Theory of Mind in Multiple Sclerosis: Disease Subtype Differences and Association with Measures of Social Functioning
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Abstract
Theory of mind (ToM) allows a person to make inferences about the mental and emotional states of others. Generally, people with multiple sclerosis (MS) perform more poorly on ToM tests than neurologically intact controls. However, no study has compared ToM abilities between MS subtypes. The present study investigated three hypotheses. First, that secondary-progressive MS (SPMS) patients would perform worse on ToM tasks than relapsing-remitting MS (RRMS) patients and controls, and that RRMS patients would perform worse than controls. Second, that SPMS patients would report poorer social functioning than RRMS patients and controls and that RRMS patients would report more impairment than controls. Finally, within MS patients, we hypothesized that poorer performance on ToM tasks would be associated with poorer perceived social functioning in the areas of social support, social abilities, and loneliness. People with RRMS (n = 34), SPMS (n = 32), and controls (n=31) were recruited; MS diagnosis was confirmed by patients’ neurologists. The Social Perceptions Total (SPT) and SP Pairs (SPP) subtests of the Advanced Clinical Solutions battery and the Reading the Mind in the Eyes test (RME) were used to measure ToM. In addition, the Medical Outcomes Study Modified Social Support Survey, Tromsø Social Intelligence Scale, and the UCLA Loneliness Scale Version 3 were used for the second and third hypothesis. The first hypotheses was partially supported; groups (RRMS, SPMS, and controls) differed significantly on two of the three primary ToM outcome variables. SPMS patients performed significantly worse on the SPT and SPP than the other two groups. There were no significant differences between groups on the RME. The second and third hypotheses were not supported. This was the first study to compare ToM abilities between MS subtypes. People with SPMS performed significantly worse than people with RRMS and controls. More research is needed to understand the real-world implications of these findings in the lives of patients with SPMS. In addition, self-reported social functioning abilities were not associated with objective performance on ToM tests, and clinicians of MS patients may wish to implement broader means to assess social functioning in their patients.
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Introduction -- Methodology -- Results -- Discussion -- Appendix A. List of neuropsychological tests administered -- Appendix B. List of questionnaires administered
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Ph.D.