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How does high schizotypy affect empathy and social thinking?

People with high schizotypy struggle to understand others' emotions and tend to undermentalize, a deficit partially driven by lower cognitive flexibility and inhibition.

Source

Cognitive Correlates of Different Mentalizing Abilities in Individuals with High and Low Trait Schizotypy: Findings from an Extreme-Group Design

Kocsis-Bogár K, Kotulla S, Maier S, et al. · Frontiers in psychology · 2017

doi.org/10.3389/fpsyg.2017.00922Read the full paper ↗15 citationscc by

What they did

The researchers screened healthy volunteers and selected 86 participants, placing 39 in a high-schizotypy group and 47 in a low-schizotypy group. They assessed participants' social understanding using a 15-min-long movie featuring 45 questions about characters' thoughts and feelings. They also measured cognitive inhibition with the Stroop Test, cognitive flexibility with the Trail-Making Test, and self-agency with a computerized cursor task.

What they found

The high-schizotypy group performed significantly worse on emotional understanding (affective Theory of Mind) and committed more undermentalizing errors compared to the low-schizotypy group. While the groups did not differ on overall executive function tests, statistical analysis showed that individual levels of cognitive flexibility and inhibition significantly influenced these social gaps. Additionally, high-schizotypy participants showed self-agency deficits only when their cursor movement was manipulated by a 60 o deviation.

The limits

What it doesn't show

Because this study used a cross-sectional, extreme-groups design, it cannot prove that schizotypy or cognitive deficits causally produce social cognition difficulties over time. The sample was highly skewed toward female participants, representing 72% of the tested group, which contrasts with clinical schizophrenia populations where males are typically slightly overrepresented. The research did not assess a distinct disorganized schizotypy dimension due to the limitations of the German version of the questionnaire, meaning potential relationships with disorganized traits remain unexamined. Additionally, the social assessment had participants passively view interactions, so the results may not reflect how people with high schizotypy interact when they are active participants in real-life social situations.

Key terms

Theory of Mind (ToM)
The cognitive ability to attribute mental states, such as beliefs, intents, desires, and emotions, to oneself and others.
Schizotypy
A spectrum of personality traits and experiences ranging from normal dissociative states to creative thinking, extending up to clinical schizophrenia.
Affective ToM
The capacity to represent and understand other people's feelings and emotional states.
Cognitive ToM
The capacity to represent and understand other people's abstract thoughts, beliefs, and intentions.
Undermentalizing
An error in social reasoning where a person attributes overly simplistic mental states, or none at all, to others.
Self-agency
The subjective awareness of initiating, executing, and controlling one's own volitional actions.

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In patients with schizophrenia, what clinical symptoms are most closely associated with undermentalizing (the attribution of overly simplistic mental states)?

Common questions

Why did the researchers look at healthy individuals instead of patients with schizophrenia?

Studying healthy individuals with high schizotypy allows researchers to investigate the underlying cognitive and social mechanisms of the schizophrenia spectrum without the confounding effects of clinical medication, hospitalization, or severe disease progression.

What is the difference between undermentalizing and overmentalizing?

Undermentalizing involves attributing overly simple or no mental states to others, whereas overmentalizing involves attributing overly complex, speculative, or paranoid motives that are not supported by the situation.

Did the high-schizotypy group perform poorly on all cognitive tests?

No, the high- and low-schizotypy groups performed similarly on general verbal intelligence, cognitive inhibition, and cognitive flexibility tests; however, individual variations in these executive functions still played a major role in explaining their social cognition differences.

How was self-agency tested in this study?

Self-agency was measured using a cursor task where participants moved a cursor but faced occasional, hidden angle deviations controlled by the computer, requiring them to judge whether they or the computer controlled the movement.

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