Theory of mind performance in depression: A meta-analysis

Background: Theory of mind (ToM) is a social-cognitive skill that involves the ability to understand the thoughts and feelings of others. Evidence is mixed regarding the extent of ToM ability in individuals with depression.

Methods: We conducted a meta-analysis of 43 studies to investigate the strength of the association between ToM and depression.

Results: Results indicated significant, small- to moderate impairment in ToM with a medium overall effect size (g = -0.398) in individuals with depression. Moderator analyses compared effect sizes across groups for the following variables: ToM content, process, and sample type. Additionally, meta-regression analyses tested age and gender as continuous moderators.

Limitations: The cross-sectional nature of included studies limits this meta-analysis from clarifying temporal or bidirectional relations.

Conclusions: We discuss findings in the context of the extant developmental, cognitive, social, and clinical literatures. We also suggest several possible explanations for these findings and offer implications for intervention.