General mentalizing, emotional theory of mind and interpersonal mistrust in anorexia nervosa: The validation of the Hebrew version of the Cambridge mindreading face-task

Objective: This study had two goals. The first was to validate and examine the potential of the Hebrew version of the Cambridge Mindreading face task (CAM^Heb)—an ecological measure of emotional theory of mind (eToM)—to assess eToM in individuals with anorexia nervosa (AN). The second goal was to examine whether interpersonal mistrust would mediate the relation between mentalizing and eToM and the severity of AN. Method: The validity of the CAM^Heb was examined using well-established measures of mentalizing ability and eToM in 45 young female patients with AN and 53 control participants. Next, the mediation model was assessed using a subsample of 33 AN patients and 34 controls, in which interpersonal mistrust was additionally assessed. Results: The CAM^Heb correlated with the measures of mentalizing ability and eToM. The CAM^Heb, along with the measure of general mentalizing, significantly differentiated between the AN and control groups. The associations of general mentalizing and CAM^Heb with eating disorder (ED) symptoms were mediated by interpersonal mistrust. Conclusion: The CAM^Heb is a valid measure of deficient eToM in AN. In therapy, an increase in mentalizing ability and accurate eToM may enhance interpersonal trust, which may further contribute to attenuation of AN symptoms.