title: The neural basis of theory of mind and its relationship to social functioning and social anhedonia in individuals with schizophrenia.
abstract: Theory of mind (ToM), the ability to attribute and reason about the mental states of others, is a strong determinant of social functioning among individuals with schizophrenia. Identifying the neural bases of ToM and their relationship to social functioning may elucidate functionally relevant neurobiological targets for intervention. ToM ability may additionally account for other social phenomena that affect social functioning, such as social anhedonia (SocAnh). Given recent research in schizophrenia demonstrating improved neural functioning in response to increased use of cognitive skills, it is possible that SocAnh, which decreases one's opportunity to engage in ToM, could compromise social functioning through its deleterious effect on ToM-related neural circuitry. Here, twenty individuals with schizophrenia and 18 healthy controls underwent fMRI while performing the False-Belief Task. Aspects of social functioning were assessed using multiple methods including self-report (Interpersonal Reactivity Index, Social Adjustment Scale), clinician-ratings (Global Functioning Social Scale), and performance-based tasks (MSCEIT-Managing Emotions). SocAnh was measured with the Revised Social Anhedonia Scale. Region-of-interest and whole-brain analyses revealed reduced recruitment of medial prefrontal cortex (MPFC) for ToM in individuals with schizophrenia. Across all participants, activity in this region correlated with most social variables. Mediation analysis revealed that neural activity for ToM in MPFC accounted for the relationship between SocAnh and social functioning. These findings demonstrate that reduced recruitment of MPFC for ToM is an important neurobiological determinant of social functioning. Furthermore, SocAhn may affect social functioning through its impact on ToM-related neural circuitry. Together, these findings suggest ToM ability as an important locus for intervention.
authors.affiliation: Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
authors.forename: David
authors.initials: D
authors.lastname: Dodell-Feder
authors.affiliation: Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Tully
authors.affiliation: Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
authors.forename: Sarah Hope
authors.initials: SH
authors.lastname: Lincoln
authors.affiliation: Department of Psychology, Harvard University, Cambridge, MA 02138, USA.
authors.forename: Christine I
authors.initials: CI
authors.lastname: Hooker
mesh_terms: D000328:Adult; D059445:Anhedonia / Q000502:physiology*; D001921:Brain / Q000098:blood supply / Q000473:pathology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications* / Q000473:pathology*; D012565:Schizophrenic Psychology; D057566:Self Report; D012938:Social Perception; D013223:Statistics as Topic; D056345:Theory of Mind / Q000502:physiology*; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: Schizophrenia; Social anhedonia; Social functioning; Theory of mind; fMRI