What do you think I think? Theory of Mind and Schizophrenia

Having a ‘theory of mind ' (ToM) means that one appreciates one’s own and others ' mental states. Experimental studies have provided evidence that ToM is impaired in schizophrenia. Conversational interaction depends on the ability to make judgements about other participants’ intentions and beliefs. Consequently, a key prediction that follows from the experimental studies is that people with schizophrenia should display specific communicative problems associated with these judgements. We present a detailed analysis of 35 naturally occurring encounters between health professionals and people with schizophrenia. Using conversation analytic techniques, we provide evidence that patients a) show intact first- and second-order ToM in their discussion of their own and others ’ mental states b) are able to use third position repair, which depends on diagnosing another participant’s possible misunderstanding and c) retain the ability to plan complex conversational moves on the basis of what their interlocutor knows