Counterfactual thoughts (CFT) are mental representations of alternatives to past events, actions or states. For example, “If only I had studied, I would have passed the exam”).

CFT in healthy subjects is associated with learning, behavioral regulation and planning.

Damage to the prefrontal brain regions has been related to decreased generation and use of CFT. Due to the fact that frontal deficits are documented in patients with schizophrenia, it is expected that these patients could also present impairments in CFT.

The aim of our study was to examine the role of the generation of CFT in schizophrenia patients.

Forty subjects who met DSM-IV criteria for schizophrenia and 40 healthy control participants were recruited. The two groups were matched in age, education, and handedness.

To investigate the generation of CTF we used an adaptation of the task made by Wells, Taylor & Turtle (1987). In this task, we presented to the subjects one history with 4 different scenarios. After the presentation of the history, we asked to the subjects that list alternatives to solve the problem presented in the history.

The schizophrenic patients generated less responses of CTF that controls. The patients obtained a mean of responses of 1.48 (1 SD). The mean for the controls was 2.08 (.971 SD). The control subjects generated significantly more counterfactual responses than schizophrenic patients ([t (78) = −2.670, p = .269]).

Our findings indicate that patients with schizophrenia have impoverished the generation of CFT compared to normal control participants.