting Task
Gil, D., Fernández-Modamio, M., Bengochea, R., & Arrieta, M. (2012) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2011.11.004 · Cited by 85
Adaptation of the Hinting Task theory of the mind test to Spanish
Gil, D., Fernández-Modamio, M., Bengochea, R., & Arrieta, M. (2012) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsmen.2011.11.002 · Cited by 49
“18,19 Using a regression model, Roncone et al. 28 determined that the capacity to represent the mental states of other people was among the best predictors of good social functioning, together with recent onset of illness, good verbal ﬂuency and low levels of positive or negative symptomatology Based on these results,…”
Humour experience in schizophrenia: relationship with executive dysfunction and psychosocial impairment
Tsoi, D. T.-Y., Lee, K.-H., Gee, K., Holden, K. L., Parks, R. W., & Woodruff, P. W. R. (2008) · Psychological Medicine · doi:10.1017/s0033291707002528 · Cited by 46
“Roncone et al. (2002) have reported that social cognition, in particular the capacity to make social inferences, has a significant contribution in the global social functioning in individuals with schizophrenia.”
Background
Empathic accuracy and cognition in schizotypal personality disorder.
Ripoll, L. H., Zaki, J., Pérez-Rodríguez, M., Snyder, R., Strike, K., Boussi, A., Bartz, J. A., Ochsner, K., Siever, L., & New, A. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.05.025 · Cited by 48
Subjective and Objective Cognitive Dysfunction in Schizophrenia – is there a Link?
Homayoun, S., Nadeau-Marcotte, F., Luck, D., & Stip, É. (2011) · Frontiers in Psychology · doi:10.3389/fpsyg.2011.00148 · Cited by 54
“However, the complexity of the situation is revealed in that although better metacognition is linked with improved treatment outcomes (Roncone et al., 2002), it is also linked with more depression as mentioned above, where Sands and Harrow (1999) found that having a co-morbid diagnosis of…”
Background

Authors: Roncone, R., Falloon, I. R. H., Mazza, M., De Risio, A., Pollice, R., Necozione, S., Morosini, P., & Casacchia, M.
Affiliations: University of L'Aquila (IT)
University of Auckland (NZ)
ORCID: Roncone, Rita
Mazza, Monica
Necozione, Stefano
Casacchia, Massimo
Venue: Psychopathology
Publisher: S. Karger AG
Published: 2002
Volume: 35
Issue: 5
Pages: 280-288
ISSN: 0254-4962 (ISSN-L)
1423-033X
DOI: 10.1159/000067062
OpenAlex: W2049150789
Cited by: 255
References: 0
Citations by year: 2026: 4 · 2025: 4 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 5 · 2020: 6 · 2019: 6 · 2018: 5 · 2017: 10 · 2016: 7 · 2015: 14 · 2014: 16 · 2013: 20 · 2012: 19
FWCI: 3.84
Type: journal article
Language: en
Open access: closed
Licence: www.karger.com/Services/SiteLicenses (vor)
www.karger.com/Services/SiteLicenses (tdm)
Locations: Psychopathology (publishedVersion)
PubMed (publishedVersion)
Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords: theory of mind, schizophrenia, social cognition, social functioning, community functioning, neurocognitive impairment, social inference, negative symptoms, positive symptoms, verbal fluency, disease onset, psychosocial rehabilitation, neuropsychological assessment
MeSH terms: Adolescent, Adult, Brain, Cognition Disorders, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Brief Psychiatric Rating Scale, Psychological Theory, Schizophrenia, Severity of Illness Index, Social Behavior, Social Perception, Diagnostic and Statistical Manual of Mental Disorders

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Is Theory of Mind in Schizophrenia More Strongly Associated with Clinical and Social Functioning than with Neurocognitive Deficits?

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