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1 KISEP Original Article J Korean Neuropsychiatr Assoc Vol 44, No 3 만화과제를이용한정신분열병환자의사회인지능력의측정 오정은 1,2 나명현 1,2 하태현 1,3 신용욱 1 노규식 1 홍순범 3 이경진 3 신민섭 3 이영호 2 권준수 1,3 Social Cognition Deficits of Schizophrenia in Cartoon Task Jung Eun Oh 1,2, Myung Hyon Na 1,2, Tae Hyon Ha, MD 1,3, Yong Wook Shin, MD 1, Kyu Sik Roh, MD 1, Soon Beom Hong, MD 3, Kyung Jin Lee, MD 3, Min Seop Shin, PhD 3, Young Ho Lee, PhD 2 and Jun Soo Kwon, MD, PhD 1,3 Clinical Cognitive Neuroscience Center, 1 Neuroscience Institute, SNU-MRC, Seoul, Department of Psychology, 2 Catholic University, Seoul, Department of Psychiatry, 3 Seoul National University College of Medicine, Seoul, Korea Objectives:This study is to investigate the hypothesis that schizophrenic patients have difficulty in inferring mental state of others. Methods:Twenty schizophrenic patients and twenty normal subjects were administered to the Cartoon Task required inferring the character s intention in a given context. Results:The schizophrenic patients showed a statistically significant impairment in the Cartoon Task. Both groups chose the card depicting a frequent everyday action significantly more rather than the similar card to the last picture in each story for wrong answers. Conclusion:These preliminary results suggest that schizophrenia is associated with a specific deficit of the cognitive ability referred to as social cognition, and this deficit can be detected not only in the acute phase as found in previous research studies, but also in remission. Also when subjects fail to appreciate what is going on in the minds of other people, they seem to rely on a socially familiar experience. (J Korean Neuropsychiatr Assoc 2005;44(3): ) KEY WORDS:Schizophrenia Social cognition The cartoon task. 서 - 론 295

2 - - 방법 연구대상 296

3 Table 1. Demographic and clinical characteristics of the schizophrenic patients and the normal controls Variables Schizophrenics n20 Controls n20 Mean SD Mean SD p-value Age years * Education years * IQ * PANSS total score positive score negative score global score Duration years Onset years p.01 연구도구및실시방법 한국판웩슬러성인용지능검사단축형 (Short-form of Korean-Wechsler Adult Intelligence Scale: K-WAIS) 양성및음성증상증후군척도 (Positive and Negative Syndrome Scale:PANSS) 만화과제 (Cartoon task) 분석방법

4 Fig. 1. Group differences on scores of the cartoon task between the schizophrenic patients n20 and controls n20, ANCO- VA, p.05. Score RT s Cartoon Task* 만화과제의수행비교 결 Cartoon Task* 과 Controls n20 Schizophrenics n20 Controls n20 Schizophrenics n20 Fig. 2. Group differences on RT of the Cartoon Task between the schizophrenic patients n20 and controls n20, ANOVA, p.001, RTreaction time. 반응유형분석 정신분열병증상과과제수행의상관 고찰 298

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6 결 중심단어 REFERENCES 1) Ostrum T. The sovereignty of social cognition. Handbook of Social Cognition Hillsdale, NJ: Erlbaum;1984. p ) Corrigan WP, Penn DL. Social Cognition and Schizophrenia. Washington, DC: American Psychological Association;2001. p ) Cutting J, Murphy D. Impaired ability of schizophrenics, relative to manics or depressives, to appreciate social knowledge about their culture. Br J Psychiatry 1990;157: ) Baron-Cohen S, Leslie A, Frith U. Does the autistic child have a Theory of Mind? Cognition 1985;21: ) Frith U. A new look at language and communication in autism. Br J Disord Commun 1989;24: ) Frith U, Happe FG. Autism: beyond theory of mind. Cognition 1994;50: ) Frith CD. Neuropsychology of schizophrenia, what are the implications of intellectual and experiential abnormalities for the neurobiology of schizophrenia? Br Med Bull 1996;52: ) Bellack AS, Morrison RL, Mueser KT. Social problem solving in schizophrenia. Schizophr Bull 1989;15: ) Frith CD. The Cognition Neuropsychology of Schizophrenia. Lawrence Erlbaum, Hove; ) Mazza M, De Risio A, Surian L, Roncone R, Casacchia M. Selective impairments of theory of mind in people with schizophrenia. Schizophr Res 2001;47: ) Corcoran R, Mercer G, Frith CD. Schizophrenia, symptomatology and social inference: investigating theory of mind in people with schizophrenia. Schizophr Res 1995;17: ) Bell M, Bryson G, Lysaker P. Positive and negative affect recognition in schizophrenia: a comparison with substance abuse and normal control subjects. Psychiatry Res 1997;73: ) Penn DL, Combs DR, Ritchie M, Francis J, Cassisi J, Morris S, et al. 론 Emotion recognition in schizophrenia: further investigation of generalized versus specific deficit models. J Abnorm Psychol 2000;109: ) Davis PJ, Gibson MG. Recognition of posed and genuine facial expressions of emotion in paranoid and nonparanoid schizophrenia. J Abnorm Psychol 2000;109: ) 권정혜, 전진수, 최기홍. 사회행동배열과제의개발과타당도연구 : 정신분열병환자의사회인지능력을측정하는가? 한국심리학회지임상 2003;22: ) 이우경, 임영란. 정신분열병환자의사회적도식처리결함에관한연구. 한국심리학회지임상 2001;20: ) Wimmer H, Perner J. Beliefs about beliefs: representation and constraining function of wrong beliefs in young children s understanding of deception. Cognition 1983;13: ) Happe FGE. An advanced test of Theory of Mind: Understanding of story characters thoughts and feelings by able autistic, mentally handicapped, and normal children and adults. J Autism Dev Disord 1994;24: ) Sarfati Y, Hardy-Bayle MC, Brunet E, Widlocher D. Investigating theory of mind in schizophrenia: influence of verbalization in disorganized and non-disorganized patients. Schizophr Res 1999;37: ) 리광철, 오상우, 정일관, 백영석, 박민철. 정신분열증환자의인지결함. 한국심리학회지 2002;21: ) 김성직, 한양순. 만성정신분열증의사회적기능과인지적변인및증상과의관계. 한국심리학회지임상 1997;16: ) Hardy-Bayle MC, Sarfati Y, Olivier V, Besche C, Lefrere F, Passerieux C. Conscience intentionnelle et schizophrenia. Encephale. 1996; 22: ) Abbeduto L, Short-Meyerson K, Benson G, Dolish J. Relationship between theory of mind and language ability in children and adolescents with intellectual disability. J Intellect Disabil Res 2004;48: ) Sarfati Y, Hardy-Bayle MC, Besche C, Widlocher D. Attribution of intentions to others in people with schizophrenia: a non-verbal exploration with comic strips. Schizophr Res 1997;25: ) American Psychologic Association. Diagnostic and Statistical Manual of Mental disorder. 4th ed. Washington DC: American Psychiatric Association; ) First MB, Spitzer RL, Gibbon M, Wiliams JB. Structured Clinical Interview for DSM-IV Axis I Disorder. NY: New York State Psychiatric Institute; ) 염태호, 박영숙, 오경자, 김정규, 이영호. K-WAIS 실시요강. 서울 : 가이던스 ; ) Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13: ) Frith CD, Corcoran R. Exploring theory of mind in people with schizophrenia. Psychol Med 1996;26: ) Pickup GJ, Frith CD. Theory of mind impairments in schizophrenia: symptomatology, severity and specificity. Psychol Med 2001;31: ) Herold R, Tenyi T, Lenard K, Trixler M. Theory of mind deficit in people with schizophrenia during remission. Psychol Med 2002; 32:

7 부 록 만화과제의예 1. 문제 4 번째로올가장적절한카드를선택하시오

8 2. 문제 4 번째로올가장적절한카드를선택하시오

- KEY WORDS 서론

- KEY WORDS 서론 KISEP Original Article 생물정신의학 Vol. 11, No. 2, November 2004 만성정신분열병환자들의인지기능과정서인식능력의관련성 * 황혜리 ** 황태연 ** 이우경 ** 한은선 ** The Relationship between Neurocognitive Functioning and Emotional Recognition in Chronic