Emotion recognition and emotional theory of mind in chronic fatigue syndrome

Abstract

Background: Difficulties with social function have been reported in chronic fatigue syndrome (CFS), but underpinning factors are unknown. Emotion recognition, theory of mind (inference of another's mental state) and ‘emotional’ theory of mind (eToM) (inference of another's emotional state) are important social abilities, facilitating understanding of others. This study examined emotion recognition and eToM in CFS patients and their relationship to self-reported social function.

Methods: CFS patients (n = 45) and healthy controls (HCs; n = 50) completed tasks assessing emotion recognition, basic or advanced eToM (for self and other) and a self-report measure of social function.

Results: CFS participants were poorer than HCs at recognising emotion states in the faces of others and at inferring their own emotions. Lower scores on these tasks were associated with poorer self-reported daily and social function. CFS patients demonstrated good eToM and performance on these tasks did not relate to the level of social function.

Conclusions: CFS patients do not have poor eToM, nor does eToM appear to be associated with social functioning in CFS. However, this group of patients experience difficulties in emotion recognition and inferring emotions in themselves and this may impact upon social function.

Keywords:

• chronic fatigue syndrome
• fatigue social cognition
• theory of mind
• empathy
• emotion
• mentalisation
• social function

Acknowledgements

This work was supported by a grant (ref: PAXKAZK) from the NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London and by the ARIADNE programme (Applied Research into Anorexia Nervosa and Not Otherwise Specified Eating Disorders), funded by a Department of Health NIHR Programme Grant for Applied Research (Reference number RP-PG-0606-1043) to U. Schmidt, J. Treasure, K. Tchanturia, H. Startup, S. Ringwood, S. Landau, M. Grover, I. Eisler, I. Campbell, J. Beecham, M. Allen and G. Wolff. The views expressed herein are not necessarily those of DoH/NIHR. David Hambrook was financially supported by the NIHR Biomedical Research Centre grant. Anna Oldershaw was supported by the Psychiatry Research Trust. The authors would like to thank all of the study participants and the staff within all the NHS Trusts who helped to recruit clinical participants.