Data from: Hyper-Theory-of-Mind in children with psychotic experiences

Background: Alterations in Theory-of-Mind (ToM) are associated with psychotic disorder. In addition, studies in children have documented that alterations in ToM are associated with Psychotic Experiences (PE). Our aim was to examine associations between an exaggerated type of ToM (HyperToM) and PE in children. Children with this type of alteration in ToM infer mental states when none are obviously suggested, and predict behaviour on the basis of these erroneous beliefs. Individuals with HyperToM do not appear to have a conceptual deficit (i.e. lack of representational abilities), but rather they apply their theory of the minds of others in an incorrect or biased way. Method: Hypotheses were tested in two studies with two independent samples: (i) a general population sample of 1630 Danish children aged 11–12 years, (ii) a population-based sample of 259 Dutch children aged 12–13 years, pertaining to a case-control sampling frame of children with auditory verbal hallucinations. Multinomial regression analyses were carried out to investigate the associations between PE and ToM and HyperToM respectively. Analyses were adjusted for gender and proxy measures of general intelligence. Results: Low ToM score was significantly associated with PE in sample I (OR = 1.6 95%CI 1.1–2.3 χ2(4) = 12.42 p = 0.010), but not in sample II (OR = 0.9 95%CI 0.5–1.8 χ2(3) = 7.13 p = 0.816). HyperToM was significantly associated with PE both in sample I (OR = 1.8, 95%CI 1.2–2.7 χ2(3) = 10.11 p = 0.006) and II (OR = 4.6, 95%CI 1.3–16.2 χ2(2) = 7.56 p = 0.018). HyperToM was associated particularly with paranoid delusions in both sample I (OR = 2.0, 95%CI: 1.1–3.7% χ2(4) = 9.93 p = 0.021) and II (OR = 6.2 95%CI: 1.7–23.6% χ2(4) = 9.90 p = 0.044). Conclusion: Specific alterations in ToM may be associated with specific types of psychotic experiences. HyperToM may index risk for developing psychosis and paranoid delusions in particular.

背景：心理理论（Theory-of-Mind, ToM）异常与精神病性障碍密切相关。此外，针对儿童群体的已有研究证实，心理理论异常与精神病性体验（Psychotic Experiences, PE）存在关联。本研究旨在探讨儿童中过度心理理论（HyperToM）这类异常心理理论与精神病性体验之间的关联。具备此类心理理论异常的个体，会在无明显线索的情况下推断他人的心理状态，并基于这些错误信念预测行为。表现出过度心理理论的个体并未出现概念性缺陷（即缺乏表征能力），而是以错误或偏倚的方式运用对他人心理的推断理论。

方法：本研究通过两项纳入独立样本的研究对研究假设进行验证：(1) 一般人群样本，包含1630名11~12岁的丹麦儿童；(2) 基于人群的样本，包含259名12~13岁的荷兰儿童，该样本取自存在言语性幻听（auditory verbal hallucinations）的儿童的病例对照抽样框架。本研究分别采用多项回归分析，探讨精神病性体验与心理理论、过度心理理论之间的关联。分析过程校正了性别与一般智力的替代指标。

结果：在样本I中，低心理理论得分与精神病性体验存在显著关联（比值比（Odds Ratio, OR）=1.6，95%置信区间（95% Confidence Interval, 95%CI）=1.1~2.3，χ²(4)=12.42，P=0.010），但该关联未在样本II中得到验证（OR=0.9，95%CI=0.5~1.8，χ²(3)=7.13，P=0.816）。过度心理理论与精神病性体验的关联在样本I（OR=1.8，95%CI=1.2~2.7，χ²(3)=10.11，P=0.006）与样本II（OR=4.6，95%CI=1.3~16.2，χ²(2)=7.56，P=0.018）中均显著存在。进一步分析显示，在两个样本中，过度心理理论均尤其与偏执妄想相关：样本I（OR=2.0，95%CI=1.1~3.7，χ²(4)=9.93，P=0.021），样本II（OR=6.2，95%CI=1.7~23.6，χ²(4)=9.90，P=0.044）。

结论：心理理论的特定异常或与特定类型的精神病性体验相关。而过度心理理论或可作为精神病性障碍尤其是偏执妄想的发病风险标志物。