Theory of mind deficits in chronically depressed patients

Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, Freiburg im Breisgau, Germany.
Depression and Anxiety (Impact Factor: 4.41). 09/2010; 27(9):821-8. DOI: 10.1002/da.20713
Source: PubMed

ABSTRACT Poor theory of mind (ToM) performance has been found in patients with mood disorders, but it has not been examined in the subgroup of chronic depression where ToM deficits may be even more persistent than in acute depressive episodes. The aim of this study was to compare the ToM performance of chronically depressed patients with a healthy control group and to clarify the relation of ToM to other cognitive functions.
ToM performance was assessed in 30 chronically depressed patients and 30 matched healthy controls by two cartoon picture story tests. In addition, logical memory, alertness, and executive functioning were evaluated.
Chronically depressed patients were markedly impaired in all ToM- and neuropsychological tasks compared to healthy controls. Performance in the different ToM tests was significantly correlated with at least one other cognitive variable. After controlling for logical memory and working memory, no ToM tasks predicted being a patient.
Patients with chronic depression present significant deficits in "reading" social interactions, which may be associated with general cognitive impairments.

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    • "These studies differed in the assessments that were used. Two studies (Wilbertz et al., 2010; Wolkenstein et al., 2011) employed a movie depicting a social interaction to explore theory of mind deficits (Dziobek, Fleck, Kalbe et al., 2006), one study (Zobel et al., 2010) assessed theory of mind using cartoon picture story tests. Another study employed a test that was specifically developed to assess preoperational thinking (Kuhnen et al., 2011). "
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    ABSTRACT: Chronic depression is assumed to be caused and maintained by interpersonal deficits. We describe the development and psychometric evaluation of the Interactive Test of Interpersonal Behavior (ITIB) that we developed for self-assessment of these deficits. Participants with chronic depression (CD, N = 15), episodic depression (ED, N = 15) and healthy controls (HC, N = 15) participated in this pilot study. They completed the ITIB and a number of pen and paper questionnaires including the Lübeck Questionnaire of Preoperational Thinking (LQPT) and the inventory of interpersonal problems (IIP). The ITIB was highly acceptable for use in these participants. Internal consistency for the ITIB was adequate for group comparisons (Cronbach's alpha = 0.649). Item-total correlations indicated adequate discriminatory power of five of the six items. The ITIB correlated moderately with the LQPT (r = 0.524) and the IIP (r = -0.568). The ITIB score differed significantly between the diagnostic groups (ANOVA F(2,42) = 6.22, p = 0.004). It was the only measure that - albeit at a trend level - was associated with diagnostic group (CD vs. ED) on multinomial logistic regression analysis (B = 0.049 ± 0.029; OR 1.051; p = 0.088). We found preliminary evidence that the ITIB is an acceptable and psychometrically adequate measure of interpersonal behavior that distinguishes between patients with CD and patients with ED. If replicated with an improved version of the test, our results could support the hypothesis that having interpersonal problems is a core deficit in patients with CD. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
    Scandinavian Journal of Psychology 05/2015; DOI:10.1111/sjop.12222 · 1.29 Impact Factor
    • "Please cite this article in press as: Jobst A, et al., Effects of social exclusion on emotions and oxytocin and cortisol levels in patients with chronic depression, Journal of Psychiatric Research (2014), show severe interpersonal dysfunction (Zobel et al., 2010), a significant number of early adverse life events (Nemeroff et al., 2003), and a disease course that results in chronic impairment in psychosocial dimensions (Judd et al., 2000). In humans, one function of OT is to maintain and strengthen social bonding (Francis et al., 2000). "
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    • "Our results are also at odds with influential work by McCullough (2000) who has suggested that chronically depressed patients, in particular, have heightened difficulties with perspective taking and empathy due to adverse life experiences causing disrupted socialemotional development. This assertion has shaped psychotherapeutic intervention and recently been empirically tested in two studies contrasting theory of mind (ToM) abilities in chronic depressed patients with healthy controls (Wilbertz et al., 2010; Zobel et al., 2010). Only few studies have specifically investigated the relation between the burden of depressive illness and social cognitive ability (Cusi et al., 2012). "
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    ABSTRACT: a b s t r a c t There is a growing awareness that social cognition is a valuable construct for understanding the psycho-social disabilities in depressive illness. Numerous studies have linked affective disorders to impairments in social cognition and specifically the processing of discrete emotional stimuli. Only few studies have investigated the relation between the burden of depressive illness and social cognitive ability. To study these issues, we compared a group of first-episode depressed patients with a group of chronically depressed patients (duration 42 years) on a broad array of higher-order social cognitive measures including the metacognition assessment scale abbreviated. Contrary to prediction, deficits in social cognition were roughly equivalent between the two groups and there was no significant link between symptom severity and social cognitive ability. Having moderate to severe major depressive disorder (MDD) could be sufficient to predict the presence of deficits in social cognitive ability.
    Psychiatry Research 12/2014; 220(3):883-889. DOI:10.1016/j.psychres.2014.10.005 · 2.47 Impact Factor
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