| Purpose:In social cognition,the integration of multiple social clues is crucial.Low-level social cognition needs to classify and identify stimuli,while high-level social cognition needs to integrate and process social stimuli.The advanced social cognition--Theory of Mind of schizophrenia appears serious impairment.Joint Attention is the basis of social cognition and could predict the social cognition.However,there is a lack of research on the Joint Attention of schizophrenics and Theory of Mind under the same framework.By studying the clue integration of schizophrenia under different requirements of Joint Attention and Theory of Mind,and analyzing influence factors,to confirm that there are impairments in both Joint Attention and Theory of Mind in schizophrenia.Methods:We recruited 58 healthy subjects and 31 patients living with schizophrenia to investigate the characteristics and clue strategies in the Joint Attention experiment and Theory of Mind experiment.In the end,56 healthy participants and 28 patients completed the experiments.Chi-square test and t-test were used to analyze group differences and response differences,tree of strategies was used to analyze the cognitive process of subjects in the judgment process,K-Means cluster analysis was used to explore the response types of subjects,and logistics regression was used to analyze the influencing factors of clue integration in schizophrenia patients.Results:Demographic variables and clinical indicators:(1)the age of the healthy population(26.18 ± 4.046)was significantly lower than that of the patient group(42.00 ± 11.337);The years of schooling in the healthy group(17.18 ± 2.420)were significantly longer than those in the patient group(10.85 ± 3.840).There was no significant difference in sex ratio between the two groups.(2)The healthy group showed significantly stronger performance in HAMA,HAMD,SDSS,MMSE and RBANS than the patient group;The PANSS score of the patient group was 69.12 ± 13.612.JA experiment:(1)The responses of both healthy and schizophrenia were affected by gaze clues.(2)The healthy group also processed the emotional consistency(expression),while the schizophrenia ignored the stimulus.(3)The healthy group tended to use the multiclue integration for analysis,while the schizophrenia tended to use the single gaze clue processing.The healthy group was more capable of using clue integration.(4)The logistic regression result model was effective.The model found that the age,gender and years of education of the subjects all had an impact on the response to JA.The gaze clue and expression clue in the experiment had a significant impact on the results.Among the clinical indicators HAMA,SDSS,MMSE,RBANS and PANSS total scores and negative symptom scores influence the response to JA.ToM experiment:(1)The response to the To M of both the healthy group and the schizophrenia was affected by the gaze clue and the expression clue;The healthy group processed clues that included a picture clue,while the schizophrenia ignored the clue.(2)The disappearance of emotional consistency(expression)in To M experiments is due to the limitations of experimental requirements.(3)The healthy group tended to perform multiclue integration for analysis,and the schizophrenia group also attempted multi-clue integration due to experimental requirements,but the number of clue integration was significantly lower than that of the healthy group.The healthy group was more capable of using clue integration.(4)The logistic regression result model was effective,and it was found that gender and years of education of the subjects would have an impact on the response to To M,the gaze clue and face clue in the experiment had a significant impact on the result,and neuroticism,extraversion and conscientiousness among the big five personality traits had a significant impact on the result.The scores of HAMA,SDSS,MMSE,RBANS and PANSS on all the subscales of clinical indicators affect the response to To M.Conclusion:Clue processing was affected by purpose."Attention" purpose paid attention to the gaze,and "like" target facial expression.Schizophrenic patients prefer to use gaze clue when processing clues,showing the advantage of gaze clue.The clue integration of patients was affected by personality,anxiety,social function,and neuropsychological state of Figure Copy,Picture Naming,Digit Span and Coding.The integration ability of emotional social clues was affected by negative symptoms,and the integration of various clues was affected by positive symptoms,negative symptoms and general psychopathological symptoms. |
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