Psychotically driven aggression is associated with greater mentalizing challenges in psychotic spectrum disorders

BMC Psychiatry

Sven Bölte¹  Marianne Kristiansson²  Malin Källman³  Anette GM Johansson⁴  Lennart Högman⁵  Håkan Fischer⁶ 

[1]Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, 118 61, Stockholm, Sweden

[2]Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia

[3]Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

[4]Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

[5]Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research

[6] Department of Women’s and Children’s Health, Karolinska Institutet &, Stockholm Health Care Services, Region Stockholm, 113 30, Stockholm, Sweden

[7]Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

[8]Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research

[9] Department of Women’s and Children’s Health, Karolinska Institutet &, Stockholm Health Care Services, Region Stockholm, 113 30, Stockholm, Sweden

[10]Centre for Psychiatry Research, 113 64, Stockholm, Sweden

[11]Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden

[12]Department of Psychology, Stockholm University, 106 91, Stockholm, Sweden

[13]Department Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

关键词: Violence;    Psychosis;    Schizophrenia;    Aggression;    Social cognition;    DMASC-MC;    Theory of mind;   

DOI  :  10.1186/s12888-020-02868-7

来源: Springer

【 摘 要 】

BackgroundSome aggressive acts committed by individuals with psychotic spectrum disorders (PSD) are understandable in the context of interpersonal conflict or goal attainment, yet others are unpredictable, arising from delusions or hallucinations (psychotically driven aggressive acts, PDA). It is unknown if there are underlying differences in cognitive or perceptive social cognition in relation to aggression motivation in PSD.MethodWe compared differences in social cognition performance between 49 individuals with PSD who had committed PDA with those exhibiting other types of aggression (n = 31) (non-PDA) and to community controls (n = 81) on the Swedish version of Double Movie for the Assessment of Social Cognition – Multiple Choice (DMASC-MC). Participants with PSD had more than 3 months of clinical stability and substance use abstention and stable antipsychotic medication doses. General intellectual ability was assessed with the information and matrix reasoning subtests of the Wechsler Intelligence Scales.ResultsThe PSD group with a history of PDA exhibited lower total and perceptive social cognition scores on the DMASC-MC than the non-PDA group and controls. In addition, they also showed lower cognitive scores compared to typical controls. Lower total scores were associated with lower scores on Wechsler intelligence subtests information and matrix reasoning. Taking this into account, the PDA group still had lower social cognition scores. There were no associations of antipsychotic medication dosages, positive or negative symptoms with social cognition scores. Higher antipsychotic dosage at the time of DMASC-MC testing and social cognition scores predicted a past history of PDA.ConclusionsWe conclude that impaired social cognition, particularly perceptive social cognition, is associated with PDA in individuals with PSD.

【 授权许可】

CC BY