Characterization and Prediction of Theory of Mind Disorders in Temporal Lobe Epilepsy
Characterization and Prediction of Theory of Mind Disorders in Temporal Lobe Epilepsy
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DOI：
10.1037/neu0000126
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发表时间：
2015-05-01
期刊：
影响因子：
2.4
通讯作者：
Szurhaj, William
中科院分区：
文献类型：
--
作者：
Hennion, Sophie;Delbeuck, Xavier;Szurhaj, William
目的：颞叶癫痫（TLE）患者的心理理论功能受损。然而，ToM涉及多种过程，例如理解一个人的意图（“认知”ToM）和情绪状态（“情感”ToM）。本研究的目的是表征TLE患者的ToM障碍，识别有ToM障碍风险的患者，并研究心理行为和生活质量因素与ToM障碍的关系。方法：50名TLE患者和50名对照者执行ToM任务，评估他们对言语笨拙（失礼）、讽刺言论和心理行为的理解。记录人口统计学、认知和心理行为数据，以及（TLE患者）临床和生活质量因素。结果：与对照组相比，TLE患者在所有ToM任务中都表现出障碍：84%的人误解了失礼，约50%的人误解了讽刺。癫痫持续时间长和起病年龄小是ToM损伤的危险因素。在TLE患者中，ToM损伤与移情功能受损和快感缺乏症有关。与对照组相比，他们的情感状态更少积极，更多消极。在失礼任务中，低的积极情感预示着更大的认知和情感ToM障碍，而高的消极情感预示着讽刺任务中更大的认知ToM能力。缺乏社会支持与认知障碍相关，但不是预测因素。结论：TLE患者的认知和情感ToM过程均受损。TLE患者的移情能力受损与情感障碍有关。
Objective: Patients with temporal lobe epilepsy (TLE) have impaired theory of mind (ToM). However, ToM involves a variety of processes, such as understanding a person's intentions ("cognitive" ToM) and emotional states ("affective" ToM). The objectives of the present study were to characterize ToM disorders in TLE patients, identify patients at risk of ToM disorders, and study the relationships between psychobehavioral and quality of life factors and ToM disorders. Method: Fifty TLE patients and 50 controls performed ToM tasks assessing their understanding of verbal clumsiness (faux pas), sarcastic remarks, and mentalistic actions. Demographic, cognitive, and psychobehavioral data, and (for TLE patients) clinical and quality of life factors, were recorded. Results: Compared with controls, TLE patients showed impairments in all ToM tasks: 84% misunderstood faux pas, and around 50% misunderstood sarcasm. A long duration of epilepsy and young age at onset were risk factors for ToM impairments. In TLE patients, ToM impairments were associated with impaired empathy and anhedonia. Their affective states were less positively and more negatively valenced than in controls. Low positive affectivity was predictive of greater cognitive and affective ToM impairments for the faux pas task, and high negative affectivity was predictive of greater cognitive ToM abilities for the sarcasm task. The lack of social support was correlated with impaired ToM but was not a predictive factor. Conclusions: Both cognitive and affective ToM processes are impaired in TLE patients. Impaired ToM has an impact on empathy abilities and is related to affective disturbances in TLE patients.