Theory of Mind and Information Processing Speed in Multiple Sclerosis: Associations With Personality Traits

Cognitive impairment, particularly decreased information processing speed (IPS), is a common symptom of multiple sclerosis (MS). Social cognition (SC) is also affected, but it is less studied, and the influence of personality traits on theory of mind (ToM), a key component of SC, and IPS remains unclear. Therefore, this study examined how IPS and ToM are associated with personality traits, demographic factors, and clinical factors in people with MS (PwMS).

This cross-sectional study included 100 PwMS attending a tertiary MS clinic in Isfahan, Iran. Demographic (age, sex, education, employment, marital status) and clinical data (disease type, duration, disability, and treatment) were collected. Personality traits were evaluated using the NEO Five-Factor Inventory (FFI), ToM using the Reading the Mind in the Eyes Test (RMET), and IPS using the Symbol Digit Modalities Test (SDMT). Spearman correlations and linear regression analysis were used to examine associations.

The SDMT was correlated positively with the RMET (r = 0.35, p < 0.001) and Conscientiousness (r = 0.31, p = 0.001) and negatively with Expanded Disability Status Scale (EDSS) (r = -0.33, p < 0.001). The RMET was correlated with Extraversion (r = 0.31, p = 0.002), Agreeableness (r = 0.31, p = 0.002), Conscientiousness (r = 0.35, p < 0.001), and Openness (r = 0.40, p < 0.001). In multivariate regression analyses, the SDMT was associated with higher RMET (B = 0.37, p = 0.009) and lower EDSS (B = -1.98, p = 0.004). The RMET was associated with Openness (B = 0.43, p < 0.001), Agreeableness (B = 0.17, p = 0.020), and Conscientiousness (B = 0.18, p = 0.006).

ToM was associated with personality traits, while IPS was associated with ToM performance and disability. Taken together, these cross-sectional associations suggest that cognitive functioning in MS may relate to both brain- and person-related factors.