Examination of attachment patterns, theory of mind functions andmothers' theory of mind functions in adolescents with social anxiety disorder

Examınatıon Of Attachment Patterns, Theory Of Mınd Functıons and Mothers' Theory Of Mınd Functıons In Adolescents Wıth Socıal Anxıety Dısorder Objective: This study aims to examine attachment patterns, theory of mind (ToM) functions of adolescents with social anxiety disorder (SAD) and their mothers. Given the high prevalence of SAD among adolescents and its significant impact on social functionality, this research investigates the effects of attachment styles and ToM skills on the development of SAD. The objective is to better understand how these factors contribute to SAD development and influence the clinical presentation of SAD. Method: The study was conducted with a comparative sample of adolescents diagnosed with SAD (n=30) and a healthy control group (n=30). Sociodemographic data, ToM functions, and attachment patterns were evaluated using various scales: the Reading the Mind in the Eyes Test, the Hinting Test, and the Relationship Scales Questionnaire were used to measure ToM skills and attachment styles in adolescents. Additionally, the ToM skills of mothers were also analyzed. Statistical analyses included the Kolmogorov-Smirnov test, independent samples t-test, Mann-Whitney U test, and logistic regression analysis. Results: - Adolescents with SAD had significantly lower secure attachment scores compared to the healthy group (p<0.001), whereas their fearful (p<0.001), dismissing (p=0.003), and preoccupied attachment scores were significantly higher (p<0.001). - The effect of preoccupied attachment score on SAD severity was found to be significant, with an increased likelihood of developing SAD by 4.56 times as the score increased (p=0.002, OR=4.56). - The dismissing attachment score also showed a significant effect on the development of SAD, with an increased likelihood of 3.015 times as the score increased (p=0.048, OR=3.015). - The ToM scores of the SAD group were lower than those of the healthy group, with significant differences in the Hinting Test (p<0.001), the Eyes Test (p<0.001), and mothers' ToM skills (p<0.001). Conclusion: This study demonstrates that insecure attachment and lower ToM functions are significant risk factors in adolescents diagnosed with SAD. The development and severity of SAD were particularly associated with preoccupied and dismissing attachment styles. Low ToM skills in mothers were also found to be potentially related to social anxiety disorder in adolescents. These results emphasize the importance of therapeutic interventions focusing on improving attachment styles and ToM skills in the treatment of SAD. Keywords: Theory of mind, Social anxiety disorder, Attachment theory, Reading the mind in the eyes test, Hinting test