Mental State Decoding in Adolescent Boys with Major Depressive Disorder versus Sex-Matched Healthy Controls

Abstract

Background: Several adult depression studies have investigated mental state decoding, the basis for theory of mind, using the Reading the Mind in the Eyes Test. Findings have been mixed, but a comprehensive study found a greater severity of depression to be associated with poorer mental state decoding. Importantly, there has yet to be a similar study of adolescent depression. Converging evidence suggests that atypical mental state decoding may have particularly profound effects for psychosocial functioning among depressed adolescent boys. Sampling and Methods: Adolescent boys with major depressive disorder (MDD, n = 33) and sex-matched healthy controls (HCs, n = 84) completed structured clinical interviews, self-report measures of psychopathology and the Child Eyes Test (CET). Results: The MDD group performed significantly better than HCs on the CET overall (p = 0.002), underscored by greater accuracy for negatively valenced items (p = 0.003). Group differences on items depicting positive (p = 0.129) and neutral mental states (p = 0.081) were nonsignificant. Conclusions: Enhanced mental state decoding among depressed adolescent boys may play a role in the maintenance of and vulnerability to adolescent depression. Findings and implications are discussed. Limitations of this study include a reliance on self-report data for HC boys, as well as a lack of ‘pure' depression among the boys with MDD.

Theory of Mind in Depressive Disorders: A Review of the Literature

“…Enhanced mental state decoding was reported in a recent study [39] among depressed adolescent boys on the Child Eyes Test [40], an adapted version of the RMET, compared to sex-matched healthy controls. The MDD group performed significantly better than the control group on the whole, but specifically they were more accurate than the controls at identifying negatively valenced items.…”

“…On the other hand, a number of studies have not reported significant between-group differences between MDD patients and healthy controls [42,53,55,57,58] or found minimal differences [35]. Adolescent boys with MDD were actually found to be better at mental state decoding than healthy adolescent boys [39]. It should be noted that the number of participants in several of these studies has been rather small [35,42,45,53,55,57,58,68].…”

Social cognition in first episode adolescent depression and its correlation with clinical features and quality of life

“…The only study conducted so far in adolescent MDD about mental state decoding reported that adolescent boys with MDD performed significantly better than healthy controls (Mellick & Sharp, 2016). But this study differs from majority of findings in adults and adolescents (Lenti et al, 2000).…”

“…However adult studies are pointing mostly to possible deficits in all three orders of the social cognitive functioning in MDD (Bora & Berk, 2016), child and adolescent studies have found conflicting results. Among the limited number of studies investigating social cognition in adolescents' depression, while Mellick et al found enhanced mental state decoding among adolescent boys with depression (Mellick & Sharp, 2016), in two other studies examining the recognition of facial expressions, Schepman et al reported no overall or specific deficits in facial expression recognition (Schepman et al, 2012) and Lenti et al reported failure to recognize negative-aroused facial expressions in children and adolescents with depression (Lenti et al, 2000).…”

Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder

“…Of the few studies directly comparing ToM performance across diagnostic groups, most were limited to a comparison between two groups. For example, Purcell et al (2013) found comparable ToM impairments between remitted BD and MDD patients, while a number of other studies did not find significant ToM impairment in MDD patients (Bazin et al, 2009;Berecz et al, 2016;Mellick and Sharp, 2016;Wilbertz et al, 2010), even a better ToM performance was found in depressed adolescent boys (Mellick and Sharp, 2016) and woman with a maternal history of depression (Harkness et al, 2011). Similarly, previous studies comparing ToM performance in SCZ with BD patients suggested that SCZ patients might be more impaired in ToM than BD patients (Caletti et al, 2013;Guastella et al, 2013;Lahera et al, 2015) while some studies reported similar extent of ToM impairment in these two groups of patients (Donohoe et al, 2012;Thaler et al, 2013) .…”