Validation of the Arabic version of the “Cognitive Theory of Mind (ToM-15) scale” among Lebanese patients with schizophrenia

Schizophrenia is characterized by cognitive and social impairments, including deficiencies in Theory of Mind (ToM). Although numerous ToM assessment instruments are available, none have been validated for Lebanese Arabic-speaking individuals with schizophrenia. This study aimed to translate and validate the Arabic version of the Cognitive Theory of Mind Scale (ToM-15). A cross-sectional study was performed at the Psychiatric Hospital of the Cross in Lebanon from March to June 2025. The sample consisted of 75 clinically stable in-patients diagnosed with schizophrenia and 50 healthy participants. Participants administered the Arabic ToM-15 in conjunction with other validated instruments evaluating social and cognitive functioning. Patients with schizophrenia exhibited significantly lower scores on all ToM-15 assessments compared to healthy participants (Total ToM-15 score: 18.94 ± 0.65 vs. 27.11 ± 0.85; p < 0.001). The Arabic ToM-15 demonstrated a good internal consistency (Cronbach's α = 0.817) and a five-factor structure accounting for 51.8% of the variance (KMO = 0.430; Bartlett's test <0.001). A positive correlation was identified between the total score of the ToM-15 and its subscales ( r = 0.929 and r = 0.737; p ≤ 0.001). A negative correlation was identified between ToM-15 total scores and cognitive complaint scores ( r = −0.266, p < 0.05), while no correlation was detected with social cognitive complaint and empathy. The Arabic ToM-15 demonstrates acceptable reliability and preliminary evidence of validity for evaluating cognitive Theory of Mind in patients with schizophrenia. Further studies with larger and more diverse samples is required to support these findings.