Theory of Mind in Adolescents with Bipolar Disorder in Euthymic Phase: Using the Strange Stories Test
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Abstract
Objective: This study evaluated the theory of mind (ToM) in adolescents diagnosed with bipolar disorder (BD) during their euthymic period compared to a typically developing (TD) group.
Method: The BD group consisted of thirty 11-18 year old inpatients in euthymic phase. The TD group included 30 age, gender, and IQ matched volunteer students. To assess the diagnosis and comorbid disorders, we performed the semi-structured interview of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) for the BD adolescents. To evaluate the severity of attention deficit hyperactivity disorder (ADHD) and mania, Conner's Parent Rating Scale-Revised version (CPRS-R), and Young Mania Rating Scale (YMRS) were used, respectively. Ravens Progressive Matrices was conducted to evaluate intellectual ability in the both groups. Happe Strange Stories test was performed to assess ToM in the participants. Data were analyzed using the independent t-test, analysis of covariance, and Pearson Correlation analysis.
Results: The two groups did not show any differences in comprehending the stories; however, the BD group’s mentalizing scores were significantly weaker than the TD group (p<0.05).
Conclusion: The ToM impairments in adolescents with BD may be explained as a trait marker which may lead to continuation of social problems even during remission.
Merikangas KR, Pato M. Recent developments in the epidemiology of Bipolar disorder in adults and children: Magnitude, correlates, and future directions. Clinical Psychology: Science and Practice. 2009; 16:121-133.
Lewinsohn PM, Seeley JR, Buckley ME, Klein DN. Bipolar disorder in adolescence and young adulthood. Child and adolescent psychiatric clinics of North America 2002; 11: 461-475, vii.
Jerrell JM, Shugart MA. Community-based care for youths with early and very-early onset bipolar I disorder. Bipolar Disord 2004; 6: 299-304.
Brissos S, Dias VV, Carita AI, Martinez-Arán A. Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates. Psychiatry Research 2008; 160: 55-62.
Duax JM, Youngstrom EA, Calabrese JR, Findling RL. Sex differences in pediatric bipolar disorder. The Journal of Clinical Psychiatry 2007; 68: 1565-1573.
Dickerson FB, Sommerville J, Origoni AE, Ringel NB, Parente F. Outpatients with schizophrenia and bipolar I disorder: Do they differ in their cognitive and social functioning? Psychiatry Res 2001; 102: 21-27.
Jamrozinski K. Do euthymic bipolar patients have normal cognitive functioning? Current Opinion in Psychiatry 2010; 23: 255-260.
Brotman MA, Guyer AE, Lawson ES, Horsey SE, Rich BA, Dickstein DP, et al. Facial emotion labeling deficits in children and adolescents at risk for bipolar disorder. The AmericanJournal of Psychiatry 2008; 165: 385-389.
Green MJ, Cahill CM, Malhi GS. The cognitive and neurophysiological basis of emotion dysregulation in bipolar disorder. Journal of Affective Disorders 2007; 103: 29-42.
Premack D, Woodruff G. Does the chimpanzee have a theory of mind? Behavioral and Brain Sciences 1978; 1: 515-526.
Baron-Cohen S, Wheelwright S, Hill J, Raste Y, Plumb I. The "Reading the Mind in the Eyes" Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, and Allied Disciplines 2001; 42: 241-251.
Baron-Cohen S, Belmonte MK. Autism: a window onto the development of the social and the analytic brain. Annu. Rev. Neurosci. 2005; 28: 109-126.
Rocca CC, Heuvel E, Caetano SC, Lafer B. Facial emotion recognition in bipolar disorder: a critical review. Revista brasileira de psiquiatria (Sao Paulo, Brazil: 1999) 2009; 31: 171-180.
Kerr N, Dunbar RI, Bentall RP. Theory of mind deficits in bipolar affective disorder. Journal of Affective Disorders 2003; 73: 253-259.
Montag C, Ehrlich A, Neuhaus K, Dziobek I, Heekeren HR, Heinz A, et al. Theory of mind impairments in euthymic bipolar patients. Journal of Affective Disorders 2010; 123: 264-269.
Olley AL, Malhi GS, Bachelor J, Cahill CM, Mitchell PB, Berk M. Executive functioning and theory of mind in euthymic bipolar disorder. Bipolar Disord 2005; 7 Suppl 5: 43-52.
Bora E, Vahip S, Gonul A, Akdeniz F, Alkan M, Ogut M, et al. Evidence for theory of mind deficits in euthymic patients with bipolar disorder. Acta psychiatrica Scandinavica 2005; 112: 110-116.
Wolf F, Brune M, Assion HJ. Theory of mind and neurocognitive functioning in patients with bipolar disorder. Bipolar Disord 2010; 12: 657-666.
Bora E, Berk M. Theory of mind in major depressive disorder: A meta-analysis. Journal of Affective Disorders 2016; 191: 49-55.
Birmaher B, Axelson D. Course and outcome of bipolar spectrum disorder in children and adolescents: a review of the existing literature. Dev Psychopathol 2006; 18: 1023-1035.
Goldstein TR, Birmaher B, Axelson D, Goldstein BI, Gill MK, Esposito-Smythers C, et al. Psychosocial functioning among bipolar youth. Journal of Affective Disorders 2009; 114: 174-183.
Pine DS, Guyer AE, Goldwin M, Towbin KA, Leibenluft E. Autism spectrum disorder scale scores in pediatric mood and anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry 2008; 47: 652-661.
Birmaher B, Axelson D, Goldstein B, Monk K, Kalas C, Obreja M, et al. Psychiatric disorders in preschool offspring of parents with bipolar disorder: the Pittsburgh Bipolar Offspring Study (BIOS). The American Journal of Psychiatry 2010; 167: 321-330.
Whitney J, Howe M, Shoemaker V, Li S, Marie Sanders E, Dijamco C, et al. Socio-emotional processing and functioning of youth at high risk for bipolar disorder. Journal of Affective Disorders 2013; 148: 112-117.
Correll CU, Penzner JB, Frederickson AM, Richter JJ, Auther AM, Smith CW, et al. Differentiation in the preonset phases of schizophrenia and mood disorders: evidence in support of a bipolar mania prodrome. Schizophrenia Bulletin 2007; 33: 703-714.
Schenkel LS, Marlow-O'Connor M, Moss M, Sweeney JA, Pavuluri MN. Theory of mind and social inference in children and adolescents with bipolar disorder. Psychol Med 2008; 38: 791-800.
Schenkel LS, Chamberlain TF, Towne TL. Impaired theory of mind and psychosocial functioning among pediatric patients with type I versus type II bipolar disorder. Psychiatry Research 2014; 215: 740-746.
White S, Hill E, Happe F, Frith U. Revisiting the strange stories: revealing mentalizing impairments in autism. Child Development 2009; 80: 1097-1117.
Shahrivar Z, Tehrani Doost M. Evaluation of undrestanding others’s mental states in primary school children using the “Happe strange stories” and assessment of its psychometric properties, (a research report) 2015.
Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry 1997; 36: 980-988.
Shahrivar Z, Kousha M, Moallemi S, Tehrani‐Doost M, Alaghband‐Rad J. The Reliability and Validity of Kiddie‐Schedule for Affective Disorders and Schizophrenia‐Present and Life‐time Version‐Persian Version. Child and Adolescent Mental Health 2010; 15: 97-102.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. The British journal of Psychiatry 1978; 133: 429-435.
Shafiee K, Barakatain M, Bashardoost N, Mahmoodi- gharaei J. Comparison of clinical response rate in patients with acute mania while prescribing oral sodium valproate using loading and gradual titration methods. Journal of Research in Medical Sciences. 2003; 8:25-29.
Conners CK, Sitarenios G, Parker JD, Epstein JN. The revised Conners' Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. Journal of Abnormal Child Psychology 1998; 26: 257-268.
Rahmani J. The reliability, validity & normalization of Raven's progressive matrics test among the students of Azad Khorasgan University. Journal of Knowledge and Research in Psychology. 2008; 34:61-74.
Phillips ML, Ladouceur CD, Drevets WC. A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder. Molecular Psychiatry 2008; 13: 829, 833-857.
Green MJ, Cahill CM, Malhi GS. The cognitive and neurophysiological basis of emotion dysregulation in bipolar disorder. Journal of Affective Disorders 2007; 103: 29-42.
Blair RJ. Neurobiological basis of psychopathy. British journal of psychiatry: 2003; 182: 5-7.
Rolls ET. The functions of the orbitofrontal cortex. Brain and Cognition 2004; 55: 11-29.
Judd LL, Akiskal HS, Schettler PJ, Endicott J, Leon AC, Solomon DA, et al. Psychosocial disability in the course of bipolar I and II disorders: a prospective, comparative, longitudinal study. Archives of General Psychiatry 2005; 62: 1322-1330.
Whitney J, Howe M, Shoemaker V, Li S, Marie Sanders E, Dijamco C, et al. Socio-emotional processing and functioning of youth at high risk for bipolar disorder. Journal of Affective Disorders 2013; 148: 112-117.
Charlton RA, Barrick TR, Markus HS, Morris RG. Theory of mind associations with other cognitive functions and brain imaging in normal aging. Psychology and Aging 2009; 24: 338-348.
Mahlberg R, Adli M, Bschor T, Kienast T. Age effects on Trail Making Test during acute depressive and manic episode. The International Journal of Neuroscience 2008; 118: 1347-1356.
Buitelaar JK, Van der Wees M, SWAAB–BARNEVELD H, Van der Gaag RJ. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. Development and Psychopathology 1999; 11: 39-58.
O'Hare AE, Bremner L, Nash M, Happe F, Pettigrew LM. A clinical assessment tool for advanced theory of mind performance in 5 to 12 year olds. Journal of Autism and Developmental Disorders 2009; 39: 916-928.
| Files | ||
| Issue | Vol 11 No 3 (2016) | |
| Section | Original Article(s) | |
| Keywords | ||
| Adolescents Bipolar Disorder Social Cognition Theory of Mind | ||
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