Theory of mind in epilepsy.

Epilepsy is characterized by recurrent, chronic, and unprovoked seizures. Epilepsy has a significant negative impact on a patient's quality of life even if seizures are well controlled. In addition to the distress caused by seizures, patients with epilepsy (PwE) may suffer from cognitive impairment with serious social consequences such as poor interpersonal relationships, loss of employment, and reduced social networks. Pathological changes and functional connectivity abnormalities observed in PwE can disrupt the neural network responsible for the theory of mind. Theory of mind is the ability to attribute mental states to other people (intentions, beliefs, and emotions). It is a complex aspect of social cognition and includes cognitive and affective constructs. In recent years, numerous studies have assessed the relationship between social cognition, including the theory of mind, in PwE, and suggested impairment in this domain. Interventions targeting the theory of mind can be potentially helpful in improving the quality of life of PwE.

Mentalizing impairments and hypermentalizing bias in individuals with first-episode schizophrenia-spectrum disorder and at-risk mental state: the differential roles of neurocognition and social anxiety.

Mentalizing, or theory of mind (ToM), impairments and self-referential hypermentalizing bias are well-evident in schizophrenia. However, findings compared to individuals with at-risk mental states (ARMS) are inconsistent, and investigations into the relationship between social cognitive impairments and social anxiety in the two populations are scarce. This study aimed to examine and compare these deficits in first-episode schizophrenia-spectrum disorder (FES) and ARMS, and to explore potential specific associations with neurocognition and symptomatology. Forty patients with FES, 40 individuals with ARMS, and 40 healthy controls (HC) completed clinical assessments, a battery of neurocognitive tasks, and three social cognitive tasks. The comic strip and hinting tasks were used to measure non-verbal and verbal mentalizing abilities, and the gaze perception task was employed to assess self-referential hypermentalizing bias. FES and ARMS showed comparable mentalizing impairments and self-referential hypermentalizing bias compared to HC. However, only ambiguous self-referential gaze perception (SRGP) bias remained significantly different between three groups after controlling for covariates. Findings suggested that self-referential hypermentalizing bias could be a specific deficit and may be considered a potential behavioral indicator in early-stage and prodromal psychosis. Moreover, working memory and social anxiety were related to the social cognitive impairments in ARMS, whereas higher-order executive functions and positive symptoms were associated with the impairments in FES. The current study indicates the presence of stage-specific mechanisms of mentalizing impairments and self-referential hypermentalizing bias, providing insights into the importance of personalized interventions to improve specific neurocognitive domains, social cognition, and clinical outcomes for FES and ARMS.

Mind reading dysfunctions in patients with obstructive sleep apnoea: A neuropsychological approach.

Obstructive sleep apnoea syndrome (OSAS) is a prevalent sleep-related breathing disorder that has been extensively studied for its effects on cognitive functions. However, little attention has been given to investigating Mind Reading (MR) skills in patients with OSAS. In this study, we employed a neuropsychological approach to thoroughly assess various facets of MR skills in patients with OSAS. Forty-two patients with untreated moderate or severe OSAS (AHI ≥15; 30 men, 12 women) and 16 healthy controls (7 men and 9 women), matched by age, were enrolled. To assess MR skills, we used: (i) The Story-based Empathy Task (SET), which includes three experimental conditions: identifying intentions (SET-IA), emotional states (SET-EA), and a control condition for inferring causality reactions (SET-CI); (ii) the Ekman 60 Faces Test (Ek60), which measures emotion recognition from facial expressions. Our findings revealed that patients with OSAS exhibit deficits in emotion-related MR skills, while their ability to make inferences about the cognitive states of social partners remains largely preserved. This finding corroborates previous evidence indicating that social cognition, particularly MR skills, may be one of the cognitive domains affected by OSAS. It emphasizes the significance of investigating social cognition and the relationship between MR skills and social functioning as a new and intriguing area of research in patients with OSAS.

Precision Mapping of the Default Network Reveals Common and Distinct (Inter)activity for Autobiographical Memory and Theory of Mind.

The default network is widely implicated as a common neural substrate for self-generated thought, such as remembering one's past (autobiographical memory) and imagining the thoughts and feelings of others (theory of mind). Findings that the default network comprises subnetworks of regions - some commonly and some distinctly involved across processes - suggest that one's own experiences inform their understanding of others. With the advent of precision fMRI methods, however, it is unclear if this shared substrate is observed instead due to traditional group analysis methods. We investigated this possibility using a novel combination of methodological strategies. Twenty-three participants underwent multi-echo resting-state and task fMRI. We used their resting-state scans to conduct cortical parcellation sensitive to individual variation but preserving our ability to conduct group analysis. Using multivariate analyses, we assessed the functional activation and connectivity profiles of default network regions while participants engaged in autobiographical memory, theory of mind, or a sensorimotor control condition. Across the default network, we observed stronger activity associated with both autobiographical memory and theory of mind compared to the control condition. Nonetheless, we also observed that some regions showed preferential activity to either experimental condition, in line with past work. The connectivity results similarly indicated shared and distinct functional profiles. Our results support that autobiographical memory and theory of mind - two theoretically important and widely-studied domains of social cognition - evoke common and distinct aspects of the default network even when ensuring high fidelity to individual-specific characteristics.

Variation in gaze following across the life span: A process-level perspective.

Following eye gaze is fundamental for many social-cognitive abilities, for example, when judging what another agent can or cannot know. While the emergence of gaze following has been thoroughly studied on a group level, we know little about (a) the developmental trajectory beyond infancy and (b) the sources of individual differences. In Study 1, we examined gaze following across the lifespan (N = 478 3- to 19-year-olds from Leipzig, Germany; and N = 240 20- to 80-year-old international, remotely tested adults). We found a steep performance improvement during preschool years, in which children became more precise in locating the attentional focus of an agent. Precision levels then stayed comparably stable throughout adulthood with a minor decline toward old age. In Study 2, we formalized the process of gaze following in a computational cognitive model that allowed us to conceptualize individual differences in a psychologically meaningful way (N = 60 3- to 5-year-olds, 50 adults). According to our model, participants estimate pupil angles with varying levels of precision based on observing the pupil location within the agent's eyes. In Study 3, we empirically tested how gaze following relates to vector following in non-social settings and perspective-taking abilities (N = 102 4- to 5-year-olds). We found that gaze following is associated with both of these abilities but less so with other Theory of Mind tasks. This work illustrates how the combination of reliable measurement instruments and formal theoretical models allows us to explore the in(ter)dependence of core social-cognitive processes in greater detail. RESEARCH HIGHLIGHTS: Gaze following develops beyond infancy. The highest precision levels in localizing attentional foci are reached in young adulthood with a slight decrease towards old age. We present a computational model that describes gaze following as a process of estimating pupil angles and the corresponding gaze vectors. The model explains individual differences and recovers signature patterns in the data. To estimate the relation between gaze- and vector following, we designed a non-social vector following task. We found substantial correlations between gaze following and vector following, as well as Level 2 perspective-taking. Other Theory of Mind tasks did not correlate.

Hot and cool executive function and theory of mind in children with and without specific learning disorders.

Executive function (EF) in specific learning disorders (SLD) has been investigated using mainly cool EF tasks, whilst less is known about hot EF and theory of mind (ToM) in this population. The aim of this study was to examine group differences in hot and cool EF and ToM in school-aged children with SLD relative to typically developing peers. It also attempted to investigate whether EF measures are significant predictors of ToM in SLD and typical development. Cross-sectional data were collected from 135 school-aged children with and without SLD (8-10 years old), tested on measures of cool & hot EF and ToM. Significant group differences were observed in EFs inhibition (p= .04), working memory (p= .04) and delay of gratification (p < .001), as well as ToM mental state/emotion recognition (p = .019). Inhibition and planning contributed to 22% of the explained variance of ToM mental state/emotion recognition, but not false belief overall. Results suggest that cool EF may be a crucial predictor of ToM in children with and without SLD. Finally, stepwise logistic regression analysis identified specific hot EF and ToM measures contributing to group differentiation, specifically delay of gratification (odds ratio=.995, 95% CI [.993-.998]) and mental state/emotion recognition (odds ratio= .89, 95% CI [.796-.995]). This study contributes to our understanding of cognitive deficits and socio-cognitive impairment in children with SLD, which hold promise for informing interventions aimed at addressing these cognitive challenges.

A Hierarchical Bayesian Model of Adaptive Teaching.

How do teachers learn about what learners already know? How do learners aid teachers by providing them with information about their background knowledge and what they find confusing? We formalize this collaborative reasoning process using a hierarchical Bayesian model of pedagogy. We then evaluate this model in two online behavioral experiments (N = 312 adults). In Experiment 1, we show that teachers select examples that account for learners' background knowledge, and adjust their examples based on learners' feedback. In Experiment 2, we show that learners strategically provide more feedback when teachers' examples deviate from their background knowledge. These findings provide a foundation for extending computational accounts of pedagogy to richer interactive settings.

Cognitive and affective theory of mind in young and elderly patients with multiple sclerosis.

Theory of mind (ToM) deficits have been reported in persons with multiple sclerosis (pwMS). However, most studies have used pictures or written scenarios as stimuli without distinguishing between cognitive and affective ToM, and no studies have investigated older pwMS. We recruited 13 young healthy controls (HC), 14 young pwMS, 14 elderly HC and 15 elderly pwMS. ToM was measured using an adaptation of the Conversations and Insinuations task (Ouellet et al., J. Int. Neuropsychol. Soc., 16, 2010, 287). In this ecological video-based task, participants watch four 2-minute videos of social interactions, which are interrupted by multiple choice questions about either the emotional state (affective ToM) or the intention (cognitive ToM) of the characters. They also underwent a short neuropsychological battery including cognitive, executive and social cognition tasks and questionnaires. We observed a significant interaction between the ToM conditions and the groups regarding ToM performance. Elderly pwMS scored significantly lower than elderly HC and young pwMS in cognitive ToM, but not in affective ToM. They also showed the largest discrepancy between their cognitive and affective ToM. Young pwMS showed relatively preserved ToM in both conditions. Both cognitive and affective ToM correlated with global cognition and executive abilities, but not with social cognitive measures (emotion recognition, real-life empathy). This study suggests that decline in cognitive ToM might be accentuated by advancing age in pwMS. These impairments are most likely underlied by cognitive and executive difficulties, but not by core social cognitive impairments. Future studies should investigate the real-life impacts of ToM impairments in pwMS.

The role of speech-language pathologists in supporting theory of mind through literacy-based activities.

PURPOSE: This tutorial discusses the importance of speech-language pathologists (SLPs) supporting individuals with language disorders in their understanding of others' cognitive and affective states (theory of mind, ToM), with a special consideration given to applying these suggestions with individuals who are neurodivergent. METHOD: I motivate this tutorial by first reviewing the literature related to ToM and language abilities for various populations of individuals with language difficulties, highlighting the need for explicitly targeting the language-related skills that are thought to underlie ToM for individuals with language disorders. I next present concrete examples of how to support ToM through literacy-based activities. I follow this discussion with a short description of how these activities may be applied with individuals who are neurodivergent through concrete examples, such as how inclusion of neurodivergent characters in storybooks can aid in educating children about understanding others' perspectives. It further emphasizes the importance of discussing various types of mental and emotional states for individuals who share as well as differ in their neurotypes. CONCLUSIONS: Language skills are an integral part of ToM abilities. SLPs play an important role in supporting clients' academic, literacy, and social outcomes and can support important perspective-taking skills through associated language/communication skills. The various skills that fall under the umbrella term 'theory of mind' can be appropriately incorporated into intervention and literacy-based tasks in a way that respects differences in neurotype while still building important language and communication skills for clients.

Differential relationships between autistic traits and anthropomorphic tendencies in adults and early adolescents.

Anthropomorphism, the attribution of human-like qualities (e.g., mental states) to nonhuman entities, is a universal but variable psychological experience. Adults with professionally diagnosed autism or high levels of subclinical autistic traits consistently show greater tendencies to anthropomorphize, which has been hypothesized to reflect 1) a compensatory mechanism for lack of social connectedness and 2) a persistence of childhood anthropomorphism into adulthood. Here, we directly tested these hypotheses in a general population sample consisting of both adults (N=685, 17-58 years old) and early adolescents (N=145, 12-14 years old) using the refined 9-item Anthropomorphism Questionnaire (AnthQ9), which measures both present and childhood anthropomorphic tendencies. We found that adults with heightened autistic traits reported increased present anthropomorphism (e.g., tend more to perceive computers as having minds), which held even after controlling for social connectedness. In contrast, adolescents with heightened autistic traits did not show increased present anthropomorphism, but rather reported reduced childhood anthropomorphism (e.g., less likely to perceive toys as having feelings) after controlling for social connectedness. We also found evidence that the present and childhood subscales of the AnthQ9 may tap into fundamentally different aspects of anthropomorphism. The results suggest that increased anthropomorphic tendencies in adults with heightened autistic traits cannot be explained solely by increased sociality motivation, but may be due to delayed development of anthropomorphism, although alternative possibilities of measurement problems cannot be ruled out. Implications for the measurement of anthropomorphism and its relation with theory of mind were also discussed.

Children use disagreement to infer what happened.

In a rapidly changing and diverse world, the ability to reason about conflicting perspectives is critical for effective communication, collaboration, and critical thinking. The current pre-registered experiments with children ages 7 to 11 years investigated the developmental foundations of this ability through a novel social reasoning paradigm and a computational approach. In the inference task, children were asked to figure out what happened based on whether two speakers agreed or disagreed in their interpretation. In the prediction task, children were provided information about what happened and asked to predict whether two speakers will agree or disagree. Together, these experiments assessed children's understanding that disagreement often results from ambiguity about what happened, and that ambiguity about what happened is often predictive of disagreement. Experiment 1 (N = 52) showed that children are more likely to infer that an ambiguous utterance occurred after learning that people disagreed (versus agreed) about what happened and found that these inferences become stronger with age. Experiment 2 (N = 110) similarly found age-related change in children's inferences and also showed that children could reason in the forward direction, predicting that an ambiguous utterance would lead to disagreement. A computational model indicated that although children's ability to predict when disagreements might arise may be critical for making the reverse inferences, it did not fully account for age-related change.

Meaning as mentalization.

The way we establish meaning has been a profound question not only in language research but in developmental science as well. The relation between linguistic form and content has been loosened up in recent pragmatic approaches to communication, showing that code-based models of language comprehension must be augmented by context-sensitive, pragmatic-inferential mechanisms to recover the speaker's intended meaning. Language acquisition has traditionally been thought to involve building a mental lexicon and extracting syntactic rules from noisy linguistic input, while communicative-pragmatic inferences have also been argued to be indispensable. Recent research findings exploring the electrophysiological indicator of semantic processing, the N400, have raised serious questions about the traditional separation between semantic decoding and pragmatic inferential processes. The N400 appears to be sensitive to mentalization-the ability to attribute beliefs to social partners-already from its developmental onset. This finding raises the possibility that mentalization may not simply contribute to pragmatic inferences that enrich linguistic decoding processes but that the semantic system may be functioning in a fundamentally mentalistic manner. The present review first summarizes the key contributions of pragmatic models of communication to language comprehension. Then, it provides an overview of how communicative intentions are interpreted in developmental theories of communication, with a special emphasis on mentalization. Next, it discusses the sensitivity of infants to the information-transmitting potential of language, their ability to pick up its code-like features, and their capacity to track language comprehension of social partners using mentalization. In conclusion, I argue that the recovery of meaning during linguistic communication is not adequately modeled as a process of code-based semantic retrieval complemented by pragmatic inferences. Instead, the semantic system may establish meaning, as intended, during language comprehension and acquisition through mentalistic attribution of content to communicative partners.

Dogs do not use their own experience with novel barriers to infer others' visual access.

Despite extensive research into the Theory of Mind abilities in non-human animals, it remains controversial whether they can attribute mental states to other individuals or whether they merely predict future behaviour based on previous behavioural cues. In the present study, we tested pet dogs (in total, N = 92) on adaptations of the 'goggles test' previously used with human infants and great apes. In both a cooperative and a competitive task, dogs were given direct experience with the properties of novel screens (one opaque, the other transparent) inserted into identical, but differently coloured, tunnels. Dogs learned and remembered the properties of the screens even when, later on, these were no longer directly visible to them. Nevertheless, they were not more likely to follow the experimenter's gaze to a target object when the experimenter could see it through the transparent screen. Further, they did not prefer to steal a forbidden treat first in a location obstructed from the experimenter's view by the opaque screen. Therefore, dogs did not show perspective-taking abilities in this study in which the only available cue to infer others' visual access consisted of the subjects' own previous experience with novel visual barriers. We conclude that the behaviour of our dogs, unlike that of infants and apes in previous studies, does not show evidence of experience-projection abilities.

EXPRESS: Are visual artists better visual perspective takers? An exploratory study with an unexpected outcome.

Visual perspective taking (VPT) has been argued to elicit image-like representations of other people's visual experiences. Separately, it has been demonstrated that there are inter-individual differences in the ability to successfully take other people's visual perspectives. In the present study, adults were asked to judge how long two lines appeared visually from the point of view of an agent. The lines were of identical length, but the agent was always closer to one of the lines than the other, meaning that the closer line should be judged as appearing visually longer. It was hypothesised that adults with experience in the visual arts would perform better at this task for one or both of two reasons: 1) they should be more familiar with the knowledge that the closer an object is the larger it looms, and 2) they might be able to "draw" an image-like representation that more accurately reflects the effect of distance on perceived size. Consistent with previous experiments with this paradigm, adults generally failed to judge the closest line as appearing longer; indeed, as many judged this line would appear visually shorter. Crucially, increasing experience in the visual arts failed to improve the accuracy of VPT judgments; even a group of professional illustrators failed to recognise that the line closest to the agent would appear longer than the line furthest from the agent. These results are discussed in the context of the processes and representation types potentially involved in VPT.

The roles of language and executive function in Mandarin-speaking children's theory of mind development.

Introduction: Research has indicated that language and executive function relate closely to first-order false belief reasoning, yet their roles in second-order false belief reasoning are under-explored, and their interplay in theory of mind development remains obscure. Methods: This study assessed 160 Mandarin-speaking preschoolers' and early primary schoolers' language, executive function, and theory of mind abilities to examine the unique roles and interplay of language and executive function in first-order and second-order false belief reasoning. Results: Results showed that language significantly uniquely predicted the children's first-order as well as second-order false belief reasoning when controlling for the effects of age and executive function. Although executive function significantly predicted first-order FB reasoning when controlling for age, it was no longer a significant predictor of first-order FB reasoning when language was included in the model. However, executive function played a significant unique role in second-order FB reasoning when controlling for the effects of age and language. Discussion: The current findings suggest that language plays a greater role than executive function in Mandarin-speaking children's theory of mind development and the contributors to theory of mind development vary in different levels of false belief reasoning.

From One's Heart to the Mind of Others: A Study in School-Aged Children.

Studies have shown a significant association between effective parasympathetic modulation of the heart and processes linked to social cognition. Particularly, Quintana and colleagues documented a relation between vagally-mediated heart rate variability (vmHRV) and performance on a theory of mind (ToM) task, namely, the Reading the Mind in the Eyes Test (RMET), in a sample of university students. The purpose of the present study was to test whether such result would extend to a sample of school-aged children (7-9 years old) using the child version of the RMET. In addition, the Eyes Test Revised was administered as it is more suitable to evaluate ToM during childhood. Results supported the positive association between vmHRV and ToM abilities, replicating and extending previous results obtained in young adults. The current study adds to the existing literature pointing to HRV as a putative biomarker of social cognition abilities.

Theory of mind abilities during the course of bipolar disorder: A longitudinal study using mixed models.

Theory of mind (ToM) deficits, difficulties in recognizing the intentions, propensities, and beliefs of others have been shown in individuals with bipolar disorder in several studies; however, it is not yet elucidated how ToM abilities changes over the course of bipolar disorder and is related to illness symptoms. This is one of the first longitudinal studies to compare the ToM abilities of euthymic bipolar individuals and healthy controls over a four and a half years period. ToM abilities were measured using the Reading the Mind in the Eyes Test (RMET). A total of 91 euthymic bipolar individuals and 91 healthy controls were included in the analyses. Linear mixed models were used to compare ToM abilities of bipolar individuals and healthy controls. It was found that bipolar individuals scored lower on average on the RMET than healthy controls and that these RMET scores were stable over four and a half years. The results of this study suggest that ToM deficits are a stable (possibly endophenotypic) trait of bipolar disorder. This understanding can contribute to better identification, assessment, and treatment strategies for individuals with bipolar disorder, ultimately improving their overall care and outcome.

A Systematic Review and Meta-Analysis of Social Cognition Among People Living with HIV: Implications for Non-Social Cognition and Social Everyday Functioning.

Social cognition-the complex mental ability to perceive social stimuli and negotiate the social environment-has emerged as an important cognitive ability needed for social functioning, everyday functioning, and quality of life. Deficits in social cognition have been well documented in those with severe mental illness including schizophrenia and depression, those along the autism spectrum, and those with other brain disorders where such deficits profoundly impact everyday life. Moreover, subtle deficits in social cognition have been observed in other clinical populations, especially those that may have compromised non-social cognition (i.e., fluid intelligence such as memory). Among people living with HIV (PLHIV), 44% experience cognitive impairment; likewise, social cognitive deficits in theory of mind, prosody, empathy, and emotional face recognition/perception are gradually being recognized. This systematic review and meta-analysis aim to summarize the current knowledge of social cognitive ability among PLHIV, identified by 14 studies focused on social cognition among PLHIV, and provides an objective consensus of the findings. In general, the literature suggests that PLHIV may be at-risk of developing subtle social cognitive deficits that may impact their everyday social functioning and quality of life. The causes of such social cognitive deficits remain unclear, but perhaps develop due to (1) HIV-related sequelae that are damaging the same neurological systems in which social cognition and non-social cognition are processed; (2) stress related to coping with HIV disease itself that overwhelms one's social cognitive resources; or (3) may have been present pre-morbidly, possibly contributing to an HIV infection. From this, a theoretical framework is proposed highlighting the relationships between social cognition, non-social cognition, and social everyday functioning.

Theory of Mind: A Brief Review of Candidate Genes.

Deficits in theory of mind (ToM), known as the ability to understand the other's mind, have been associated with several psychopathological outcomes. The present systematic review aims to summarize the results of genetic studies that investigated gene polymorphisms associated with mentalization performance tasks in children and adults. The systematic review was carried out following PRISMA guidelines, and the literature search was conducted in PubMed and EBSCOhost using the following keywords: 'theory of mind, mentalizing, mindreading' and 'gene, genetic basis'. Nineteen studies met the eligibility criteria for inclusion. Most of the literature focused on the role of DRD4, DAT1, OXTR, OXT, COMT, ZNF804A, AVP, AVPR, SCL6A4, EFHC2, MAO-A, and the family of GTF2I genes in influencing ToM. However, controversial results emerged in sustaining the link between specific genetic polymorphisms and mentalization abilities in children and adults. Available data show heterogeneous outcomes, with studies reporting an association between the same family genes in subjects of the same age and other studies reporting no correlation. This does not allow us to draw any solid conclusions but paves the way for exploring genes involved in ToM tasks.

Imaginative elaboration in agenesis of the corpus callosum: topic modeling and perplexity.

OBJECTIVE: Previous studies have found deficits in imaginative elaboration and social inference to be associated with agenesis of the corpus callosum (ACC; Renteria-Vasquez et al., 2022; Turk et al., 2009). In the current study, Thematic Apperception Test (TAT) responses from a neurotypical control group and a group of individuals with ACC were used to further study the capacity for imaginative elaboration and story coherence. METHOD: Topic modeling was employed utilizing Latent Diritchlet Allocation to characterize the narrative responses to the pictures used in the TAT. A measure of the difference between models (perplexity) was used to compare the topics of the responses of individual participants to the common core model derived from the responses of the control group. Story coherence was tested using sentence-to-sentence Latent Semantic Analysis. RESULTS: Group differences in perplexity were statistically significant overall, and for each card individually (p < .001). There were no differences between the groups in story coherence. CONCLUSIONS: TAT narratives from persons with ACC were normally coherent, but more conventional (i.e., more similar to the core text) compared to those of neurotypical controls. Individuals with ACC can make conventional social inferences about socially ambiguous stimuli, but are restricted in their imaginative elaborations, resulting in less topical variability (lower perplexity values) compared to neurotypical controls.