Journal of International Psychiatry

Objective: To explore the relationship between the theory of mind(ToM) and hostile attributional bias in patients with schizophrenia. Methods: One hundred and eighteen stable schizophrenic patients and 91 community normal controls were assessed with Theory of Mind-Picture Sequencing Task (ToM-PST) and Chinese version of the Ambiguous Intentions Hostility Questionnaire (AIHQ-C). Results: Compared with normal controls, the total score of ToM-PST, the subscale scores of primary false belief, secondary false belief and tertiary false belief in patients with schizophrenia were significantly decreased (all P<0.01). The AIHQ-C subscale scores of hostility bias, blame bias, aggression bias in accidental scenario and the total score of aggression bias in shcizophrenia were significantly higher than those in normal controls (all P<0.05-0.01). In patents, correlation analysis showed that the ToM-PST total score was negatively correlated with the AIHQ-C total scores of hostility bias and aggression bias (all P<0.05). The relationship between theory of mind and hostility attribution bias was mainly observed in ambiguous and accidental scenarios, which only partially existed after controlling age, sex, years of education, course of disease, antipsychotic dose and PANSS scores. Conclusion: The results further confirmed that the ability of stable schizophrenic patients to understand others behaviors and intentions was impaired, and it was easy to make hostile attribution to other peoples benign behaviors. The relationship between patients theory of mind and hostility attribution bias was influenced by clinical symptoms and demographic characteristics.

Schizophrenia; Theory of Mind; Hostility Attributional Bias; Psychiatric Symptoms; Correlation