A machine-learning approach to investigating the complexity of theory of mind in individuals with schizophrenia

Aug 5, 2026

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Individuals with schizophrenia show difficulty attributing mental states to self and others—Theory of Mind (ToM). ToM is a multifaceted construct including first and second order, first and third person, egocentric and allocentric perspectives, and cognitive and affective ToM. Prior research often treats ToM deficits as an “all-or-nothing” ability and relies on classical null-hypothesis testing. This study applies machine learning to detect patterns in heterogeneous, multivariate data, capturing degrees of impairment. Results emphasize the complex nature of ToM deficits and the relationships among distinct ToM components.

LanguageEnglish

CategoryResearch & Report

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Pages12

Reading Time30 min

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Introduction

Theory of Mind (ToM) and schizophrenia

Facets of ToM: order, person, perspective, and domain

Heliyon 10 (2024) e30693 Contents lists available at ScienceDirect Heliyon journal [homepage:](homepage: www.cell.com/heliyon)[ www.cell.com/heliyon](homepage: www.cell.com/heliyon) | Research article
A machine-learning approach to investigating the complexity of theory of mind in individuals with schizophrenia | | | | | --- | --- | --- | --- | | Francesca Marina Bosco a, *, Livia Colle a, c, Rogerio Salvinib, Ilaria Gabbatore a
a University of Turin, Department of Psychology, GIPSI Research Group, Italy b Instituto de Inform´atica, Universidade Federal de Goi´as, Goiˆania, GO, Brazil c Terzo Centro di Psicoterapia Cognitiva, Roma | | | | | A R T I C L E I N F O | | A B S T R A C T | | | Keywords:
First and second order
First and third person
Egocentric and allocentric perspective Cognitive and affective ToM Mindreading
Social cognition | | Individuals with schizophrenia have difficulty attributing mental states to themselves and to others-Theory of Mind (ToM). ToM is a complex, multifaceted theoretical construct comprising first and second order, first and third person, egocentric and allocentric perspective, and cognitive and affective ToM. Most studies addressing ToM deficit in people with schizophrenia consider it an "all-or-nothing" ability and use a classical statistical methodology to test a null hypothesis. With the present study, we investigated ToM in individuals with schizophrenia, considering its complex nature and degrees of impairment. To do this, we used a machine-learning approach to detect patterns in heterogeneous and multivariate data. Our findings highlight the complex nature of ToM deficit in individuals with schizophrenia and reveal the relationship between various different aspects of ToM. | | 1. Introduction Human social cognition relies on the ability to attribute mental states to oneself and others-Theory of Mind (ToM), a theoretical construct introduced by Ref. [1](for a review, see Refs. [2,3]). Since its conceptualization, ToM has attracted increasing attention from researchers and clinicians as a useful theoretical basis to explain various pathological conditions (for a review, see Ref. [4]). One of the most commonly studied clinical disorders is schizophrenia. The first to suggest that a deficit in ToM could explain the cognitive and behavioral abnormalities observed in individuals with schizophrenia was Frith [5,6]. He suggested that an impairment in ToM could explain the complex symptomatology of schizophrenia, both its negative (poverty of speech and action, social withdrawal, flattening of affect, catatonic behavior) and its positive symptoms (disordered thoughts and speech, hallucinations, delusions). Hardy-Bayl´e et al. [7] argued that patients, particularly those with disorganized behavior, exhibit ToM deficits; Abu-Akel & Bailey [8] suggested that individuals with schizophrenia, especially those with delusions, exhibit ToM difficulties by overattributing intentions to others as"hyperToM activation". Over the past two decades, a large body of empirical evidence has documented ToM difficulties in individuals with schizophrenia (for reviews, see Refs. [9–12]; for metanalyses see Refs. [13,14]) and in their non-psychotic first-degree relatives [15,16]. What was originally proposed as a unified ability- "the ToM" -was later shown to possess a complex nature composed of various different facets [17]. * Corresponding author. Department of Psychology, University of Turin, Via Verdi 10, 10124 Torino, Italy. E-mail addresses: francesca.bosco@unito.it (F.M. Bosco), livia.colle@unito.it (L. Colle), [rogeriosalvini@ufg.br](rogeriosalvini@ufg.br) (R. Salvini), ilaria.gabbatore@ unito.it (I. Gabbatore). [https://doi.org/10.1016/j.heliyon.2024.e30693](https://doi.org/10.1016/j.heliyon.2024.e30693) Received 11 December 2023; Received in revised form 23 April 2024; Accepted 2 May 2024 Available online 3 May 2024 2405-8440/© 2024 The Authors. Published by

FAQs

How does the study frame Theory of Mind (ToM) in schizophrenia?

It treats ToM as a complex, multifaceted construct rather than a single ability, covering order (first/second), person (first/third), perspective (egocentric/allocentric), and cognitive/affective components.

What methodological limitation in prior ToM studies is addressed?

The study notes that many previous works model ToM deficits as “all-or-nothing” and use classical null-hypothesis statistics.

What is the role of the machine-learning approach in this research?

Machine learning is used to detect patterns in heterogeneous, multivariate data, aiming to capture degrees of impairment and clarify relationships among ToM aspects.

Aug 5, 2026

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