An assessment of age differences in theory of mind using the virtual assessment of mentalizing ability

Adaptation of the virtual assessment of mentalizing ability and evaluation of its utility and psychometric properties in Chinese individuals on the schizophrenia spectrum

Schizophrenia is associated with impairments in theory of mind (ToM), the ability to understand and attribute mental states. However, the nature of the deficits across ToM subconstructs (viz., first- and second-order cognitive ToM, and first- and second-order affective ToM) remains unclear, partly due to assessment issues. The current study aimed to first adapt an ecologically valid ToM assessment tool, namely, the Virtual Assessment of Mentalizing Ability (VAMA), for use among healthy Chinese individuals (Study 1). We then compared 39 schizophrenia patients with 37 controls, and 48 individuals with high social anhedonia (SA) with 54 individuals with low SA (Study 2) using the adapted version of VAMA and Yoni Task. Results of Study 1 showed that the adapted VAMA demonstrated acceptable reliability (item-total correlation and test-retest reliability for total score, r = 0.731, pFDR < 0.01) and construct validity (main effect of Order and Type). In Study 2, schizophrenia patients performed significantly worse than controls, making more "hypermentalizing" and "no mentalizing" ToM errors. Moreover, hypermentalizing error in the patient group was found to be significantly associated with their negative symptoms (r = 0.388, pFDR < 0.05). Interestingly, the VAMA results differed from those of the Yoni Task, possibly due to differences in task complexity. Finally, individuals with high SA showed impairments in second-order cognitive ToM compared to the controls. Overall, our findings suggest that the VAMA can be adapted for use in China, and is sensitive to ToM impairments in clinical and at-risk groups. Limitations on the psychometric properties were discussed.

Older adults' subjective aging perceptions, mentalization, and social relationships: a micro-longitudinal study

OBJECTIVES

Social relationships are associated with various positive physical, psychological, and emotional outcomes in older adults. In line with the growing understanding of the role of subjective views of aging (VoA) for older adults' quality of life, the current work examines how daily fluctuations in VoA affect social relationships. Moreover, as the ability to mentalize others' states of mind (i.e. Theory of Mind) considerably enhances such relationships, this study assesses whether mentalization abilities mediate the VoA-social relationships link.

METHOD

Eighty-two Israeli older adults (mean age = 73.44, SD = 8.64, range = 60-95) completed a baseline online questionnaire containing background information, and subsequently filled out daily online questionnaires assessing ageist attitudes, subjective age, mentalization abilities, and positive social relationships for 14 consecutive days.

RESULTS

Positive VoA (reduced ageist attitudes and/or a young subjective age) were associated with enhanced mentalization and positive relationships on a given day and in time-lagged analyses. Moreover, mentalization mediated the effect of previous-day VoA on next-day positive social relationships. VoA also mediated the effect of previous-day mentalization on next-day positive social relationships.

CONCLUSION

The study highlights the importance of mentalization capabilities for maintaining positive VoA/social relationships and expands the understanding of underlying factors associated with meaningful and close relationships in older adults.

A further study of the psychometric qualities of the Strange Stories-Revised across the three stages of aging

INTRODUCTION

Happé's Strange Stories task was developed in 1994 to assess theory of mind, the ability to infer mental states in oneself and others. Since then, it has undergone revisions, translations, and adaptations. A modified version of the task, the Strange Stories-Revised (SS-R), previously showed satisfactory qualities in a study aiming at identifying psychometrically acceptable social cognitive measures.

OBJECTIVE

The current study expands upon the psychometric evaluation study by examining the qualities of a short version of the SS-R in a sample of healthy adult subjects.

METHODS

One hundred and eighteen healthy adults completed the task along with neurocognitive measures. Mean scores of the long and short versions were compared. Associations between ToM as measured by performance on this abbreviated version of the SS-R, and potential confounders were explored. Internal consistency, dimensionality of the short version, and performance comparisons across three stages of aging (18-34; 35-59; 60-85 years old) were investigated, and standard measurement error was calculated to improve precision and data interpretation.

RESULTS

Reliability coefficients were comparable in the short and long versions. Principal component analysis showed that a one-factor structure best fits the data. Significant differences were observed in ToM performance across the three age groups, indicating a decline with time that was also captured by the long version, starting during midlife and increasing in significance with age.

CONCLUSION

The short version of the SS-R is a promising measure that can be profitably used in time-limited settings to assess theory of mind.

Evidence for the role of affective theory of mind in face-name associative memory

Poor face-name recall has been associated with age-related impairments in cognitive functioning, namely declines in episodic memory and executive control. However, the role of social cognitive function - the ability to remember, process, and store information about others - has been largely overlooked in this work. Extensive work has shown that social and nonsocial cognitive processes rely on unique, albeit overlapping, mechanisms. In the current study, we explored whether social cognitive functioning - specifically the ability to infer other people's mental states (i.e., theory of mind) - facilitates better face-name learning. To do this, a sample of 289 older and young adults completed a face-name learning paradigm along with standard assessments of episodic memory and executive control alongside two theory of mind measures, one static and one dynamic. In addition to expected age differences, several key effects emerged. Age-related differences in recognition were explained by episodic memory, not social cognition. However, age effects in recall were explained by both episodic memory and social cognition, specifically affective theory of mind in the dynamic task. Altogether, we contend that face-name recall can be supported by social cognitive functioning, namely understanding emotions. While acknowledging the influence of task characteristics (i.e., lures, target ages), we interpret these findings in light of existing accounts of age differences in face-name associative memory.

Determinants of Social Cognitive Aging: Predicting Resilience and Risk

This review focuses on conceptual and empirical research on determinants of social cognitive aging. We present an integrated model [the social cognitive resource (SCoRe) framework] to organize the literature and describe how social cognitive resilience is determined jointly by capacity and motivational resources. We discuss how neurobiological aging, driven by genetic and environmental influences, is associated with broader sensory, neural, and physiological changes that are direct determinants of capacity as well as indirect determinants of motivation via their influence on expectation of loss versus reward and cognitive effort valuation. Research is reviewed that shows how contextual factors, such as relationship status, familiarity, and practice, are fundamental to understanding the availability of both types of resource. We conclude with a discussion of the implications of social cognitive change in late adulthood for everyday social functioning and with recommendations for future research.

Affective Theory of Mind as a residual ability to preserve mentalizing in amnestic Mild Cognitive Impairment: A 12-months longitudinal study

INTRODUCTION

Theory of Mind (ToM) decline has been outlined in people with amnestic Mild Cognitive Impairment (aMCI), but evidence from longitudinal studies is lacking. This longitudinal study aims to investigate changes in cognitive and affective ToM performance in an aMCI sample (n = 28; 14 females, mean age = 76.54 ± 4.35).

METHOD

Participants underwent two steps of neurocognitive evaluation, at the baseline (T1) and 12-month follow-up (T2), to obtain their global cognitive level and both affective (Reading the Mind in the Eyes test, ET) and cognitive (Strange Stories, SS) ToM profile. Then, participants were categorized into two groups based on ToM changes: people who worsened (ETΔ < 0; SSΔ < 0) and people who did not (ETΔ≥0; SSΔ≥0) at follow-up. Differences between groups in cognitive functions and ToM profiles at baseline have been investigated.

RESULTS

Our results showed that 46% of subjects worsened in affective (ET) and 28% in cognitive (SS) ToM at follow-up. People who worsened in ET reported a statistically significantly higher performance in ET at baseline (p = 0.002) but not at follow-up than people who did not worsen. In contrast, subjects who worsened in SS showed a lower Immediate Free Recall (IFR, p = 0.026) and Delayed Free Recall (DFR, p = 0.028) score of the Free and Cued Selective Reminding test at baseline and at follow-up, a lower ET (p = 0.020) baseline score, a lower SS and MMSE level at follow-up than people who not worsened. About 71% of MCI subjects showed the same trend of evolution of the Mini-Mental State Examination and SS. Variables that significantly differed between groups have been inserted in a stepwise logistic regression to pilot explore predictors of affective and cognitive ToM evolution. Logistic regression showed ET at baseline (p = 0.015) as the only significant predictor of affective ToM evolution (R2 = 0.450), while both ET (p = 0.044) and memory performance (p = 0.045) at baseline significantly predicted cognitive ToM evolution (R2 = 0.746).

DISCUSSION

In conclusion, our results support the role of affective ToM as a residual mentalizing ability in preserving the mentalizing level in people with aMCI.

They Cannot, They Will Not, or We Are Asking the Wrong Questions: Re-examining Age-Related Decline in Social Cognition

Social cognition is critical for successfully navigating social relationships. Current evidence suggests that older adults exhibit poorer performance in several core social-cognitive domains compared to younger adults. Neurocognitive decline is commonly discussed as one of the key arbiters of age-related decline in social-cognitive abilities. While evidence supports this notion, age effects are likely attributable to multiple factors. This paper aims to recontextualize past evidence by focusing issues of motivation, task design, and representative samples. In light of these issues, we identify directions for future research to aide our understanding of social-cognitive aging.

Theory of Mind as a Correlate of Bystanders' Reasoning About Intergroup Bullying of Syrian Refugee Youth

The current study examined how ingroup and outgroup Theory of Mind (ToM) predicts children’s and adolescents’ reasoning for their acceptability judgments of intergroup bullying of Syrian refugee peers and group support of intergroup bullying. Participants included 587 Turkish middle (n = 372, M_age = 12.19, SD = 1.01; 208 girls) and high school (n = 215, M_age = 14.81, SD = 0.97; 142 girls) students. Participants read a bias-based bullying story with a Syrian refugee peer targeted by an ingroup Turkish peer. Then, participants rated the acceptability of bullying and group support of bullying and were presented with a reasoning question (Why?) after each acceptability question (bullying and group support of bullying). Reasoning codes included Fairness, Refugee Status/War, Prejudice and Discrimination, Harm, Prescriptive Norms, Group Functioning, and Relationship with the Bully. Participants’ ingroup and outgroup ToM abilities (measured using the Strange Stories) were evaluated as predictors of reasoning. Results documented that middle school students were more likely to attribute mental states to their ingroup members compared to outgroup members while high school students’ ToM performance did not differ across contexts. Further, the more unacceptable participants judged bullying to be, the more they reasoned about the bullying by referencing fairness, refugee status, discrimination, and harm. Results also documented that ingroup and outgroup ToM were positively related to attribution to fairness and participants’ usage of multiple reasoning judgments while only outgroup ToM was a significant predictor of reasoning around refugee status/war, discrimination, and prejudice. The findings provide implications for intervention programs that tackle intergroup bullying by examining bystanders’ social cognitive skills in a specific context.

Social Cognition in Patients with Amnestic Mild Cognitive Impairment and Mild Dementia of the Alzheimer Type

BACKGROUND

Social cognition (SC) is a core criterion for neurocognitive disorders. However, findings in patients with amnestic mild cognitive impairment (aMCI) and dementia of the Alzheimer type (DAT) are inconsistent.

OBJECTIVE

We report assessments of emotion recognition (ER), affective and cognitive theory of mind (ToM) in young (YC) and older controls (OC) compared to aMCI and DAT.

METHODS

28 aMCI, 30 DAT, 30 YC, and 29 OC received tests of SC and a comprehensive neuropsychological assessment. Analysis of covariance was used to determine group differences. Multiple regression models were applied to identify predictors for each SC task.

RESULTS

In controls, OC performed worse in ER and both ToM tasks compared to YC except for one subtest. No significant differences were found between OC and patients concerning ER and affective ToM. In cognitive ToM, differences between OC and patients depended on content and cognitive load with significant impairment in DAT compared to OC. A cognitive composite score predicted SC in OC, but not in patients. Associations of SC with single cognitive domains were found in all groups with language and complex attention as best predictors. Not all variance of SC performance was explained by variance in cognitive domains.

CONCLUSION

Lower performance on SC tasks in OC versus YC was confirmed, although not all tasks were equally affected. With progressive cognitive impairment, cognitive ToM is more impaired than ER or affective ToM. SC seems to be at least partly independent of other cognitive domains, justifying its inclusion in batteries for dementia diagnostic.

The relationship between testosterone and social cognition in younger and older adults

Testosterone (T) has been linked to poorer social cognition in younger adults. Because social cognition and T both decline with normal aging, a different type of relationship may exist between T and social cognition in late adulthood. To test this possibility, younger and older adults provided a salivary T sample and completed two social cognition tasks. The results showed that age-group was a significant moderator in the relationship between T and theory of mind (ToM) performance for males, such that T was a negative predictor of ToM in younger males and a positive predictor of ToM in older age. No relationships were identified for females. These findings show for the first time that T is differentially related to ToM in the early and later stages of the male adult lifespan, and are discussed in relation to prior work that suggests T may have neuroprotective effects in older age.

Personality Factors' Impact on the Structural Integrity of Mentalizing Network in Old Age: A Combined PET-MRI Study

The mentalizing network (MN) treats social interactions based on our understanding of other people's intentions and includes the medial prefrontal cortex (mPFC), temporoparietal junction (TPJ), posterior cingulate cortex (PCC), precuneus (PC), and amygdala. Not all elders are equally affected by the aging-related decrease of mentalizing abilities. Personality has recently emerged as a strong determinant of functional connectivity in MN areas. However, its impact on volumetric changes across the MN in brain aging is still unknown. To address this issue, we explored the determinants of volume decrease in MN components including amyloid burden, personality, and APOE genotyping in a previously established cohort of 130 healthy elders with a mean follow-up of 54 months. Personality was assessed with the Neuroticism Extraversion Openness Personality Inventory-Revised. Regression models corrected for multiple comparisons were used to identify predictors of volume loss including time, age, sex, personality, amyloid load, presence of APOE epsilon 4 allele, and cognitive evolution. In cases with higher Agreeableness scores, there were lower volume losses in PCC, PC, and amygdala bilaterally. This was also the case for the right mPFC in elders displaying lower Agreeableness and Conscientiousness. In multiple regression models, the effect of Agreeableness was still observed in left PC and right amygdala and that of Conscientiousness was still observed in right mPFC volume loss (26.3% of variability, significant age and sex). Several Agreeableness (Modesty) and Conscientiousness (order, dutifulness, achievement striving, and self-discipline) facets were positively related to increased volume loss in cortical components of the MN. In conclusion, these data challenge the beneficial role of higher levels of Agreeableness and Conscientiousness in old age, showing that they are associated with an increased rate of volume loss within the MN.

Empathy and Theory of Mind in Alzheimer's Disease: A Meta-analysis

OBJECTIVE

A large literature now shows that Alzheimer's disease (AD) disrupts a number of social cognitive abilities, including social perceptual function and theory of mind (ToM). However, less well understood is how the specific subcomponents of ToM as well as both the broader and specific subcomponents of empathic processing are affected.

METHOD

The current study provides the first meta-analytic review of AD that focuses on both empathy and ToM as broad constructs, as well as their overlapping (cognitive empathy and affective ToM) and distinct (affective empathy and cognitive ToM) subcomponents.

RESULTS

Aggregated across 31 studies, the results revealed that, relative to controls, AD is associated with large-sized deficits in both cognitive ToM (g = 1.09) and affective ToM/cognitive empathy (g = 0.76). However, no statistical differences were found between the AD participants and controls on affective empathic abilities (g = 0.36).

CONCLUSIONS

These data point to a potentially important disconnect between core aspects of social cognitive processing in people with AD. The practical and theoretical implications of these findings are discussed.