Assessing perspective taking in schizophrenia using Relational Frame Theory

Relational Frame Theory (RFT) explains perspective-taking performance in terms of deictic relational responding, which has been empirically examined in a number of studies employing both adults and children. Following this view, the current study aims at assessing deictic relational responding in people with schizophrenia, a population for whom there is evidence of a deficit in mental states attribution. A perspective-taking task and a mental states attribution task were employed with a sample of 15 patients diagnosed with schizophrenia and 15 age-matched controls. Results revealed poorer performance of participants with schizophrenia in responding in accordance with deictic frames at the highest levels of relational complexity (i.e., reversed and double reversed perspective-taking), while no difference appeared between the two groups on simple perspective-taking. In addition, a significant deficit emerged on the mental states attribution task. Group effects remained significant after controlling for IQ. Furthermore, performance in complex deictic responding was a strong predictor of accuracy on the mental states attribution task in both groups, thus supporting the RFT approach to Theory of Mind. These findings suggest the relevance of conceptualizing mental states attribution in terms of relational responding for the understanding and remediation of deficits linked to schizophrenia.