Department of Psychology, The Pennsylvania State University, University Park, PA 16802, United States.
Department of Psychology, The Pennsylvania State University, University Park, PA 16802, United States.
J Affect Disord. 2018 Feb;227:824-833. doi: 10.1016/j.jad.2017.11.084. Epub 2017 Nov 15.
Theory-of-mind (ToM) is the ability to accurately infer others' thoughts and feelings. In generalized anxiety disorder (GAD), cognitive and emotion regulation theories allude to the plausibility that ToM is conditional on the degree of individuals' state worry, a hallmark symptom. GAD and state worry may interact to predict ToM constructs. However, no experiments have directly tested such interactional hypotheses, and used ToM as a framework to advance understanding of social cognition in GAD. This study therefore aimed to address this gap.
171 participants (69 GAD, 102 Controls) were randomly assigned to either a Worry or Relaxation induction and completed well-validated ToM decoding (Reading the Mind in the Eyes Test) and reasoning (Movie for the Assessment of Social Cognition) tasks.
GAD status significantly interacted with state worry to predict accuracy of overall reasoning, cognitive-reasoning, positive-reasoning, and negative-reasoning ToM. Worry, as opposed to relaxation, led sufferers of GAD to display more accurate overall reasoning and cognitive-reasoning ToM than controls, especially for negative signals. Participants with GAD who worried, but not relaxed, were also significantly better than the norm at interpreting negative signals. These findings remained after controlling for gender, executive function, social anxiety, and depressive symptoms. For other ToM abilities, mean scores of persons with and without GAD who either worried or relaxed were normative.
The ToM reasoning measure lacked self-reference, and these preliminary findings warrant replication.
Theoretical implications, such as the state worry-contingent nature of ToM in GAD, and clinical implications are discussed.
心理理论（ToM）是准确推断他人想法和感受的能力。在广泛性焦虑症（GAD）中，认知和情绪调节理论暗示了 ToM 取决于个体状态焦虑的程度，这是一个标志性症状。GAD 和状态焦虑可能相互作用，从而预测 ToM 结构。但是，尚无实验直接检验这种相互作用假设，并使用 ToM 作为框架来深入了解 GAD 中的社会认知。因此，本研究旨在解决这一差距。
171 名参与者（69 名 GAD，102 名对照组）被随机分配到担忧或放松诱导组，并完成了经过充分验证的 ToM 解码（《读心术测试》）和推理（《社会认知电影评估》）任务。
GAD 状态与状态焦虑显著相互作用，预测整体推理、认知推理、积极推理和消极推理 ToM 的准确性。与放松相比，担忧会导致 GAD 患者的整体推理和认知推理 ToM 比对照组更准确，尤其是对负面信号。与对照组相比，担忧但不放松的 GAD 患者在解释负面信号方面也明显更好。在控制性别、执行功能、社交焦虑和抑郁症状后，这些发现仍然存在。对于其他 ToM 能力，无论是否患有 GAD，无论是担忧还是放松，患者的平均得分均在正常范围内。
ToM 推理测试缺乏自我参照，这些初步发现需要进一步验证。
讨论了理论意义，例如 GAD 中 ToM 的状态焦虑条件性，以及临床意义。
