# The relationship between mental state decoding and real-world social functioning – An experience sampling investigation

## TL;DR

This study explores how the ability to decode mental states relates to real-life social functioning in people with psychosis, their relatives, and controls.

## Contribution

The study uses experience sampling to investigate the link between mental state decoding and real-world social outcomes in psychosis patients and their relatives.

## Key findings

- Patients with psychosis scored lower on mental state decoding compared to controls and relatives.
- Lower mental state decoding scores were associated with greater feelings of social exclusion across all groups.
- Mental state decoding was not significantly linked to other social functioning indicators like interaction frequency or social emotions.

## Abstract

Social cognition, particularly Theory of Mind (ToM), is thought to play a crucial role in social functioning. Patients with psychosis often exhibit ToM deficits, but research findings on associations with social outcomes in daily life remain conflicting.

This study investigated the relationship between mental state decoding, a core aspect of ToM, measured by the Reading the Mind in the Eyes Test (RMET), and quantity and subjective quality of real-life social interactions in patients with psychosis, first-degree relatives, and controls.

A 7-day Experience Sampling Method (ESM) design assessed the number and quality of real-life social interactions, including time spent alone vs. in social company, loneliness, feelings of social exclusion, preferences for company, being alone by choice, enjoyment of solitude, and perceived relationship quality in 27 patients with psychosis, 17 first-degree relatives, and 26 controls. All participants completed the RMET.

Patients scored lower on the RMET compared to both relatives (β = −0.13, p = .006) and controls (β = −0.19, p < .001), suggesting mental state decoding deficits in patients. Relatives did not differ from controls (p = .17), suggesting no association with familial risk. Across groups, lower RMET scores predicted feelings of social exclusion (β = −0.05, p = .02) but there were no significant associations between RMET performance and other aspects of real-life social functioning (all p > .7).

Lower RMET performance was linked to greater feelings of social exclusion across groups but was unrelated to other indicators of real-life social functioning, including social emotions or frequency of social interactions. This finding is in line with other recent ESM studies, and highlights the importance of other, possibly more proximal factors for real-life social functioning.