Psychometric properties of three measures assessing advanced theory of mind: Evidence from people with schizophrenia

Patients with schizophrenia tend to have deficits in advanced Theory of Mind (ToM). The “Reading the mind in the eyes” test (RMET), the Faux Pas Task, and the Strange Stories are commonly used for assessing advanced ToM. However, most of the psychometric properties of these 3 measures in patients with schizophrenia are unknown. The aims of this study were to validate the psychometric properties of the 3 advanced ToM measures in patients with schizophrenia, including: (1) test-retest reliability; (2) random measurement error; (3) practice effect; (4) concurrent validity; and (5) ecological validity. We recruited 53 patients with schizophrenia, who completed the 3 measures twice, 4 weeks apart. The Revised Social Functioning Scale-Taiwan short version (R-SFST) was completed within 3 days of first session of assessments. We found that the intraclass correlation coefficients of the RMET, Strange Stories, and Faux Pas Task were 0.24, 0.5, and 0.76. All 3 advanced ToM measures had large random measurement error, trivial to small practice effects, poor concurrent validity, and low ecological validity. We recommend that the scores of the 3 advanced ToM measures be interpreted with caution because these measures may not provide reliable and valid results on patients' advanced ToM abilities.