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Irony comprehension and schizophrenia: mental states’ representation and update in context Volume 10, issue 2, Avril-Mai-Juin 2018

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Authors
1 Université Paris 8,
Laboratoire de psychopathologie et neuropsychologie (LPN),
EA 2027,
2, rue de la Liberté,
93526 Saint-Denis,
France
2 Centre hospitalier de Versailles,
Centre Eugen-Bleuler,
EA 4047,
78157 Le Chesnay,
France
3 Centre hospitalier de Versailles,
EA 4047,
78157 Le Chesnay,
France
* Correspondance

Difficulties in understanding irony are part of the mentalization deficits in patients with schizophrenia. Many studies have proposed that these difficulties may be due to a contextual impairment. However, the way this contextual impairment can affect mentalization processes remains poorly understood. Thus, the aim of this study was to test the impact of context processing on the different stages of mentalization (i.e. the processes of representing and updating others’ mental states) in schizophrenia. Seventeen patients with schizophrenia and 17 age-, sex- and IQ-matched healthy participants completed a verbal task consisting of 72 stories. The last sentences were either literal or ironic in relation to the context (e.g.: “Peter always loved/hated fish. For dinner, his mother prepared salmon. Peter says: I’m very happy!”). The stories were followed by either a question about the factual content (e.g.: “Did Peter's mother prepare salmon?”) or the character's mental state (e.g.: “Did Peter say what he thinks?” or “Did Peter say the opposite of what he thinks?”). Analyzes showed that patients’ performances on mental questions about literal stories were comparable to that of controls (P = 0.828), indicating that patients with schizophrenia proactively used contextual information to activate a speaker's mental state representation. However, patients made more errors than controls when answering mental state questions about ironic stories. This underlines the specific difficulties in ambiguous situations in which a re-analysis of the context is necessary to update the mental state representation. Moreover, the absence of differences between the groups on factual questions makes it possible to say that these difficulties were not the consequence of attention, memory or general understanding deficits. Thus, this study provides valuable insights into the way the impairment of contextualization processes affects mental states’ attribution in schizophrenia. It also indicates the potential relevance of cognitive remediation programs that target contextual processing in schizophrenia.

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