Sense of agency and mentalizing: Dissociation of subdomains of social cognition in patients with schizophrenia

The sense of agency, i.e., the sense that “I am the one who is causing an action”, and mentalizing, the ability to understand the mental states of other individuals, are key domains of social cognition. It has been hypothesized that an intact sense of agency is an important precondition for higher-level mentalizing abilities. A substantial body of evidence shows that both processes rely on similar brain areas and are severely impaired in schizophrenia, suggesting a close link between agency and mentalizing. Yet this relationship has not been explicitly tested. We investigated 40 individuals with schizophrenia and 40 healthy controls on an agency and mentalizing task. On the agency task, participants carried out simple mouse movements and judged the partially manipulated visual feedback as either self- or other-generated. On the mentalizing task, participants inferred mental states from pictures that depicted others' eyes (“Reading the mind in the eyes test”). Neuropsychological, psychopathological and social functioning levels were also evaluated. Both sense of agency and mentalizing were impaired in schizophrenia patients compared to healthy controls. However, testing for a relationship revealed no significant correlations between the two processes, either in the schizophrenia or the control group. The present findings demonstrate a dissociation of agency and mentalizing deficits in schizophrenia, suggesting that the multifaceted construct of social cognition consists of independent subdomains in healthy and psychiatrically ill individuals.