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Reading the mind in the eyes and cognitive ability in schizophrenia- and autism spectrum disorders

Alvarez, R., Velthorst, E., Pinkham, A. , Ludwig, K. A., Alamansa, J., Gaigg, S. B., Penn, D. L., Harvey, P. D. & Fett, A-K. ORCID: 0000-0003-0282-273X (2023). Reading the mind in the eyes and cognitive ability in schizophrenia- and autism spectrum disorders. Psychological Medicine, 53(16), pp. 7913-7922. doi: 10.1017/s0033291723002052


Schizophrenia (SZ) and autism spectrum disorders (ASD) are characterized by difficulties in theory of mind (ToM). We examined group differences in performance on a ToM-related test and associations with an estimated IQ.

Participants [N = 1227, SZ (n = 563), ASD (n = 159), and controls (n = 505), 32.2% female] completed the Reading the Mind in the Eyes Test (RMET) and assessments of cognitive ability. Associations between IQ and group on RMET were investigated with regression analyses.

SZ (d = 0.73, p < 0.001) and ASD (d = 0.37, p < 0.001) performed significantly worse on the RMET than controls. SZ performed significantly worse than ASD (d = 0.32, p = 0.002). Adding IQ to the model, SZ (d = 0.60, p < 0.001) and ASD (d = 0.44, p < 0.001) continued to perform significantly worse than controls, but no longer differed from each other (d = 0.13, p = 0.30). Small significant negative correlations between symptom severity and RMET performance were found in SZ (PANSS positive: r = −0.10, negative: r = −0.11, both p < 0.05). A small non-significant negative correlation was found for Autism Diagnostic Observation Schedule scores and RMET in ASD (r = −0.08, p = 0.34).

SZ and ASD are characterized by impairments in RMET. IQ contributed significantly to RMET performance and accounted for group differences in RMET between SZ and ASD. This suggests that non-social cognitive ability needs to be included in comparative studies of the two disorders.

Publication Type: Article
Additional Information: This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. Copyright © The Author(s), 2023. Published by Cambridge University Press
Publisher Keywords: Autism spectrum disorder, cognitive ability, reading the mind in the eyes, schizophrenia, social cognition
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Departments: School of Health & Psychological Sciences > Psychology
SWORD Depositor:
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