The Grinch Who Stole Thoughts: A Virtual Reality Study of Theory of Mind in Early Psychosis and Chronic Schizophrenia

Abstract

Social cognition refers to the collection of cognitive processes that enable fluid social engagement. One of the core processes subsumed under social cognition is theory of mind (ToM), which refers to the capacity to infer the thoughts, feelings, and intentions of others. A substantial body of research has demonstrated that ToM is impaired in a variety of neuropsychiatric disorders including schizophrenia. There is good empirical evidence that many psychotic symptoms may best be understood in light of a disturbed capacity to monitor one’s own and others’ intentions. Nonetheless, exactly how impaired ToM contributes to the clinical presentation of schizophrenia remains unclear, as is the magnitude of deterioration in ToM that results from illness chronicity. Furthermore, the extent to which ToM is associated with neurocognition and other domains of social cognition (e.g., empathy) is still under debate. Preliminary research has also started to examine the different types and functional consequences of ToM impairment in schizophrenia. Examination of these potential research areas has likely been limited by the lack of psychometrically sound and sensitive measures of ToM that are suitable for use with healthy and clinical adult populations.