Vol. 72, No. 3 (Summer 2008) 191 Salvatore et al. Mindreading deficits and schizophrenia Deficits in mindreading in stressful contexts and their relationships to social withdrawal in schizophrenia Giampaolo Salvatore, MD Giancarlo Dimaggio, MD Raffaele Popolo, MD Paul H. Lysaker, PhD Patients with schizophrenia are commonly observed to socially withdraw and also to have difficulty forming representations of what other people feel, think, and intend. Yet it is unclear whether these two dysfunctions are related to one another. To address this issue, the authors offer two case analyses and hypothesize that difficulties knowing the thoughts and feelings of others are correlated with un- pleasant emotional arousal, are more intense during certain interper- sonal interactions, and can generate social withdrawal. (Bulletin of the Menninger Clinic, 72[3], 191-209) Social withdrawal is frequently observed in patients with psychi- atric and/or neurocognitive diseases, including patients with severe mood disorder (Kaya, Aydemir, & Selcuki, 2007), personality dis- orders (Millon, 1996; Sperry, 1995) and Parkinson’s disease (Win- ograd-Gurvich, Fitzgerald, Georgiou-Karistianis, Bradshaw, & White, 2006). Social withdrawal is particularly common in schizo- phrenia (Blanchard, Horan, & Brown, 2001; Blanchard, Mueser, & Bellack, 1998; Costello, 1993; Falloon & Marshall, 1983; Ke- mali, May, Ariano, Arena, & Lovero, 1985), and especially in schizophrenia patients presenting with other negative symptoms (Salvatore, Dimaggio, & Lysaker, 2007; Velligan et al., 1997). Dr.s Salvatore, Dimaggio, and Popolo are with the Third Center for Cognitive Psycho- therapy, Training School in Psychotherapy, Rome, Italy. Paul H. Lysaker, PhD is with the Roudebush VA Medical Center and the Indiana University School of Medicine Indianapolis, Indiana. Correspondence may be sent to Dr. Lysaker at the Roudebush VA Medical Center, 1481 West 10th Street, Indianapolis, IN 46202; E-mail: plysaker@iupui.edu. (Copy- right © 2008 The Menninger Foundation)