Theory of mind deficit is a potential trait marker of schizophrenia

Study analyzes patients and unaffected siblings

Yet more evidence that sz is not entirely genetic and is the upshot of environmental as well as genetic factors?

AUGUST 6, 2015

Theory of mind (ToM) deficit is a potential trait marker of schizophrenia, based on an assessment of patients with the disorder and their unaffected siblings.

A family-based control design study of 41 patients with first-episode schizophrenia, 43 unaffected siblings, and 42 healthy controls revealed that patients and unaffected siblings both exhibit ToM impairment vs the control group. However, there was no dissociation between affective and cognitive component.

The siblings performed better than patients but worse than controls on the Faux Pas Task. Meanwhile, patients performed worse than controls on the Yoni Task, whereas their siblings did not.

ToM impairment had previously been consistently demonstrated in individuals with schizophrenia, but the its presence in unaffected siblings was poorly studied. These results support the notion of using ToM as a trait marker of schizophrenia.

Ho K, Hung K, Wang Y, et al. Theory of mind impairments in patients with first-episode schizophrenia and their unaffected siblings. Schizophr Res. 2015; 166:1-8.

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Some info on Theory of Mind for those who may not be familiar:



Yes; thank you.

I often wonder about TOM and how it applies to me(if it does). I know that if I think X another person may think Y but I find it difficult to get my head around why they do. Often in my mind there is a proper POV and a wrong POV and no room for ambiguity in between .I once posted on autism newsgroup without posting an introduction and was quite upset when people didn’t automatically get in tune with what I was saying.
Nowadays If I join a forum I try and introduce myself.

Dunno if I’m out to lunch here but isn’t any group under 50 considered so small as to not really be all that relevant? Especially when ToM isn’t really something one can directly measure anyhow? Seems to me like one of those very small studies that indicate a larger study may be warranted?


I’m like 99.8% sure that my partner’s diagnosis of Schizophrenia is accurate and I wouldn’t say that he has any ToM issues… :confused:

It is true that larger sample sizes are more likely to give accurate/meaningful results. However even meta analysis can have problems re studies excluded or included.

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How does your partner interpret what others think, say and do?

As far as I am able to tell from discussion, he interprets them accurately unless in a state of psychosis. But while not in any sort of episode Therory of mind is not even questionable.
I can only assume the individuals with schizophrenia who participated in this study were not all wildly episodic at the time of interview…So I am comparing with that in mind,

I agree. BUT… I can also see with my own eyes and hear with my own ears how sz pts tend to interpret the mental processing of others. And it is far more often inaccurate (and paranoia-bound) that is the case in the average schmuck.

I’ll have to take your word for it. The closest I come to working with the mentally ill is shuttling around the odd school bus full of the hormone imbalanced (a.k.a. ‘teenagers’). Accusing them of mental processing may also be giving them too much credit on some days. Oy to the vey.


Why? Why not have a look and a listen for yourself? (You can do it everyday right here on this forum.)

Does, however, that really have anything to do with what can easily see and hear when engaging with sz pts? I didn’t need a “rigorously controlled study” make it evident to me that the vast majority of sz pts are paranoid, and that they mis-interpret the intentions of others left and right.

I was making a general comment re sample sizes and meta analysis rather than necessarily dismissing the argument for TOM deficits in psychosis/schizophrenia. I agree that interpretations can often be inaccurate/irrational . There’s a tendency to see things within a comment or action that just aren’t there.
Psychosis/schizophrenia can be a curious mix of emotional over reactiveness(paranoia-positive symptom) and under reactiveness( blunted effect-negative symptoms)

And if you have seen as many of the families of origin of sz pts as I have since the late 1980s, you might agree with me that that over- or under-reactiveness makes complete behavioral sense. And that the reasons for their paranoid expectations of being invaded, criticized, verbally abused, invalidated and functionally marginalized, rejected and/or abandoned are built on their histories of exactly such treatment… however subtle that treatment may have been. (And sometimes, it was very subtle. But it was always there. Even it was being done by an older brother or cousin, and mother and dad were denying that it ever happened.)

Genetics has never been the “whole story” back of the etiology of any sz patient I have ever seen in almost 30 years. Never.

My tendency has been to emotionally under react to positive stimuli/things while having an heightened reaction to aversive/negative stimuli/ things. A case of negative and positive symptoms at play ?

Which – using a tool from Behavior Modification called “functional assessment of behavior” (FAB) – would point backwards in time to having been exposed (probably many times) to over-stimulation associated with threat and under-stimulation associated with pleasure. I can’t tell you how many times I have seen this FAB in severely mentally ill pts. (Hundreds? At least.)

You may be right but it’s hard for me to analyse that far back.

I had to read books that triggered my memory. (Attention lurkers: Don’t start in here on false memory syndrome. Joel Paris and I have already gone the rounds on that one, and even he admits he was wrong in allowing a very good idea of his to be egregiously misinterpreted.)

I did it more or less in this order (see below; key words are bold-faced). And found out that my inner child was NOT to blame for what it took in, internalized, and vomited back up at the innocent bystanders, even though my inner adult is now responsible to see that my IC vomits as little as possible anymore.

Anonymous: Adult Children of Alcoholics: Alcoholic / Dysfunctional Families, Torrance, CA: ACA World Service Office, 2006.

Woititz, J. G.: Adult Children of Alcoholics, Pompano Beach. FL: Health Communications, 1983.

Black, C.: It Will Never Happen to Me: Children of Alcoholics as Youngsters-Adolescents-Adults, New York: Ballentine, 1981, 1987.

Miller, A.: For Your Own Good: Hidden Cruelty in Child Rearing and the Roots of Violence, London: Farrar, Straus & Giroux, 1979, 1983.

Miller, A.: Prisoners of Childhood / The Drama of the Gifted Child, New York: Basic Books, 1979, 1996.

Miller, A.: Thou Shalt Not Be Aware: Society’s Betrayal of the Child, London: Farrar, Straus & Giroux, 1981, 1984, 1998.

Perry, B.; Szalavitz, M.: The Boy Who was Raised as a Dog…, New York: Basic Books, 2007.

Forward, S.: Toxic Parents: Overcoming their Hurtful Legacy and Reclaiming Your Life, New York: Bantam Books, 1989.

Forward, S.: Emotional Blackmail: When the People in Your Life Use Fear, Obligation and Guilt to Manipulate You, New York: HarperCollins, 1997.

Bateson, G., Jackson, D., Haley, J.; et al: Perceval’s Narrative: A Patient’s Account of his Psychosis, Palo Alto, CA: Stanford University Press, 1961. Etiology of schizophrenia.

Esterson, A.: The Leaves of Spring: Schizophrenia, Family and Sacrifice, London: Tavistock, 1972.

Henry, J.: Pathways to Madness, New York: Random House, 1965.

Jackson, D. (ed.): The Etiology of Schizophrenia: Genetics / Physiology / Psychology / Sociology, London: Basic Books, 1960.

Laing, R. D.; Esterson, A.: Sanity, Madness and the Family, London: Tavistock, 1964.

Lidz, T.: The Origin and Treatment of Schizophrenic Disorders, New York: Basic Books, 1973.

Lidz, T.; Fleck, S., Cornelison, A.: Schizophrenia and the Family, 2nd Ed.; New York: International Universities Press, 1985.

And lately:

Payson, E.: The Wizard of Oz and other Narcissists: Coping with One-Way Relationships in Work, Love and Family, Royal Oak, MI: Julian Day, 2002.

Brown, N.: Children of the Self-Absorbed: A Grown-Up’s Guide to getting Over Narcissistic Parents, 2nd. Ed., Oakland, CA: New Harbinger, 2008.

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