The Association BetweenMentalizing and Psychopathology: AMeta-Analysis of the Reading theMind in the Eyes Task Across Psychiatric Disorders

The Reading the Mind in the Eyes Task (RMET) is commonly used to assess mentalizing, the capacity to make inferences about mental states. The RMET has been used to examine mentalizing across mental health disorders such as autism, schizophrenia, eating disorders, and schizotypal, borderline, and narcissistic personality disorders. In this meta-analysis, we examine differences in within-disorder associations between mentalizing and clinical correlates as a function of diagnosis to determine the strength of the relationship between mentalizing and dysfunction within these conditions. We analyzed 414 effect sizes from 54 studies including 12 different diagnostic groups. As expected, we found significant associations between total RMET score and clinical correlates in bipolar (r = -.32), psychosis (r = -.30), substance use disorders (r = -.25), autism spectrum disorder (r = -.21), and borderline personality disorder (r = -.21), though not in antisocial personality disorder (r = -.14). The average effect size among putative disorders of mentalizing (r = -.27) exceeded that of other disorders (r = -.09). Our findings suggest mentalizing deficits are implicated in the psychological functioning a range of psychiatric disorders, such as psychosis, autism, and borderline personality disorder. Our results also support using the RMET to predict important clinical manifestation among samples with these diagnostic characteristics.