Abstract
Objective: The normal maturational processes of theory of mind (ToM) capacity are ongoing during adolescence and even early adulthood. However, research has shown that ToM ability also declines among adults suffering from prodromal psychotic experiences. The goal of this study was to investigate the characteristics of ToM performance in youth with clinical high risk (CHR) of psychosis. Methods: The Reading Mind in Eyes Task (RMET), including own-race and other-race eyes, was administered to 40 CHR youth; 42 age-, gender-, and education-matched healthy controls (HCs); and 62 adult patients with schizophrenia (SZ). Nine-month follow-up data were collected from 31 CHR subjects, of whom 7 (22.6%) had made the transition to psychosis. Results: CHR youth showed significant impairment in RMET performance compared to HC youth but performed better than did SZ patients. Moreover, they were significantly slower than were HC youth in responding to the RMET, with a response time similar to that of SZ patients. In particular, they had significantly poorer accuracy in interpreting positive and neutral eye expressions compared to the HC group, but not in interpreting negative eye expressions. Preliminary follow-up data showed a trend toward significance (p = 0.079) for RMET performance between those who transitioned to psychosis and those who did not. Conclusions: Our findings illustrate that deficits in ToM capacity, specifically the ability to interpret people’s mental state from eye expressions, occur early on in prodromal psychosis in youth. Early interventions for CHR youth focusing on ToM enhancement may halt progress toward psychosis.
Funding
This study was supported by National Natural Science Foundation of China (81201043, 81171267, 81171280, 81261120410, 81361120403), SHSMU-ION Research Center for Brain Disorders (2015NKX001), Shanghai Science and Technology Committee (15411967200), National Key Clinical Disciplines at Shanghai Mental Health Center (OMA-MH, 2011-873), Shanghai Key Laboratory of Psychotic Disorders (13dz2260500), and Shanghai Jiao Tong University Foundation (14JCRY04, YG2014MS40). It was also supported by Program of Shanghai Academic Research Leader(16XD1402400).
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Funding
Notes on contributors
TianHong Zhang
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
YingYing Tang
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
HuiRu Cui
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
Xi Lu
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
LiHua Xu
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
XiaoHua Liu
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
HuiJun Li
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
Annabelle Chow
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
YaSong Du
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
ChunBo Li
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
KaiDa Jiang
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
ZePing Xiao
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.
JiJun Wang
TianHong Zhang, MD, PhD, YingYing Tang, PhD, HuiRu Cui, MD, Xi Lu, MD, PhD, LiHua Xu, MD, PhD, XiaoHua Liu, MD, PhD, YaSong Du, MD, ChunBo Li, MD, PhD, KaiDa Jiang, MD, ZePing Xiao, MD, PhD, and JiJun Wang, MD, PhD, are affiliated with the Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China. HuiJun Li, PhD, is affiliated with the Department of Psychology, Florida A&M University, Tallahassee, Florida. Annabelle Chow, PhD, is affiliated with the Department of Psychological Medicine, Changi General Hospital, Singapore.