Abstract
Background
In recent decades, research in the treatment of schizophrenia has shifted to early detection and intervention. Unfortunately, the development of psychosis is still poorly understood, making such an endeavour more challenging. Cognitive models of psychosis suggest that neurocognitive deficits place an individual at greater risk of developing metacognitive deficits. Such deficits in metacognition have been shown to contribute to the development of positive symptomatology. A large body of literature supports that patients with schizophrenia exhibit impairments across nearly all domains of neurocognition, as well as metacognition. Theory of mind (ToM) is one of the most widely studied components of metacognition, which includes both cognitive (i.e., understanding what another person is thinking) and affective (i.e., understanding what another person is feeling) processes. Research indicates patients with schizophrenia demonstrate deficits in cognitive and affective ToM, and these deficits are associated with delusional symptomatology. If ToM is involved in the development of positive symptoms, it is expected that this deficit would be present prior to the onset of a first episode psychosis. It is unclear from current research findings if this is the case, however. Additionally, research examining the role of neurocognition as it relates to ToM is lacking. While some research has examined these variables in clinically-high-risk (CHR) groups, little research has examined nonclinical samples at risk for psychosis. Thus, this study sought to examine the relationship between ToM and neurocognition in a nonclinical sample with schizotypal traits, as research suggests these individuals may be at risk of developing a psychotic illness. It was hypothesized that lower performance in working memory and executive functioning would be related to poorer performance in cognitive and affective ToM, which would subsequently be associated with subsyndromal delusions. It was further predicted that schizotypal traits would moderate the relationship between neurocognitive performance and ToM abilities.
Methods
Undergraduate students (N = 99) completed self-report measures of personality and psychosocial functioning, including the Schizotypal Personality Questionnaire, Beck Depression Inventory-II, Launay-Slade Hallucination Scale-Revised, and 21-Item Peters Delusions Inventory. Participants also completed the Neuropsychological Assessment Battery Screening Module, which is a screening measure for neurocognitive dysfunction. Finally, they completed the Recognition of Faux Pas Test, a task-based measure that evaluates cognitive and affective ToM.
Results
Data collection is complete, and the data will be analysed using partial least squares structural equation modeling. This is a regression-based path analysis designed for exploratory models. This statistical method is better able to handle non-normally distributed data and smaller sample sizes when compared to covariance-based structural equation modeling.
Discussion
Study findings will be discussed in the context of cognitive models for the development of psychosis. The ways in which these findings, and cognitive models more broadly, can facilitate early detection of schizophrenia will be discussed, along with how such models can be used to inform psychosocial interventions for the illness.
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