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Theory of mind and social inference in children and adolescents with bipolar disorder

Published online by Cambridge University Press:  14 January 2008

L. S. Schenkel ,
M. Marlow-O'Connor ,
M. Moss ,
J. A. Sweeney  and
M. N. Pavuluri
L. S. Schenkel*
Affiliation:
Center for Cognitive Medicine and the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
M. Marlow-O'Connor
Affiliation:
Center for Cognitive Medicine and the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
M. Moss
Affiliation:
Center for Cognitive Medicine and the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
J. A. Sweeney
Affiliation:
Center for Cognitive Medicine and the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
M. N. Pavuluri
Affiliation:
Center for Cognitive Medicine and the Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
*
*Address for correspondence: Dr L. S. Schenkel, Rochester Institute of Technology, 92 Lomb Memorial Drive, Rochester, NY, 14623, USA. (Email: lindsay.schenkel@att.net)
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Summary

Background

Deficits in theory of mind (ToM), or the ability to infer what another person is thinking or feeling, have been reported in manic and euthymic adults with bipolar disorder. To date, there have been no investigations of ToM in pediatric bipolar disorder (PBD). The aim of the current study was to investigate this ability in PBD patients and healthy controls.

Method

PBD patients (n=26) and intellectually and demographically similar healthy comparison subjects (n=20) were administered two ToM tasks. In the Affective Story Task, subjects were read positive-, negative- and neutral-valenced stories, and were assessed on their ability to recognize that a misleading series of events could lead one character to develop a false belief about another character. On the Hinting Task, subjects were required to infer the real intentions behind subtle hints.

Results

The PBD group performed significantly more poorly than controls on the Hinting Task and the positive and negative conditions of the Affective Story Task. In the PBD group only, younger age, earlier illness onset and manic symptoms were associated with poorer ToM performance.

Conclusions

Consistent with past findings in adult bipolar disorder (BD), PBD youth performed more poorly than controls on ToM tasks. Data suggest that ToM ability may be more impaired in affectively charged contexts. Additionally, an earlier onset of illness among PBD youth may interfere with the development of social-cognitive skills. ToM disturbances may be a useful treatment target in PBD, with the aim of facilitating more accurate assessment of social cues and better interpersonal functioning.

Keywords

Pediatric bipolar disordersocial cognitionsocial inferencetheory of mind
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 6 , June 2008 , pp. 791 - 800
Copyright
Copyright © Cambridge University Press 2008

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