Zusammenfassung
Eine Vielzahl von Studien hat sich mit den Fähigkeiten der sozialen Kognition bei psychiatrischen Erkrankungen befasst. Dabei kommt dem Konzept der Theory of Mind (ToM), welches die Fähigkeit bezeichnet, sich die eigenen Gedanken, Gefühle und Intentionen sowie die anderer Personen zu vergegenwärtigen, eine herausragende Bedeutung zu. Zahlreiche Untersuchungen haben sich mit Beeinträchtigungen dieser Fähigkeit unter anderem bei der Schizophrenie befasst und Hinweise auf selektive Defizite gefunden. Psychotische Symptome, wie z. B. Beeinflussungserleben und Verfolgungswahn, könnten ihre Ursache in der reduzierten Fähigkeit haben, eigene Intentionen und die des Gegenübers korrekt einzuschätzen. Inwiefern verminderte ToM-Fähigkeiten bei Patienten mit einer schizophrenen Psychose mit akuten Krankheitsphasen verbunden sind und ob diese Defizite durch kognitives Training verbessert werden können, ist Gegenstand aktueller Diskussion. In rezenten Studien wird zunehmend von ursprünglichen Forschungsrichtungen, in denen lediglich Defizite erfasst wurden, abgewichen. Es werden sowohl Unterscheidungen zwischen verschiedenen Bereichen sozialer Kognition getroffen als auch deren Zusammenhänge mit Sprach- und anderen kognitiven Fertigkeiten untersucht. Ein weiterer Schwerpunkt wird auf die verschiedenen Aspekte defizitärer sozialer Kognition und ihre Verknüpfung mit schizophrenen Spektrumsstörungen gelegt. Ziel dieses Artikels ist eine Begriffsklärung der verschiedenen Bereiche der sozialen Kognition sowie die Darstellung klinischer Implikationen und neuester Ergebnisse und Forschungsmethoden.
Abstract
The term Theory of Mind (ToM) refers to the capacity to infer one’s own and other persons’ mental states. A substantial body of research has highlighted impaired ToM in a variety of neuropsychiatric disorders, including schizophrenia. There is good empirical evidence that ToM is specifically impaired in schizophrenia and that many psychotic symptoms – for instance, delusions of alien control and persecution – may best be understood in light of a disturbed capacity in patients to relate their own intentions to executing behavior, and to monitor others’ intentions. However, it is still under debate if impaired ToM in schizophrenia is a state- or trait marker and whether patients could benefit from cognitive training in this domain. Recently, research has not only emphasized social cognitive deficits in patients, but has also focussed on interactions between ToM with language and other cognitive functions. Furthermore, interest in subprocesses of social cognition in psychotic spectrum disorders (e. g. schizotypy) is growing. The aim of this article is to line out clinical aspects of disturbed social cognition, to clarify terms used in this context as well as to present the latest research approaches into social cognition deficits.
Schlüsselwörter
Theory of Mind - Schizophrenie - Kognition - linguistische Fähigkeiten - Zustands-/Episodenmarker
Key words
Theory of Mind - schizophrenia - cognition - language abilities - state-/trait marker
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Dr. med. Katja Koelkebeck
Klinik und Poliklinik für Psychiatrie und Psychotherapie Universitätsklinikum Münster
Albert-Schweitzer-Straße 11
48149 Münster
Email: katja.koelkebeck@ukmuenster.de
