Mentalization and cognitive skills in men with Klinefelter syndrome versus non-clinical controls

We investigated cognition and mentalization skills, defined as the ability to understand one's own and others' intentions and emotions, in men with Klinefelter Syndrome (KS). The sample was 26 men with KS and 26 non-clinical male controls aged 19–65 years. We measured mentalization with the Reading the Mind in the Eyes Test (RMET) and cognition with neuropsychological tests. The results showed that men with KS had significantly lower scores on the RMET compared to controls. However, the group difference was not significant when controlling for IQ. There were more significant correlations between cognitive domains and mentalization skills in the KS group than for controls. In regression models, cognitive domains explained up to 54% of the variance in mentalization skills for men with KS, compared to 15% for controls. The men with KS struggled particularly with interpreting neutral and negative emotional states relative to the control group. We conclude that men with KS exhibit mentalization difficulties, which are strongly linked to their cognitive abilities, and especially their deficits in verbal learning. Interventions aimed at enhancing language and other neuropsychological functions, as well as mentalization skills, are warranted.