Background
Among individuals with schizophrenia, deficits in theory of mind (ToM) skills predict
poor social functioning. Therefore, identifying the neural basis of ToM may assist
the development of treatments that improve social outcomes. Despite growing evidence
that the ventromedial prefrontal cortex (VMPFC) facilitates ToM skills among healthy
individuals, methodological challenges, such as the influence of general cognitive
deficits, have made it difficult to identify the relationship between ToM processing
and VMPFC function in schizophrenia.
Methods
We used voxel-based morphometry and a multi-method behavioral assessment of ToM processing,
including performance-based (Recognition of Faux Pas Test), self-report (Interpersonal
Reactivity Index, Perspective-Taking), and interview-rated (Quality of Life Scale–Empathy
score) ToM assessments, to investigate whether ToM skills were related to VMPFC gray
matter volume (GMV). Standardized neuropsychological measures were used to assess
global cognition. Twenty-one schizophrenia and 17 healthy control subjects participated.
Results
Between-group behavioral analyses showed that, as compared with healthy participants,
schizophrenia participants had worse ToM performance and lower self-reported ToM processing
in daily life. The between-group analysis of GMV showed that schizophrenia participants
had less VMPFC GMV than healthy participants. Moreover, among schizophrenia participants,
all three measures of ToM processing were associated with VMPFC GMV, such that worse
ToM skills were related to less VMPFC GMV. This association remained strong for self-reported
and interview-rated ToM skills, even when controlling for the influence of global
cognition.
Conclusions
The findings suggest that among individuals with schizophrenia, reduced VMPFC GMV
is associated with deficits using ToM skills to enhance social relationships.
Key Words
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Article info
Publication history
Published online: September 14, 2011
Accepted:
July 23,
2011
Received in revised form:
July 5,
2011
Received:
October 17,
2010
Identification
Copyright
© 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
