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Theory of mind in obsessive-compulsive disorder: Comparison with healthy controls

Published online by Cambridge University Press:  16 April 2020

A. Sayın ,
N. Oral ,
Ç. Utku ,
E. Baysak  and
S. Candansayar
A. Sayın*
Affiliation:
Psychiatry Department of Gazi University Hospital, Ankara, Turkey
N. Oral
Affiliation:
Psychiatry Department of Gazi University Hospital, Ankara, Turkey
Ç. Utku
Affiliation:
Psychiatry Department of Gazi University Hospital, Ankara, Turkey
E. Baysak
Affiliation:
Psychiatry Department of Gazi University Hospital, Ankara, Turkey
S. Candansayar
Affiliation:
Psychiatry Department of Gazi University Hospital, Ankara, Turkey
*
*Corresponding author. Tel.: +0090 312 2025415; fax: +0090 312 2025412. E-mail address: aslihansayin@yahoo.com (A. Sayın).
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Abstract

Aim

Theory of mind (ToM) is the ability to represent one's own or another's mental states and has been found to be impaired in many psychiatric disorders. Our objective was to compare ToM abilities of patients with obsessive-compulsive disorder (OCD) with healthy controls and to investigate the relation between some illness features, other cognitive functions and ToM abilities of patients.

Method

Thirty OCD patients and age, sex and education matched 30 healthy controls were compared according to their performances on ToM tasks (including first and second order false belief, hinting task and double-bluff task), verbal memory processes test, Weschler memory test (WMT) (logical memory, visual reproduction and digit span sub-tests), stroop test.

Results

Patients’ performances were worse than healthy controls on all of the ToM tasks, but the results were significant for only for double-bluff task (t = −3.992, df = 36.157, p < 0.01). Performance on double-bluff task was significantly and positively correlated with visual reproduction-immediate recall (r = −0.411, p < 0.05) and visual reproduction-delayed recall (r = 0.478, p < 0.05), hinting task was significantly and positively correlated with verbal memory (r = 0.481, p < 0.05).

Conclusion

These results show “basic” ToM abilities of OCD patients are generally preserved, but they show significant reduction in their “advanced” ToM abilities, which seem to be related to their reduced memory capacities. The possible reasons for the relation between memory and ToM impairments, as well as the clinical significance of ToM deficits in OCD are discussed.

Keywords

Theory of mindObsessive-compulsive disorderNeuropsychological testsExecutive functionsMemory
Type
Original articles
Information
European Psychiatry , Volume 25 , Issue 2 , March 2010 , pp. 116 - 122
Copyright
Copyright © Elsevier Masson SAS 2010

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References

Abu-Akel, A.A neurobiological mapping of theory of mind. Brain Res Rev 2003; 43: 29–40.CrossRefGoogle ScholarPubMed
Alexander, G.E., Crutcher, M.D., Delong, M.R.Basal ganglia-thalamocortical circuits: parallel substrates for motor, oculomotor, “prefrontal” and “limbic” functions. Prog Brain Res 1990; 85: 119–146.CrossRefGoogle ScholarPubMed
Allen, J.G., Fonagy, P.Hanbook of Mentalization-Basede Treatment. John Wiley & Sons Ltd: Chichester; 2007.Google Scholar
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edition. Washington: DC: American Psychiatric Press; 1994.Google Scholar
Badcock, J.C., Waters, F.A.V., Maybery, M.On keeping (intrusive) thoughts to one's self: testing a cognitive model of auditory hallucinations. Cognit Neuropsychiatry 2007; 12: 78–89.CrossRefGoogle ScholarPubMed
Baron-Cohen, S., Leslie, A., Frith, U.Does the autistic child have a ‘theory of mind’?. Cognition 1985; 21: 37–46.CrossRefGoogle Scholar
Baron-Cohen, S.The Essential Difference: The Truth about the Male and Female Brain. New York: Basic Books; 2003.Google Scholar
Blair, R.J.R.Neurobiological basis of psychopathology. Br J Psychiatry 2003; 182: 5–7.CrossRefGoogle Scholar
Bora, E., Vahip, S., Gonul, S., Akdeniz, F., Alkan, M., Ogut, M., Eryavuz, A.Evidence for theory of mind deficits in euthymic patients with bipolar disorder. Acta Psychiatr Scand 2005; 112: 110–116.CrossRefGoogle ScholarPubMed
Bora, E., Yucel, M., Pantelis, C.Theory of mind impairments in schizophrenia : meta-analysis. Sch Res 2009; 109: 1–9.CrossRefGoogle ScholarPubMed
Brüne, M.“Theory of mind” in schizophrenia: a review of the literature. Schizophr Bull 2005; 31: 21–42.CrossRefGoogle ScholarPubMed
Brüne, M.Theory of mind and the role of IQ in chronic disorganize schizophrenia. Schizophr Research 2003; 60: 57–64.CrossRefGoogle Scholar
Bull, R., Phillips, L.H., Conway, C.A.The role of control functions in mentalizing: Dual-task studies of Theory of Mind and executive function. Cognition 2008; 107: 663–672.CrossRefGoogle ScholarPubMed
Chamberlain, S.R., Blackwell, A.D., Fineberg, N.A., Robbins, T.W., Sahakian, B.J.The neuropsychology of obsessive-compulsive disorder: the importance of failures in cognitive and behavioral inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev 2005; 29: 399–419.CrossRefGoogle ScholarPubMed
Channon, S., Crawford, S.The effects of anterior lesions on performance on a story comprehension test: Left anterior impairment on theory of mind-type task. Neuropsychologia 2000; 38: 1006–1017.CrossRefGoogle ScholarPubMed
Corcoran, R., Mercer, G., Frith, C.D.Schizophrenia, symptomatology and social inference: investigating “theory of mind” in people with schizophrenia. Scizophr Res 1995; 17: 5–13.CrossRefGoogle ScholarPubMed
Fine, C., Lumsden, J., Blair, R.J.R.Dissociation between “theory of mind” and executive functions in patients with early amygdala damage. Brain 2001; 124: 287–298.CrossRefGoogle Scholar
Fonagy, P., Bateman, A.W.Mechanisms of change in mentalization-based treatment of BPD. J Clin Psychol 2006; 62: 411–430.CrossRefGoogle ScholarPubMed
Garcia-Montes, JM, Perez-Alvarez, M, Balbuena, CS, Garcelan, SP, Cangas, AJ.Metacognitions in patients with hallucinations and obsessive-compulsive disorder: the superstition factor. Behav Res Ther;44: 1091–104.CrossRefGoogle Scholar
Goukan, A., Ohuchi, T., Kikuchi, T., Hirano, M., Noguchi, K., Hosokawa, T.Developmental order driving the relationship between executive functions and theory of mind: a case study. Psychol Rep 2006; 98: 662–670.CrossRefGoogle Scholar
Gregory, C., Lough, S., Stone, V., Erzinclioglu, S., Martin, L., Baron-Cohen, S., Hodges, J.R.Theory of mind in patients with frontal variant frontotemporal dementia and Alzheimer's disease: theoretical and practical implications. Brain 2002; 125: 752–764.CrossRefGoogle ScholarPubMed
Greisberg, S., McKay, D.Neuropsychology of obsessive-compulsive disorder: a review and treatment implications. Clin Psychol Rev 2003; 23: 95–117.CrossRefGoogle ScholarPubMed
Happe, F.G.E.An advanced test of theory of mind: understanding of story characters’ thoughts and feelings by able autistic, mentally handicapped and normal children and adults. J Aut Develop Disord 1994; 24: 129–154.CrossRefGoogle ScholarPubMed
Harrington, L., Siegert, R., McClure, J.Theory of mind in schizophrenia: a critical review. Cognit Neuropsychiatry 2005; 10: 249–286.CrossRefGoogle ScholarPubMed
Henry, J.D., Philips, L.H., Crawford, J.R., Ietswaart, M., Summers, F.Theory of mind following traumatic brain injury: the role of emotion recognition and executive dysfunction. Neuropsychologia 2006; 44: 1623–1628.CrossRefGoogle ScholarPubMed
Inoue, Y., Tonooka, Y., Yamada, K., Kanba, S.Deficiency of theory of mind in patients with remitted mood disorders. J Affect Disord 2004; 82: 403–409.Google Scholar
Janeck, A.S., Calamari, J.E., Riemann, B.C., Heffelfinger, S.K.Too much thinking about thinking?: Metacognitive differences in obsessive-compulsive disorder. J Anxiety Disord 2003; 17: 181–195.CrossRefGoogle ScholarPubMed
Kerr, N., Dunbar, R.I.M., Bentall, R.P.Theory of mind deficits in bipolar affective disorder. J Affect Disord 2003; 73: 253–259.CrossRefGoogle ScholarPubMed
Kitis, A., Akdede, B.B.K., Alptekin, K., Akvardar, Y., Arkar, H., Erol, A., Kaya, N.Cognitive dysfunctions in patients with obsessive-compulsive disorder compared to the patients with schizophrenia: relation to overvalued ideas. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31: 254–261.CrossRefGoogle ScholarPubMed
Kuelz, K., Hohagen, F., Voderholzer, U.Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biol Psychol 2004; 65: 185–236.CrossRefGoogle ScholarPubMed
Lee, L., Harkness, K.L., Sabbagh, M.A., Jacobson, J.A.Mental state decoding abilites in clinical depression. J Affect Disord 2005; 86: 247–258.CrossRefGoogle Scholar
Leslie, A.M., Friedman, O., German, T.P.Core mechanisms in “theory of mind”. Trends in Cognitive Science 2004; 8: 528–533.CrossRefGoogle ScholarPubMed
Lezak, M.D.Neuropsychological Assessment. New York: Oxford University Press; 1995.Google Scholar
Mengelberg, A., Siegert, R.J.Is theory of mind impaired in Parkinson's disease?. Cognit Neuropsychiatry 2003; 8: 191–209.CrossRefGoogle ScholarPubMed
Moritz, S., Jacobsen, D., Willenborg, B., Jelinek, L., Fricke, S.A check on the memory deficit hypothesis of obsessive-compulsive checking. Eur Arch Psychiatry Clin Neuorscience 2006; 256: 82–86.CrossRefGoogle ScholarPubMed
Moritz, S., Kloss, M., Jahn, H., Schick, M., Hand, I.Impact of comorbid depressive symptoms on nonverbal memory and visuospatial performance in obsessive-compulsive disorder. Cogn Neuropsychiatry 2003; 8: 261–272.CrossRefGoogle ScholarPubMed
Öktem, Ö.Sözel Bellek Süreçleri Testi: Bir ön çalışma. Nöropsikoloji Arşivi 1992; 29: 196–206.Google Scholar
Olley, A., Malhi, G., Sachdev, P.Memory and executive function in obsessive-compulsive disorder: A selective review. J Affect Disord 2007; 104: 15–23.CrossRefGoogle Scholar
Penades, R., Catalan, R., Andres, S., Salamero, M., Gasto, C.Executive function and nonverbal memory in obsessive-compulsive disorder. Psychiatr Res 2005; 133: 81–90.CrossRefGoogle ScholarPubMed
Premack, D., Woodruff, G.Does the chimpanzee have a theory of mind?. Behav Brain Sci 1978; 1: 515–526.CrossRefGoogle Scholar
Purcell, R., Maruff, P., Kyrios, M., Pantelis, C.Neuropsychological deficits in obsessive-compulsive disorder: a comparison with unipolar depression, panic disorder, and normal controls. Arch Gen Psychiatry 1998; 55: 415–423.CrossRefGoogle ScholarPubMed
Purdon, C., Clark, D.A.Obsessive intrusive thoughts in nonclinical subjects. Part II. Cognitive appraisal, emotional response, and thought control strategies. Behav Res Ther 1994; 32: 403–410.CrossRefGoogle ScholarPubMed
Salkovskis, P.M.Understanding and treating obsessive-compulsive disorder. Behav Res Ther 1999; 37: S29–S52.CrossRefGoogle ScholarPubMed
Savage, C.R., Baer, L., Keuthen, N.J., Brown, H.D., Rauch, S.L., Jenike, M.A.Organizational strategies mediate nonverbal memory impairment in obsessive-compulsive disorder. Biol Psychiatry 1999; 45: 905–916.CrossRefGoogle ScholarPubMed
Schmidtke, K., Schorb, A., Winkelmann, G., Hohagen, F.Cognitive frontal lobe dysfunction in obsessive-compulsive disorder. Biol Psychiatry 1998; 43: 666–673.CrossRefGoogle ScholarPubMed
Shafran, R., Rachman, S.Thought-action fusion: a review. J Behav Ther Exp Psychiatry 2004; 35: 87–107.CrossRefGoogle ScholarPubMed
Struss, D., Gallup, G., Alexander, M.The frontal lobes are necessary for “theory of mind”. Brain 2001; 124: 279–286.CrossRefGoogle Scholar
Summerfeldt, L.J., Endler, N.S.Examining the evidence for anxiety-related cognitive biases in obsessive-compulsive disorder. J Anx Disord 1998; 12: 579–598.CrossRefGoogle ScholarPubMed
Tien, A.Y., Pearlson, G.D., Machlin, S.R., Bylsma, F.W.Oculomotor performance in obsessive-compulsive disorder. Am J Psychiatry 1992; 149: 641–646.Google ScholarPubMed
Veale, D.M., Sahakian, B.J., Owen, A.M., Marks, I.M.Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive-compulsive disorder. Psychol Med 1996; 26: 1261–1269.CrossRefGoogle ScholarPubMed
Waters, F.A.V., Badcock, J.C., Mickie, P.T., Maybery, M.T.Auditory hallucinations in schizophrenia: intrusive thoughts and forgotten memories. Cognit Neuropsychiatry 2006; 11: 65–83.CrossRefGoogle ScholarPubMed
Wells, A., Matthews, G.Modeling cognition in emotional disorder: the S-REF model. Behav Res Ther 1996; 34: 881–888.CrossRefGoogle Scholar
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