精神分裂症个体的心理理论及其影响因素

Theory of Mind in Schizophrenia and Its Impacting Factors

目的:探讨精神分裂症个体的心理理论能力特点及其影响因素。方法:被试150名,其中精神分裂症患者108名,情感障碍患者21名,正常被试21名。应用故事?图片法测量心理理论能力,PANSS量表评定精神症状,并利用中国修订韦氏智力量表简式测量智商。结果:在一级心理理论任务成绩上,症状未缓解且智商低于70的精神分裂症患者的成绩低于正常对照组(D=-56·58,P<0·01),在二级心理理论任务成绩上,症状未缓解智商低于70和症状未缓解智商高于70的精神分裂症患者的成绩明显低于正常对照组(D=-70·51,D=-37·78,P<0·01);情感障碍患者和处于缓解期的精神分裂症患者与正常对照组的心理理论任务成绩没有明显差异;精神分裂症患者的一、二级心理理论任务成绩与其言语智商均呈正相关(r分别为0·32、0·51,P<0·01和P<0·001);其病程对心理理论任务成绩没有明显的影响;阳性亚型精神分裂症组的一、二级心理理论任务成绩显著低于正常对照组(D=-21·55,D=-25·53,P<0·01)。结论:精神分裂症患者存在心理理论能力的损伤,并受到精神症状和言语智商的显著影响,但病程的作用不明显。这种损伤可能只是一种状态,而不是一种特质。

Objective： To explore the feature of theory of mind （TOM） in schizophrenic patients and the influencing factors. Methods： Subjects were 108 patients with schizophrenia, 21 with affective disorders and 21 normal subjects. Picture-story tasks, PANSS and WAIS-R were used to assess the patients＇ToM, symptoms and intelligence. Results： It was found that the scores on first-order theory of mind tasks of schizophrenic patients with IQ below 70 were lower than normal subjects＂ （ D = -56. 58, P 〈 0. 01 ）, the scores on second-order theory of mind tasks of schizophrenic patients with some symptoms were also significantly lower than normal controls＂ （ D = -70. 51 （ IQ 〈70）, D = -37. 78 （ IQ≥70）, both P 〈 0. 01 ） ; Schizophrenic patients in remission and patients with affective disorders did not differ from normal subjects in their scores on ToM tasks. Verbal IQ of schizophrenia had positive correlation with their scores on first and second-order ToM tasks （r = 0. 32, r = 0. 51, P 〈 0. 01 and P 〈 0. 001 ） . Duration of illness of schizophrenia was not related to their scores on the theory of mind tasks. Our study also showed the scores on first and second-order ToM tasks of schizophrenic patients with positive symptoms was lower than normal subjects＂ （ D = -21.55, D = -25.53, both P 〈 0. 01 ） . Conclusions： Schizophrenic patients have impairments of ToM ability. Symptoms and verbal IQ significantly impact the defcits, but not to their duration of iilness. This impairment of theory of mind in schizophrenia perhaps is state rather than trait characteristics.