Association of theory of mind and empathy abilities in adolescents with social anxiety disorder

Studies have shown that elevated empathic abilities and impaired theory of mind (ToM) tasks may be associated with social anxiety disorder (SAD). Adolescence is a critical period for the onset of SAD which may cause impairment in various domains of functioning. We aimed to investigate the association of ToM and empathy characteristics in adolescents diagnosed as having SAD. Forty-one drug-naïve adolescents (between 12 and 18 years), who were diagnosed as having SAD without comorbidities were enrolled in the patient group. Forty adolescents in the same age range without any psychiatric disorders were matched as the healthy control group. The sample was evaluated via the Kiddie and Young Adult Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version. The severity of the SAD symptoms was evaluated using the Social Anxiety Scale for Adolescents. ToM was evaluated with the Reading the Mind in the Eyes Test and emotion recognition was assessed by Faces Test. The KA-SI Empathic Tendency Scale was used to assess empathic abilities. The average age was 14.36 ± 1.41 years in the SAD group and 14.30 ± 1.04 years in the control group. Twenty-eight adolescents were female in the SAD and control groups. SAD and healthy controls did not differ in terms of sociodemographic data. There were higher scores in the KA-SI cognitive and affective empathic subscales (p < .001 in all scales) in the SAD group compared with the healthy controls. Adolescents with SAD have more difficulties both in Reading the Mind in the Eyes Test and Faces Test. The results of this study may indicate that although adolescents with SAD may be impaired in decoding aspects of ToM they may evaluate themselves as more empathic in self-report tests. The discrepancy between objective tests of ToM decoding and subjective reports of empathy may play an important role in the etiology and treatment of SAD in adolescents.