Promoting theory of mind in older adults: does age play a role?

Objectives: Previous research on age-related changes in Theory of Mind (ToM) showed a decline in older adults, particularly pronounced over 75 years of age. Evidence that ToM may be enhanced in healthy aging people has been demonstrated, but no study has focused on the role of age on the effects of ToM training for elderly people. The present study was designed to examine the efficacy of a ToM training on practiced (ToM Strange Stories) and transfer tasks (ToM Animations) in both young and older adults.

Method: The study involved 127 older adults belonging to two age groups: young–old (M_age = 64.41; SD = 2.49; range: 60–69 years) and old–old (M_age = 75.66; SD = 4.38; range: 70–85 years), randomly assigned to either a ToM group or a control group condition. All participants took part in two 2-hour testing sessions and four 2-hour training sessions.

Results: Results showed that both young–old and old–old adults in the ToM group condition improved their ability to reason on complex-mental states significantly more than participants in the control group condition. This positive effect of the training was evident on practiced and transfer ToM tasks. Crucially, age did not moderate the effect of the ToM training.

Conclusion: These findings demonstrate that young–old and old–old adults equally benefit from the ToM training. Implications for the positive effect of the ToM training in old–old adults are discussed.     

Development and psychometric properties of an informant assessment scale of theory of mind for adults with traumatic brain injury

Impairment of theory of mind (ToM) is a common phenomenon following traumatic brain injury (TBI) that has clear effects on patients’ social functioning. A growing body of research has focused on this area, and several methods have been developed to assess ToM deficiency. Although an informant assessment scale would be useful for examining individuals with TBI, very few studies have adopted this approach. The purpose of the present study was to develop an informant assessment scale of ToM for adults with traumatic brain injury (IASToM-aTBI) and to test its reliability and validity with 196 adults with TBI and 80 normal adults. A 44-item scale was developed following a literature review, interviews with patient informants, consultations with experts, item analysis, and exploratory factor analysis (EFA). The following three common factors were extracted: social interaction, understanding of beliefs, and understanding of emotions. The psychometric analyses indicate that the scale has good internal consistency reliability, split-half reliability, test-retest reliability, inter-rater reliability, structural validity, discriminate validity and criterion validity. These results provide preliminary evidence that supports the reliability and validity of the IASToM-aTBI as a ToM assessment tool for adults with TBI.     

Innocent intentions: A correlation between forgiveness for accidental harm and neural activity

Contemporary moral psychology often emphasizes the universality of moral judgments. Across age, gender, religion and ethnicity, people's judgments on classic dilemmas are sensitive to the same moral principles. In many cases, moral judgments depend not only on the outcome of the action, but on the agent's beliefs and intentions at the time of action. For example, we blame agents who attempt but fail to harm others, while generally forgiving agents who harm others accidentally and unknowingly. Nevertheless, as we report here, there are individual differences in the extent to which observers exculpate agents for accidental harms. Furthermore, we find that the extent to which innocent intentions are taken to mitigate blame for accidental harms is correlated with activation in a specific brain region during moral judgment. This brain region, the right temporo-parietal junction, has been previously implicated in reasoning about other people's thoughts, beliefs, and intentions in moral and non-moral contexts.     

Do Children with Autism have a Theory of Mind? A Non-verbal Test of Autism vs. Specific Language Impairment

Children with autism have delays in the development of theory of mind. However, the sub-group of children with autism who have little or no language have gone untested since false belief tests (FB) typically involve language. FB understanding has been reported to be intact in children with specific language impairment (SLI). This raises the possibility that a non-verbal FB test would distinguish children with autism vs. children with SLI. The present study tested two predictions: (1) FB understanding is to some extent independent of language ability; and (2) Children with autism with low language levels show specific impairment in theory of mind. Results confirmed both predictions. Results are discussed in terms of the role of language in the development of mindreading.     

Oxytocin improves "mind-reading" in humans.

BACKGROUND: The ability to "read the mind" of other individuals, that is, to infer their mental state by interpreting subtle social cues, is indispensable in human social interaction. The neuropeptide oxytocin plays a central role in social approach behavior in nonhuman mammals. METHODS: In a double-blind, placebo-controlled, within-subject design, 30 healthy male volunteers were tested for their ability to infer the affective mental state of others using the Reading the Mind in the Eyes Test (RMET) after intranasal administration of 24 IU oxytocin. RESULTS: Oxytocin improved performance on the RMET compared with placebo. This effect was pronounced for difficult compared with easy items. CONCLUSIONS: Our data suggest that oxytocin improves the ability to infer the mental state of others from social cues of the eye region. Oxytocin might play a role in the pathogenesis of autism spectrum disorder, which is characterized by severe social impairment.     

The relationship between affective decision-making and theory of mind in the frontal variant of fronto-temporal dementia

Structural brain imaging and neuropsychological data implicate the orbital aspects of prefrontal cortex in the developing neuropathology of fvFTD. Damage to this region is associated with deficient performance on laboratory tasks assessing theory of mind (ToM) and affective decision-making (DM), but the relationship between these two capacities in patients with prefrontal cortex dysfunction is unclear. We studied a group of patients with early/mild fvFTD (n=20) and a group of matched normal controls (n=10) on the Iowa gambling task (IGT) of affective decision-making, and the "reading the mind in the eyes" (MIE) and "faux pas" (FP) tests of ToM. The fvFTD group was impaired in both ToM tasks and the IGT. While performance measures from the two ToM tasks were significantly correlated, they were not associated with IGT performance. This suggests that whilst similar prefrontal circuitry is implicated in ToM and DM tasks, these cognitive domains may be independent. In clinical settings, the IGT may be useful as a complementary tool to the frontal test battery for patients with early/mild fvFTD. Deficits in decision-making and ToM observed in this study have distinct but additive effects upon the development of social behaviour in patients with prefrontal dysfunction.     

Children's and adults' neural bases of verbal and nonverbal 'theory of mind'

Theory of mind (ToM) - our ability to predict behaviors of others in terms of their underlying intentions - has been examined through verbal and nonverbal false-belief (FB) tasks. Previous brain imaging studies of ToM in adults have implicated medial prefrontal cortex (mPFC) and temporo-parietal junction (TPJ) for adults' ToM ability. To examine age and modality related differences and similarities in neural correlates of ToM, we tested 16 adults (18-40 years old) and 12 children (8-12 years old) with verbal (story) and nonverbal (cartoon) FB tasks, using functional magnetic resonance imaging (fMRI). Both age groups showed significant activity in the TPJ bilaterally and right inferior parietal lobule (IPL) in a modality-independent manner, indicating that these areas are important for ToM during both adulthood and childhood, regardless of modality. We also found significant age-related differences in the ToM condition-specific activity for the story and cartoon tasks in the left inferior frontal gyrus (IFG) and left TPJ. These results suggest that depending on the modality adults may utilize different brain regions from children in understanding ToM.     

The neuroanatomical basis of affective mentalizing in schizophrenia: comparison of patients with schizophrenia and patients with localized prefrontal lesions

Patients with schizophrenia show impaired emotional and social behavior, such as misinterpretation of social situations and lack of Theory of Mind (ToM). However, the neuroanatomical basis of impaired ToM and its nature in schizophrenia is still largely unknown. Based on previous findings, the present study suggests that impaired social cognition observed in schizophrenic patients may be similar to that observed in patients with prefrontal (PFC) damage due to impaired ‘affective ToM’ abilities, rather than to a general impairment in ToM. We examined the behavioral and neural mechanisms that underlie the social and communicative impairments observed in patients with schizophrenia and with PFC damage, by looking at differential patterns of ToM impairment in these individuals. The performance of 24 patients with schizophrenia was compared to the responses of patients with localized lesions in the ventromedial (VM) or dorsolateral PFC, patients with non-frontal lesions, and healthy control subjects. Patients with schizophrenia and those with VM lesions were impaired on ‘affective ToM’ tasks but not in cognitive ToM conditions. It was concluded that the pattern of mentalizing impairments in schizophrenia resembled those seen in patients with lesions of the frontal lobe, particularly with VM damage, providing support for the notion of a disturbance of the fronto-limbic circuits in schizophrenia.     

Changes of brain activity in the neural substrates for theory of mind during childhood and adolescence

Theory of mind (ToM) refers to the ability to attribute independent mental states, such as beliefs, preferences and desires, to the self and others. Neuroimaging studies of normal adults have consistently demonstrated the importance of particular brain regions for ToM, the superior temporal sulcus (STS), temporal pole (TP) and the medial prefrontal cortex (MPFC). However, there are little data showing how ToM develops during childhood and adolescence. Such data are important for understanding the development of social functioning and its disorders. The authors used functional magnetic resonance imaging to study age-related changes in brain activity associated with ToM during childhood and early adolescence (9-16 years). Normally developed children and adolescents demonstrated significant activation in the bilateral STS, the TP adjacent to the amygdala (TP/Amy) and the MPFC. Furthermore, the authors found a positive correlation between age and the degree of activation in the dorsal part of the MPFC; in contrast, a negative correlation was found for the ventral part of the MPFC. The authors also found a positive correlation between the Z coordinate of the peak activation in the MPFC and age. The data indicated that activity in the MPFC associated with ToM shifted from the ventral to the dorsal part of the MPFC during late childhood and adolescence. No age-related changes were found in the STS and the TP/Amy regions. The authors consider that the age-related brain activity observed in the present study may be associated with the maturation of the prefrontal cortex and the associated development of cognitive functions.