Mental state decoding abilities in clinical depression

Background: Depression is associated with profound impairments in social functioning. Past research and theory suggests that these impairments may be related to a difficulty in the ability of depressed individuals to identify and decode others' social cues. However, the nature of this difficulty is equivocal. This investigation is the first to adopt a theory-of-mind framework to examine unipolar depressed individuals' ability to identify complex mental states from eye expressions. Methods: Women with unipolar clinical depression (N = 52) and nondepressed controls (N = 30) completed the "Reading the Mind in the Eyes Task" (Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., Plumb, I., 200 1. The "Reading the Mind in the Eyes" test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. J. Child Psychol. Psychiatry, 42, 241-251.). All participants also completed self-report measures assessing depressive and anxious symptoms. Results: Depressed women were significantly impaired in their ability to identify mental states in the Eyes task compared to nondepressed participants. This difference remained after controlling for anxiety and was stronger for the affective than the somatic symptoms of depression. Limitations: The present study was limited by its sample size, resulting in low power for some comparisons. In addition, the study is limited by its use of a heterogeneous depressed sample, including outpatients and volunteers from the community, as well as its use of only female participants. Conclusions: Our results demonstrate that severely depressed individuals are significantly impaired in their ability to decode others' mental states. We suggest that strategies based on improving basic theory-of-mind reasoning could be incorporated into current therapeutic interventions for depressed individuals to ameliorate their understanding and interpretation of social information. (c) 2005 Elsevier B.V All rights reserved.