Academic journal article International Journal of Clinical and Health Psychology

Emotional Theory of Mind in Eating Disorders1

Academic journal article International Journal of Clinical and Health Psychology

Emotional Theory of Mind in Eating Disorders1

Article excerpt

ABSTRACT. The general aim of this ex post facto study was to investigate the emotional component of theory of mind (eToM) in a sample of 97 female patients with eating disorders (ED), considering all the diagnostic subtypes. Empirical research on this matter in ED is limited, specially focused on anorexia nervosa (AN), and results have been contradictory. The Reading the Mind in the Eyes test was administered to the patients and to 39 healthy controls. The emotional valence of the items was also examined. Patients with bulimia nervosa (BN) and ED-not otherwise specified (EDNOS) showed a poorer eToM ability compared to controls, especially in relation to positive emotions and non-emotional cognitive states. AN patients showed no differences in relation to controls. These results suggest that BN and EDNOS may show a specific pattern of difficulties inferring complex emotions, while AN patients would have no relevant difficulties in this regard. These deficits may need to be targeted in psychological treatment.

KEYWORDS. Theory of mind. Anorexia. Bulimia. Social cognition. Ex post facto study.

RESUMEN. El objetivo general del presente estudio ex post facto fue investigar el componente emocional de la teoría de la mente (eToM) en una muestra de 97 mujeres con trastornos de la conducta alimentaria (TCA), considerando todos los subtipos diagnósticos. La investigación empírica realizada a este respecto en los TCA es limitada, enfocada especialmente en anorexia nerviosa (AN), y los resultados encontrados han sido contradictorios. Se administró el 'Test de los Ojos' a las pacientes y a 39 controles sanos. La valencia emocional de los ítems también se examinó. Las pacientes con bulimia nerviosa (BN) y TCA no especificado (TCANE) mostraron una peor habilidad en eToM que las controles, especialmente en relación a las emociones positivas y a los estados cognitivos no emocionales. No se encontraron diferencias entre las pacientes con AN y el grupo control. Los resultados sugieren que las pacientes con BN y TCANE podrían mostrar un patrón específico de dificultades a la hora de inferir emociones complejas en los otros, mientras el grupo de AN no presentaría ninguna dificultad relevante. Estos déficits necesitarían ser tenidos en cuenta en el tratamiento psicológico.

PALABRAS CLAVE. Teoría de la mente. Anorexia. Bulimia. Cognición social. Estudio ex post facto.

Human social cognition refers to those psychological processes that allow us to make inferences about what is going on inside other people's mind -their intentions, emotions, and beliefs (Adolphs, 2009). The ability to judge the own and other people's mental states is referred to as «theory of mind» (ToM) (Leslie, 1987; Premack and Woodruff, 1978). The most extensive ToM studies have been carried out in the field of autism and developmental disorders, brain damage, and schizophrenia. Recently, these studies have been extended to other mental disorders (Brüne and Brüne-Cohrs, 2006; Uekermann and Daum, 2008) and normal aging (Happé, Winner, and Brownell, 1998; Maylor, Moulson, Munces, and Taylor, 2002). Altogether, the literature suggests that impairments of ToM probably have multiple causes and are not specific to a single disorder or psychopathological aspect.

Two major components of ToM have been described (Tager-Flusberg and Sullivan, 2000). On the one hand, the «social-affective» component -emotional ToM (eToM) involves the ability to decode others' mental states according to immediately available observable information. On the other, the «social-cognitive» component -cognitive ToM (cToM), involves the ability to reason about mental states with the aim of explaining or predicting the actions of others. Both eToM and cToM involve inferring complex mental states and are based on a brain circuitry involving frontal and temporal lobes (Platek, Keenan, Gallup, and Mohamed, 2004).

ToM, especially eToM, is considered crucial in social relationships (Couture, Penn, and Roberts, 2006), as it is essential for guiding the own behaviour and regulating the own emotional states in the social context (Roncone et al. …

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