Theory of Mind Deficit in Subjects with Alcohol Use Disorder: An Analysis of Mindreading Processes

Aim: The aim of the study was to investigate multidimensional Theory of Mind (ToM) abilities in subjects with alcohol use disorder (AUD). Method: A semi-structured interview and a set of brief stories were used to investigate different components of the participants' ToM, namely first- vs. third-person, egocentric vs. allocentric, first- vs. second-order ToM in 22 persons with AUD plus an equal number of healthy controls. Participants were administered the Theory of Mind Assessment Scale (Th.o.m.a.s., Bosco et al., 2009a) and the Strange Stories test ( Happ, et al., 1999). Results: Persons with AUD performed worse than controls at all ToM dimensions. The patterns of differences between groups varied according to the Th.o.m.a.s. dimension investigated. In particular persons with AUD performed worse at third-person than at first-person ToM, and at the allocentric than at the egocentric perspective. Conclusion: These findings support the hypothesis that the ability to understand and ascribe mental states is impaired in AUD. Future studies should focus on the relevance of the different ToM impairments as predictors of treatment outcome in alcoholism, and on the possibility that rehabilitative interventions may be diversified according to ToM assessment.