Perspective taking as a transdiagnostic risk factor for interpersonal dysfunction

Numerous psychiatric populations have demonstrated reduced tendency to adopt others' perspectives relative to those without psychiatric illness; yet, the clinical implications of these deficits remain unclear. We examined whether impairments in perspective-taking are prospectively associated with symptom severity and functional outcomes in an acute psychiatric sample. We hypothesized that poorer perspective-taking would prospectively predict more severe depressive symptoms, functional impairment, and relationship problems.

Participants were 421 adults seeking psychiatric treatment at a partial hospital program. Participants completed the following self-report questionnaires at admission and discharge: Interpersonal Reactivity Index, Patient Health Questionnaire, Work and Social Adjustment Scale, and Behavior and Symptom Identification Scale. We conducted cross-lagged panel models to estimate directional effects.

Consistent with hypotheses, more frequent perspective-taking was significantly and prospectively associated with less overall functional impairment (β = -0.08, p = 0.04) and fewer relationship problems (β = -0.11, p = 0.02). When modelled together, perspective-taking remained a significant and bidirectional predictor of relationship problems, but not overall functional impairment. Inconsistent with hypotheses, perspective-taking did not prospectively predict depressive symptoms.

Results suggest that perspective-taking deficits are uniquely associated with relationship problems among adults with severe mental illness and highlight a potential target for future intervention.