Relations among Measures of Theory of Mind in Depressed Adolescents Receiving Cognitive Behavior Therapy

Abstract

Adolescent depression is associated with cognitive and social impairments, including deficits in Theory of Mind (ToM) — the ability to infer others' thoughts and emotions. Cognitive Behavior Therapy (CBT) is a generally effective treatment although further improvements can be made. This study examined the associations among measures of ToM in depressed adolescents and tested whether integrating social cognitive training (CBT+SCT) into CBT enhanced treatment outcomes compared to CBT alone. Forty-five depressed adolescents (ages 12-17) were randomly assigned to CBT+SCT or CBT-only. ToM was assessed using four measures: Faux Pas Recognition Test, Strange Stories, Flexibility and Automaticity of Social Cognition (FASC), and Reading the Mind in the Eyes (RME) tests. Results showed that at baseline, the RME task correlated significantly with FASC Mental State Response Time. Results of the regression analyses showed that CBT+SCT produced significantly greater improvements in ToM particularly in recognizing social faux pas. These effects were strongest in adolescents with lower baseline ToM scores, suggesting that social cognitive training may enhance CBT effectiveness for those with significant ToM deficits. Findings highlight the need for individualized treatment approaches that account for individuals’ levels of social cognitive development. Future research should explore the long-term effects of ToM training on depression and interpersonal functioning.