Sex differences in theory of mind: A male advantage on Happé's “cartoon” task

Penumbral thoughts: Contents of consciousness upon waking

Thoughts shape our experience, choice, and behaviour throughout the day. Yet the content of 'penumbral thoughts'-first thoughts upon waking-has received very little research attention. Across seven independent samples (total N = 829), we used recall and reflection methods, solicited the same day, to understand what individuals think as they regain consciousness. These penumbral thoughts show remarkable thematic consistency: individuals were most likely to reflect on their somatic or psychological state, focus on temporal orientation, and prioritise waking actions. Survey results demonstrate that temporal and spatial orientation are dominated by the current time and the day ahead, rather than the past or other future timescales. Our results provide some insight into the order of priority in consciousness. We conclude that establishing one's temporal position is important to the daily process of 'rebooting' conscious awareness.

Age differences in social-cognitive abilities across the stages of adulthood and path model investigation of adult social cognition

Accumulating evidence points toward an association between older age and performance decrements in social cognition (SC). We explored age-related variations in four components of SC: emotion recognition, theory of mind, social judgment, and blame attributions. A total of 120 adults divided into three stages (18-34 years, 35-59 years, 60-85 years) completed a battery of SC. Between and within age-group differences in SC were investigated. Path analyses were used to identify relationships among the components. Emotion recognition and theory of mind showed differences beginning either in midlife, or after. Blame attributions and social judgment did not show a significant difference. However, social judgment varied significantly within groups. Path models revealed a relationship between emotion recognition and theory of mind. Findings highlight age-related differences in some components and a link between two components. Strategies promoting social functioning in aging might help to maintain or improve these abilities over time.

On the Embodiment of Social Cognition Skills: The Inner and Outer Body Processing Differently Contributes to the Affective and Cognitive Theory of Mind

A specific interpretation of embodiment assigns a central role to the body representations (BR) in cognition. In the social cognition domain, BR could be pivotal in representing others’ actions and states. However, empirical evidence on the relationship between different BR and social cognition, in terms of Theory of Mind (ToM), in the same sample of participants is missing. Here, this relationship was explored considering individual differences in the action-oriented BR (aBR), nonaction-oriented BR (NaBR), and subjective predisposition toward internal bodily sensations (interoceptive sensibility, ISe). Eighty-two healthy adults were given behavioral measures probing aBR, NaBR, ISe, and affective/cognitive ToM. The results suggest that NaBR, which mainly relies on exteroceptive signals, predicts individual differences in cognitive ToM, possibly because it can allow differentiating between the self and others. Instead, the negative association between affective ToM and ISe suggests that an alteration of the internal body state representation (i.e., over-reporting interoceptive sensations) can affect emotional processing in social contexts. The finding that distinct aspects of the body processing from within (ISe) and from the outside (NaBR) differently contribute to ToM provides empirical support to the BR role in social cognition and can be relevant for developing interventions in clinical settings.

Machine Learning Evidence for Sex Differences Consistently Influences Resting-State Functional Magnetic Resonance Imaging Fluctuations Across Multiple Independently Acquired Data Sets

Background/Introduction: Sex classification using functional connectivity from resting-state functional magnetic resonance imaging (rs-fMRI) has shown promising results. This suggested that sex difference might also be embedded in the blood-oxygen-level-dependent properties such as the amplitude of low-frequency fluctuation (ALFF) and the fraction of ALFF (fALFF). This study comprehensively investigates sex differences using a reliable and explainable machine learning (ML) pipeline. Five independent cohorts of rs-fMRI with over than 5500 samples were used to assess sex classification performance and map the spatial distribution of the important brain regions. Methods: Five rs-fMRI samples were used to extract ALFF and fALFF features from predefined brain parcellations and then were fed into an unbiased and explainable ML pipeline with a wide range of methods. The pipeline comprehensively assessed unbiased performance for within-sample and across-sample validation. In addition, the parcellation effect, classifier selection, scanning length, spatial distribution, reproducibility, and feature importance were analyzed and evaluated thoroughly in the study. Results: The results demonstrated high sex classification accuracies from healthy adults (area under the curve >0.89), while degrading for nonhealthy subjects. Sex classification showed moderate to good intraclass correlation coefficient based on parcellation. Linear classifiers outperform nonlinear classifiers. Sex differences could be detected even with a short rs-fMRI scan (e.g., 2 min). The spatial distribution of important features overlaps with previous results from studies. Discussion: Sex differences are consistent in rs-fMRI and should be considered seriously in any study design, analysis, or interpretation. Features that discriminate males and females were found to be distributed across several different brain regions, suggesting a complex mosaic for sex differences in rs-fMRI. Impact statement The presented study unraveled that sex differences are embedded in the blood-oxygen-level dependent (BOLD) and can be predicted using unbiased and explainable machine learning pipeline. The study revealed that psychiatric disorders and demographics might influence the BOLD signal and interact with the classification of sex. The spatial distribution of the important features presented here supports the notion that the brain is a mosaic of male and female features. The findings emphasize the importance of controlling for sex when conducting brain imaging analysis. In addition, the presented framework can be adapted to classify other variables from resting-state BOLD signals.

Gender Differences in Theory of Mind, Empathic Understanding, and Moral Reasoning in an Offending and a Matched Non-Offending Population

Previous research suggests that a lack of pro-social skills is characteristic of an offending personality. Two hundred male and female offenders and matched controls completed measures to assess: Theory of Mind, empathic understanding, and moral reasoning. Significant differences between the offenders and the control group, as well as between the male and female participants, were detected in theory of mind, empathic understanding and moral reasoning with offenders scoring lower than the control group, and with males scoring lower than females on most tests. The ability to assess Theory of Mind, empathic understanding, and moral reasoning, and subsequently to identify reduced ability, is not only useful for researchers but will also allow practitioners to tailor existing (or develop new) interventions specific to the needs of individuals. This could be particularly useful in terms of recidivism when applied to those involved in anti-social or offending behavior.

Faux Pas Recognition Test: transcultural adaptation and evaluation of its psychometric properties in Brazil

Introduction: Many neuropsychiatric and neurodegenerative disorders produce Theory of Mind impairment. We aimed to implement a Brazilian Portuguese version of the Faux Pas Recognition Test (FPRT) and evaluate its psychometric properties.Methods: We first completed an English-Brazilian Portuguese translation and adaptation to obtain an FPRT Brazilian Portuguese version. We performed a multicentric study with 153 healthy participants (68.6% women), mean age of 38.8 years (SD = 14.6) and 12.9 years of schooling (SD = 4.5). Linear regression analysis was performed to evaluate the association of social class, age, schooling, and FPRT scores. The psychometric analyses comprised item analysis, exploratory factor analysis, reliability, and validity analysis.Results: Normative data in a Brazilian population is presented. A positive correlation of scores with years of schooling, social class, and an inverse relation with age was found. The exploratory factorial analysis found a two-component structure, one component, consisting of questions 1 through 6 (Eigenvalue 5.325) and another component, consisting of questions 7 and 8 (Eigenvalue 1.09). Cronbach's alpha of the 20 stories was .72. All control stories had a poor discriminative index.Conclusion: The FPRT Brazilian Portuguese version demonstrated good internal consistency and, psychometric properties and is adequate for use even in lower educational contexts in Brazil.

¿El entrenamiento en lectura de creencias puede influir sobre la competencia pragmática?: un estudio sobre las relaciones de estas capacidades cognitivas en la infancia

Con el objetivo de indagar respecto a la influencia de la lectura de creencias sobre la competencia pragmática, en el presente estudio 56 niños de entre 48 y 54 meses pertenecientes al programa Buen Comienzo de la ciudad de Medellín participaron en un diseño experimental pre-post con grupo control. Para la evaluación de la lectura de creencias se adaptaron al español cuatro pruebas de la escala de Wellman y Liu (2004), mientras que para evaluar la competencia pragmática se adaptaron cuatro situaciones comunicativas propuestas por Sacco et al. (2008). Para la manipulación de la variable se llevaron a cabo 10 sesiones de entrenamiento en lectura de creencias. De acuerdo con los resultados intragrupo, el programa de entrenamiento fue efectivo para mejorar la variable entrenada, pues el grupo experimental mejoró su desempeño en la lectura de creencias (p = .007; d = –.663) y en la competencia pragmática (p = .007; d = .648); no obstante, aunque se encontraron diferencias significativas entre el grupo experimental y el grupo control para la lectura de creencias (p = .001; d = .472), no fue así para el desempeño en la competencia pragmática (p = .340; d = .143). A la luz de estos resultados, no es posible asegurar una relación de influencia de la lectura de creencias sobre la competencia pragmática; sin embargo, se encontró un modelo de regresión lineal satisfactorio cuando se incluyeron en los análisis variables sociodemográficas. Al final del artículo se discute respecto a la necesidad de integrar variables de contexto cuando se indaga por una posible relación de influencia de una variable psicológica sobre otra.

Social cognition and its relationship with sociodemographic, clinical, and psychosocial variables in first-episode psychosis

People with first episode of psychosis (FEP) show deficits in social cognition, which have been linked to several sociodemographic, clinical, and psychosocial variables. The aim of the present research was to study social cognition as a whole measure in people with FEP comparing it with a healthy control sample, to study gender differences, and to examine the relationship between sociodemographic, clinical, and psychosocial variables and social cognition in the onset of psychosis. A descriptive, cross-sectional study was performed. The study sample consisted of 63 people (18 females; 45 males) with a diagnosis of FEP and a healthy control group (78 participants: 38 females; 40 males). All the participants were assessed with the social cognitive domain of the MATRICS Consensus Cognitive Battery (MCCB) and several questionnaires related to studied variables. Our results indicated that compared with healthy controls, people with FEP showed social cognition deficits. Furthermore, premorbid IQ was the most relevant variable in social cognition performance in FEP sample. The findings of the present research may be taken into account in clinical practice to improve the intervention with people with FEP.

Systematic review and meta-analysis of socio-cognitive and socio-affective processes association with adolescent substance use

BACKGROUND

Social impairments are important features of a substance use disorder diagnosis; and recent models suggest early impairments in socio-cognitive and -affective processes may predict future use. However, no systematic reviews are available on this topic.

METHODS

We conducted a systematic review and meta-analyses exploring the association between social-cognitive and -affective processes (empathy, callous-unemotional (CU) traits, theory of mind, and social cognition) and substance use frequency (alcohol, cannabis, general drug use). We examined moderating effects of study design, gender, age, and weather conduct problems were controlled for. We also review brain studies related to social cognition and substance use disorder (SUD) risk.

RESULTS

Systematic review suggested a negative association for positively valenced constructs with substance use but mixed results on the negatively valenced construct CU traits. Meta-analyses revealed moderate positive association between CU traits with alcohol and general drug use but no significance with cannabis use. Moderate effect sizes were found for CU traits in youth predicting severity of substance use by late adolescence and significantly accounted for variance independently of conduct problems. Significant moderators included gender proportions, sample type, and age. Neuroimaging meta-analysis indicated 10 coordinates that were different in youth at a high risk/with SUD compared to controls. Three of these coordinates associate with theory of mind and social cognition.

CONCLUSION

Socio-cognitive and -affective constructs demonstrate an association with current and future substance use, and neural differences are present when performing social cognitive tasks in regions with strongest associations with theory of mind and social cognition.

Social Cognition in Autism Spectrum Disorder Across the Adult Lifespan: Influence of Age and Sex on Reading the Mind in the Eyes Task in a Cross-sectional Sample

Background: Approximately 50,000 U.S. teens with autism spectrum disorder (ASD) become adults every year, however little is known regarding how age influences social cognition and if men and women with ASD are differentially impacted across the adult lifespan. Social cognition declines non-linearly with age in neurotypical (NT) adults. Moreover, sex differences have been observed on RME tasks in NT adults but not adults with ASD, although aging effects have been largely ignored.

Objective: This cross-sectional study examined the influence of age and sex on social cognition in adults with ASD compared to NT adults.

Methods: The Reading the Mind in the Eyes (RME) task was administered to evaluate the theory of mind abilities in 95 adults with ASD and 82 NT adults ages 18–71 years. The main effects of diagnosis, age, and sex, as well as two-way and three-way interaction were modeled using linear and quadratic aging terms in a multiple regression analysis.

Results: A main effect of diagnosis was observed, indicating poorer performance in adults with ASD relative to NT adults. Age and sex interactions were nonsignificant.

Discussion: We replicated previous findings of reduced theory of mind (ToM) abilities in adults with ASD, compared to NT adults. While interactions were nonsignificant, visual inspection of quadratic age curves indicated the possibility of unique ToM trajectories in men and women with and without ASD that should be investigated in larger longitudinal studies.

Psychometric assessment of social cognitive tasks

Although there has been a marked increase in interest in social cognition (SC) in recent years, psychometric data relating to many tasks used to measure its components remain limited in healthy populations with only five articles published to date. It is accordingly premature to speak of a consensus concerning the specific components, or best tests of the components, and possible cultural differences. The present study sought to partially fill that gap, examining the psychometric properties of a battery of SC tasks in a sample of 100 healthy adults aged 18-85 years old. Initially, nine tasks assessing four SC components were selected: emotion recognition, theory of mind, attributional bias, and social judgment. Construct validity and criterion-related validity were assessed using factor and correlational analyses. Performance across age and sex groups was also investigated. Reliability was assessed through internal consistency, interrater and intercoder agreement. Results indicated satisfactory properties for the Ambiguous Intentions Hostility Questionnaire-blame score, the Social Judgment Task, the Facial Emotions Recognition Test, and a modified version of the Strange Stories Task. Statistically significant differences were found between the groups with regard to age and sex after accounting for demographic and cognitive factors. However, the correlations of these measures with relationship quality were mostly very low, raising questions about their concomitant validity. Other tasks showed sub-optimal properties, suggesting that some frequently used tests require further validation or modifications to ensure the quality of research findings. Based on the results, recommended measures for future studies and limitations are discussed.

Sex Classification by Resting State Brain Connectivity

A large amount of brain imaging research has focused on group studies delineating differences between males and females with respect to both cognitive performance as well as structural and functional brain organization. To supplement existing findings, the present study employed a machine learning approach to assess how accurately participants' sex can be classified based on spatially specific resting state (RS) brain connectivity, using 2 samples from the Human Connectome Project (n1 = 434, n2 = 310) and 1 fully independent sample from the 1000BRAINS study (n = 941). The classifier, which was trained on 1 sample and tested on the other 2, was able to reliably classify sex, both within sample and across independent samples, differing both with respect to imaging parameters and sample characteristics. Brain regions displaying highest sex classification accuracies were mainly located along the cingulate cortex, medial and lateral frontal cortex, temporoparietal regions, insula, and precuneus. These areas were stable across samples and match well with previously described sex differences in functional brain organization. While our data show a clear link between sex and regionally specific brain connectivity, they do not support a clear-cut dimorphism in functional brain organization that is driven by sex alone.

Sex and Gender Differences in Emotion Recognition and Theory of Mind After TBI: A Narrative Review and Directions for Future Research

A growing body of literature has examined sex differences in a variety of outcomes from moderate-severe traumatic brain injury (TBI), including outcomes for social functioning. Social functioning is an area in which adults with TBI have significant long-term challenges (1-4), and a better understanding of sex and gender differences in this domain may have a significant clinical impact. This paper presents a brief narrative review of current evidence regarding sex differences in one aspect of social functioning in adults with TBI: social cognition, specifically affect recognition and Theory of Mind (ToM). Data from typical adults and adults with TBI are considered in the broader context of common stereotypes about social skills and behaviors in men vs. women. We then discuss considerations for future research on sex- and gender-based differences in social cognition in TBI, and in adults more generally.

Roles of age, gender and psychological difficulties in adolescent mentalizing

INTRODUCTION

Adolescence is a critical period for the development of mentalizing - the imaginative capacity to understand one's own and others' behaviour in terms of underlying mental states. Yet, factors and mechanisms underlying individual differences in adolescent mentalizing remain poorly understood. This exploratory study examined whether and how a) age and gender and b) psychological difficulties correlate with mentalizing performance in adolescents from the general population.

METHODS

89 adolescents from Geneva, Switzerland (54 females, age 12-17 years) completed a computerized task of mentalizing and a self-report measure of psychopathology.

RESULTS

Mentalizing performance improved with age. Males showed lower scores on the mentalizing task and made more hypermentalizing errors than females. The main findings revealed a negative association between mentalizing performance and self-reported attention problems. Post-hoc analyses further demonstrated that self-reported attentional difficulties were particularly associated with weaker scores on items requiring mentalizing about intentions, while self-reported withdrawal/depression symptoms were particularly associated with weaker scores on items requiring mentalizing about emotions and thoughts.

CONCLUSION

The present study highlights a negative association between attentional difficulties and mentalizing performance in community adolescents. Moreover, it provides preliminary evidence suggesting that age, gender and psychological difficulties can be distinctively associated with patterns of correct and incorrect mentalizing in community adolescents. Implications for future research and clinical practice are discussed.

Assessing Theory of Mind by Humor: The Humor Comprehension and Appreciation Test (ToM-HCAT)

Theory of Mind (ToM) may be defined as the ability to understand the mental states, such as beliefs, desires, intentions, and emotions, of others. Impairment of ToM ability leads to disorders with pathologies in social skills, such as autism spectrum disorder and schizophrenia. In addition to differences in ToM ability among patient populations, there is variation between neurotypical individuals. Unfortunately, ToM tasks are usually developed for children or patients with cognitive disorders and cannot detect variations in healthy adults. As an alternative tool, humor may be used. Humor plays a role in social communication and requires many different cognitive functions. Humor is believed to represent complex high-order cognitive processes. There are numerous types of humor; the most complex type is considered ToM humor, where an understanding of social/emotional content is necessary. Given the need for a ToM assessment test suitable for healthy adult populations, we developed a test for measuring humor comprehension and appreciation, with and without ToM content (ToM-HCAT). The present ToM-HCAT test is a performance test consisting of cartoons. The test measures perceived funniness, reaction time to perceived funniness decision, and meaning inference. Cartoons were selected after pilot studies involving 44 participants. Subscales were constituted according to expert views and confirmed by confirmatory factor analysis (N = 135). Goodness of fit values for the final 35-item test were acceptable to excellent: GFI = 0.97; AGFI = 0.97; NFI = 0.97; RFI = 0.97, and SRMR = 0.067. Both categories were internally consistent (α1 = 0.84, α2 = 0.94). External validity was assessed against autistic traits. One hundred and three participants completed the Autism Spectrum Quotient and were grouped by +0.5 standard deviations from the mean as high in autistic traits. The meaning-inference scores of the subscale with the ToM cartoons were significantly lower (p = 0.034) for the high autistic traits group, providing evidence of external validity. In conclusion, we developed and validated a test for assessment of ToM by humor comprehension and appreciation. We believe that the present test will be useful for the detection of variations in ToM ability in the healthy adult population.

Functional Specificity and Sex Differences in the Neural Circuits Supporting the Inhibition of Automatic Imitation

Humans show an involuntary tendency to copy other people's actions. Although automatic imitation builds rapport and affiliation between individuals, we do not copy actions indiscriminately. Instead, copying behaviors are guided by a selection mechanism, which inhibits some actions and prioritizes others. To date, the neural underpinnings of the inhibition of automatic imitation and differences between the sexes in imitation control are not well understood. Previous studies involved small sample sizes and low statistical power, which produced mixed findings regarding the involvement of domain-general and domain-specific neural architectures. Here, we used data from Experiment 1 ( N = 28) to perform a power analysis to determine the sample size required for Experiment 2 ( N = 50; 80% power). Using independent functional localizers and an analysis pipeline that bolsters sensitivity, during imitation control we show clear engagement of the multiple-demand network (domain-general), but no sensitivity in the theory-of-mind network (domain-specific). Weaker effects were observed with regard to sex differences, suggesting that there are more similarities than differences between the sexes in terms of the neural systems engaged during imitation control. In summary, neurocognitive models of imitation require revision to reflect that the inhibition of imitation relies to a greater extent on a domain-general selection system rather than a domain-specific system that supports social cognition.

Impaired theory of mind in adults with traumatic brain injury: A replication and extension of findings

OBJECTIVE

To replicate a previous study of Theory of Mind (ToM) task performance in adults with traumatic brain injury (TBI) under different working memory (WM) demands, and determine if there are sex-based differences in effects of WM load on ToM task performance.

METHOD

58 adults with moderate-severe TBI (24 females) and 66 uninjured adults (34 females) matched group-wise for age, sex, and education viewed a series of video vignettes from the Video Social Inference Task (VSIT) (Turkstra, 2008) and answered ToM questions. Vignette presentation format required updating and maintenance of information, and WM load was manipulated by varying presence of distracters.

RESULTS

There were main effects of group and WM load, no significant effect of sex, and a marginal interaction of group by WM load, with larger between-group differences in conditions with higher WM load. VSIT scores for the condition with the highest WM load were significantly correlated with scores on the first trial of the California Verbal Learning Test.

CONCLUSIONS

We replicated findings of lower scores in adults with TBI on a video-based ToM task, and provided additional evidence of the effect of WM load on social cognition task performance. There were no significant accuracy differences between men and women, inconsistent with prior evidence - including our own data using the same test. There is strong evidence of a female advantage on other social cognition tasks, and the parameters of this advantage remain to be discovered.

An examination of sex differences in neurocognition and social cognition in first-episode psychosis

Due to the dearth and conflicting findings of previous research, it is unclear whether males and females with first-episode psychosis (FEP) differ in their neurocognitive and social cognitive abilities. The aims of the current study were to investigate whether: (i) there are sex differences in neurocognition and social cognition among young people with FEP; and (ii) they resemble those observed in age-matched healthy controls. The current study involved secondary analysis of data from a previous study in which a large neurocognitive and social cognitive battery was administered to 146 individuals with FEP and 46 healthy controls aged 15-25 years. Seven two-way between-groups multivariate analysis of variances revealed that FEP participants were impaired relative to controls on all cognitive domains. Only one main effect of sex was found with males, regardless of group, outperforming females on verbal comprehension. A significant interaction effect was found for information processing speed with FEP females outperforming FEP males on the Symbol Digit Modalities Test; however, post-hoc analysis of the mean difference was not significant. Despite few sex differences, the current study highlights that cognitive impairment is a key feature of FEP that should be a treatment target in early intervention.

Asymmetry and empathy: Higher asymmetry is associated with lower levels of mentalizing

People differ in their mentalizing abilities. Though past research suggests that individual differences in exposure to prenatal testosterone may be able to explain why some people excel at mentalizing, while others struggle, meta-analyses yield a null relationship between 2D:4D ratio (a proxy for prenatal testosterone) and mentalizing. Importantly, however, past research has not examined the asymmetrical differences between the digit ratios on the right and left hands. In the current work, we test whether the difference between the digit ratios of the left and right hands may function as a better predictor of mentalizing than digit ratio alone. In Study 1, we begin by validating an online, self-report measure of 2D:4D ratio, providing test-retest reliability, convergent, and concurrent validity for our measure. In Study 2, we demonstrate that a) 2D:4D is quadratically related to asymmetry, b) asymmetry is negatively associated with mentalizing, and c) the relationship between asymmetry and mentalizing cannot be explained by the relationship between asymmetry and short-term memory. Taken together, our results paint a more nuanced picture of the relationship between digit ratio and mentalizing ability.

Attachment style moderates theory of mind abilities in depression

INTRODUCTION

Being able to understand other people's emotions and intentions is crucial for social interactions and well-being. Deficits in theory of mind (ToM) functioning hamper this ability and have been observed in depression and other neuropsychiatric disorders. However, results of previous research in depression have been inconclusive, possibly due to the presence of comorbid disorders and the disregarding of other modulating factors.

METHODS

Thirty-eight patients with a major depressive disorder (MDD) and forty healthy matched controls were assessed with a ToM task using animated triangles. Results were correlated with attachment styles, empathy abilities and neurocognitive performance.

RESULTS

Our findings show that 1) healthy female controls performed significantly stronger on the ToM task than female MDD patients, 2) these performance differences were driven by attachment styles and 3) depression severity did not impact task performance.

LIMITATIONS

The pharmacological treatment of the majority of patients might limit the generalizability of this study.

DISCUSSION

Results indicate a gender-specific impact of attachment styles on ToM performance. Future studies should investigate whether impairments in social cognitive tasks pose a risk factor for depression and/or interactional styles or vice versa. Moreover, with regard to remediation programs gender-specific needs should be taken into account.

Theory of Mind in Children With Specific Language Impairment: A Systematic Review and Meta-Analysis

The relation between language and theory of mind (ToM) has been debated for more than two decades. In a similar vein, ToM has been examined in children with specific language impairment (SLI), albeit with inconsistent results. This meta-analysis of 17 studies with 745 children between the ages of 4 and 12 found that children with SLI had substantially lower ToM performance compared to age-matched typically developing children (d = .98). This effect size was not moderated by age and gender. By revealing that children with SLI have ToM impairments, this finding emphasizes the need for further investigation into the developmental interface between language and ToM as well as the extended consequences of atypical language development.

Evaluation of a newly developed measure of theory of mind: The virtual assessment of mentalising ability

This study examined the reliability and validity of the Virtual Assessment of Mentalising Ability (VAMA). The VAMA consists of 12 video clips depicting a social drama imposed within an interactive virtual environment with questions assessing the mental states of virtual friends. Response options capture the continuum of ability (i.e., impaired, reduced, accurate, and hypermentalising) within first- and second-order cognitive and affective theory of mind (ToM). Sixty-two healthy participants were administered the VAMA, three other ToM measures, and additional measures of neurocognitive abilities and social functioning. The VAMA had sound internal consistency and high test-retest reliability. Significant correlations between performance on the VAMA and other ToM measures provided preliminary evidence of convergent validity. Small to moderate correlations were observed between performance on the VAMA and neurocognitive tasks. Further, the VAMA was found to correlate significantly with indices of social functioning and was rated as more immersive, more reflective of everyday ToM processes, and was afforded a higher recommendation than an existing computer-based ToM task. These results provide potential evidence that the VAMA is an ecologically valid tool that is sensitive to the spread of ability that can occur in ToM subprocesses and may be a valuable addition to existing ToM measures. Future research should explore the validity and utility of the VAMA in larger, more diverse samples of healthy adult and clinical populations.

Empathy: gender effects in brain and behavior

Evidence suggests that there are differences in the capacity for empathy between males and females. However, how deep do these differences go? Stereotypically, females are portrayed as more nurturing and empathetic, while males are portrayed as less emotional and more cognitive. Some authors suggest that observed gender differences might be largely due to cultural expectations about gender roles. However, empathy has both evolutionary and developmental precursors, and can be studied using implicit measures, aspects that can help elucidate the respective roles of culture and biology. This article reviews evidence from ethology, social psychology, economics, and neuroscience to show that there are fundamental differences in implicit measures of empathy, with parallels in development and evolution. Studies in nonhuman animals and younger human populations (infants/children) offer converging evidence that sex differences in empathy have phylogenetic and ontogenetic roots in biology and are not merely cultural byproducts driven by socialization. We review how these differences may have arisen in response to males' and females' different roles throughout evolution. Examinations of the neurobiological underpinnings of empathy reveal important quantitative gender differences in the basic networks involved in affective and cognitive forms of empathy, as well as a qualitative divergence between the sexes in how emotional information is integrated to support decision making processes. Finally, the study of gender differences in empathy can be improved by designing studies with greater statistical power and considering variables implicit in gender (e.g., sexual preference, prenatal hormone exposure). These improvements may also help uncover the nature of neurodevelopmental and psychiatric disorders in which one sex is more vulnerable to compromised social competence associated with impaired empathy.

Theory of mind, old age, and educational opportunity in Colombia

Studies of theory of mind (ToM) abilities in older age groups have yielded mixed results. Thirteen earlier studies are reviewed: these often had small sample sizes, and varied in educational level of older participants. We hypothesized that educational level would be an important factor for ToM in elderly participants, and especially in a non-Western country. We investigated performance on ToM and non-mental story tasks in 250 participants in three age groups (young, middle-aged, and old) in Colombia. There was a decline with ToM as well as non-mental task abilities with age. However, a strong effect of education was found in the old group; those with good educational attainment performed at the same level as young participants, and outperformed the middle-aged group. The possibility of a cohort effect for the middle-aged group is discussed. It is concluded that educational opportunities are a significant protective factor for ToM abilities in elderly populations.

The borderline empathy paradox: evidence and conceptual models for empathic enhancements in borderline personality disorder

Empirical evidence and therapeutic interactions have suggested that individuals with borderline personality disorder (BPD) may demonstrate enhancements in aspects of social-emotional cognition. To assess the empirical evidence for this phenomenon, and to comprehensively evaluate alternative hypotheses for its possible role in BPD etiology and symptoms, the authors systematically searched the literature for investigations of empathy in BPD and reviewed 28 studies assessing a range of empathic abilities. Considered together, these data demonstrated comparable levels of evidence for enhanced, preserved, and reduced empathic skills in individuals with BPD. Evidence for empathic enhancements is thus substantial but inconsistent across studies, being found mainly under more socially interactive experimental paradigms. Based on the results of the review and previous explanations for BPD symptoms, the authors propose a new model for explaining the borderline paradox: that a combination of increased attention to social stimuli and dysfunctional social information processing may account in part for the specific empathic enhancements and reduced overall social functioning in BPD.

Social cognition in euthymic bipolar disorder: systematic review and meta-analytic approach

OBJECTIVE

Deficits in social cognition have been reported in euthymic subjects with bipolar disorder (BD). However, some studies have failed to find differences favoring controls. As most investigations have been conducted with small samples, they have not had sufficient power to detect statistically significant differences. Furthermore, studies communicating positive results have scarcely attempted to estimate effect sizes for patient-control differences. The aim of this study was to summarize the findings of reports on social cognition in patients with euthymic BD and to combine their data to identify possible deficits and quantify their magnitude.

METHOD

Systematic literature review and meta-analysis.

RESULTS

Impairments of moderate magnitude (0.5 < d < 0.8) were noted across mentalizing skills, whereas small but significant effect sizes (d < 0.5) were observed for facial emotion recognition. No patient-control differences were found for decision-making.

CONCLUSION

Meta-analytic findings provide evidence for emotion processing and theory of mind deficits in remitted bipolar patients. However, it is not yet clear whether these areas of impairment are related to neurocognitive dysfunctions or to medication effects. The results are discussed with regard to targets for future neuropsychological research on BDs.

A functional MRI study of Theory of Mind in euthymic bipolar disorder patients

OBJECTIVES

To determine the neural responses invoked in Theory of Mind (ToM) in euthymic bipolar patients as compared with healthy subjects.

METHODS

This study examined 20 euthymic bipolar patients (11 males and 9 females) and 20 suitably matched healthy subjects using functional magnetic resonance imaging (fMRI) while subjects were engaged in a ToM task. Within-scanner eye movements were monitored to ensure task engagement. The activation paradigm involved observing ToM and random-motion animated sequences in a block design. Both within group (ToM versus random motion) and random effects between group analyses were performed on fMRI data using the BrainVoyager software package. Demographic and clinical data, along with subject ratings of fMRI stimuli, were collated and analysed.

RESULTS

Patients were compromised in their ability to appropriately rate the ToM stimuli and assess them for intention as compared to healthy subjects. This was reflected in the fact that patients had few within-group significant activations in response to ToM animated sequences, namely, the left anterior cingulate, and precuneus and cuneus bilaterally. In contrast, robust activations in response to ToM animated sequences in healthy subjects were widespread and involved regions recognized for mental state reasoning, in particular the insula, inferior frontal, supramarginal and angular gyri, and temporal cortex. The between-group random effects analysis exclusively favoured the healthy subjects, with many activations occurring in regions overlapping with those found in the within-group analyses.

CONCLUSIONS

The findings of this novel neuroimaging study suggest that in a social context, euthymic bipolar patients, though seemingly well and capable of engaging aspects of ToM, are perhaps constrained in their ability to mentalize fully, and furthermore cannot reliably adopt an alternate cognitive perspective when appropriate. Impairment of this capacity, though subtle, may in effect compromise their ability to understand the emotions and intentions of others, and also may limit appreciation of their own illness and symptoms. Such a deficit in bipolar disorder perhaps impacts upon interpersonal relationships and adversely affects social cognition and clinical functioning. The potential implications of this putative mentalizing compromise in euthymic patients with bipolar disorder are substantial, both for the individual and for understanding the neural substrate of the illness, and therefore warrant further investigation.

Gender differences in brain networks supporting empathy

Females frequently score higher on standard tests of empathy, social sensitivity, and emotion recognition than do males. It remains to be clarified, however, whether these gender differences are associated with gender specific neural mechanisms of emotional social cognition. We investigated gender differences in an emotion attribution task using functional magnetic resonance imaging. Subjects either focused on their own emotional response to emotion expressing faces (SELF-task) or evaluated the emotional state expressed by the faces (OTHER-task). Behaviorally, females rated SELF-related emotions significantly stronger than males. Across the sexes, SELF- and OTHER-related processing of facial expressions activated a network of medial and lateral prefrontal, temporal, and parietal brain regions involved in emotional perspective taking. During SELF-related processing, females recruited the right inferior frontal cortex and superior temporal sulcus stronger than males. In contrast, there was increased neural activity in the left temporoparietal junction in males (relative to females). When performing the OTHER-task, females showed increased activation of the right inferior frontal cortex while there were no differential activations in males. The data suggest that females recruit areas containing mirror neurons to a higher degree than males during both SELF- and OTHER-related processing in empathic face-to-face interactions. This may underlie facilitated emotional "contagion" in females. Together with the observation that males differentially rely on the left temporoparietal junction (an area mediating the distinction between the SELF and OTHERS) the data suggest that females and males rely on different strategies when assessing their own emotions in response to other people.