Theory of Mind and Executive Functioning in Forensic Patients with Schizophrenia

• NCJ Number: 226571
• Journal: Journal of Forensic Sciences Volume: 54 Issue: 2 Dated: March 2009 Pages: 469-473
• Author(s): Karina Majorek M.D.; Wiebke Wolfkuhler M.D.; Christian Kuper M.D.; Nahlah Saimeh M.D.; Georg Juckel Ph.D.; Martin Brune Ph.D.
• Date Published: March 2009
• Length: 5 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study examined 33 forensic patients with schizophrenia regarding “theory of mind” (cognitive capacity to represent one’s own and other persons’ mental states in terms of beliefs, desires, intentions, and feelings); intelligence; executive functioning; and psychopathology; results were compared with a nonforensic schizophrenia sample and a group of healthy controls.

Abstract

The study found that forensic schizophrenia patients in a maximum-security psychiatric hospital were similarly impaired in understanding mental states as nonforensic patients, albeit for different reasons associated with their psychopathological profile. For the forensic patients, symptoms such as excitement, hostility, tension, and poor impulse control may negatively influence mental state comprehension during social interaction. This finding may have implications for routine assessment during detention, as well as treatment. Criminal behaviors by schizophrenic patients may not result as much from impairments related to theory-of-mind (ToM) capabilities as from deficits in empathetic perspective-taking, an issue that was not specifically addressed in this study. Forensic and nonforensic schizophrenia patients did not differ regarding premorbid intelligence or executive functioning, except for the number of errors in the Wisconsin Card Scoring Test. Social cognitive training that embraces ToM, emotion recognition, and empathic perspective-taking may be an additional tool for improving outcome and rehabilitation for forensic patients with schizophrenia. Thirty-three schizophrenic patients (32 males, 1 female) detained in a high-security psychiatric hospital were compared with a sample of 38 schizophrenic patients (18 males and 20 females) in regular psychiatric care, as well as with a group of 29 healthy controls (10 males and 19 females). The paper describes the tests used to measure verbal intelligence, cognitive flexibility, executive planning, ToM abilities, and psychopathology. 3 tables and 28 references