How Individual and Situational Factors Influence Measures of Affective and Cognitive Theory of Mind in Psychiatric Inpatients

Mental disorders are associated with difficulties to correctly infer the mental states of other's (theory of mind; ToM). These inferences either relate to affective states of others (affective ToM) or to their thoughts, intentions, or beliefs (cognitive ToM) and can be associated with mental disorder. The current study explores the influence of individual and situational effects on the measurement of ToM abilities within two clinical samples, to increase generalizability. We analyzed data from 229 in-patients; 103 patients treated for alcohol use disorder and 126 patients treated for a personality disorder. ToM was assessed with the Movie for the Assessment of Social Cognition (MASC). We analyzed changes in test performance over the course of the test using a logistic linear mixed effects model. Performance on the cognitive ToM items decreased over time, while performance on the affective ToM items increased over time. This difference was more pronounced among older individuals. The results show important moderators of ToM performance that might help to resolve inconsistencies in the current literature about ToM abilities in different clinical or age groups.