Theory of mind is the ability to infer what another individual is thinking or feeling based on their verbal and/or non-verbal behaviour. It is central to successful social interaction and develops throughout childhood and adolescence. Children with bipolar disorder often have significant impairments in their social and interpersonal functioning but there has been little research into Theory of Mind in this age group. A U.S. study of 46 children compared those with bipolar disorder to those without. In one task the participants were read stories with positive, negative and neutral emotional content and were assessed on their ability to recognize that a misleading series of events could lead one character to develop a false belief about another. In another task the participants were required to infer the real intentions behind subtle hints. The children with bipolar disorder performed significantly more poorly than the controls at picking up hints and on the positive- and negative-story tests. Among the children with bipolar disorder younger age, earlier illnes onset and manic symptoms were all associated with poorer theory-of-mind performance.
Schenkel, L.S. ... [et al] - Theory of mind and social inference in children and adolescents with bipolar disorder Psychological Medicine June 2008, 38(6), 791-800