The "Reading the Mind in the Eyes" Test Shows Poor Psychometric Properties in a Large, Demographically Representative U.S. Sample

Reading the Mind in the Eyes Test Scores Demonstrate Poor Structural Properties in Nine Large Non-Clinical Samples

The Reading the Mind in the Eyes Test (RMET) is widely used in clinical and non-clinical research. However, the structural properties of RMET scores have yet to be rigorously examined. We analyzed the structural properties of RMET scores in nine existing datasets comprising non-clinical samples ranging from 558 to 9,267 (median = 1,112) participants each. We used confirmatory factor analysis to assess two theoretically derived factor models, exploratory factor analysis to identify possible alternative factor models, and reliability estimates to assess internal consistency. Neither of the theoretically derived models was a good fit for any of the nine datasets, and we were unable to identify any better fitting multidimensional models. Internal consistency metrics were acceptable in six of the nine datasets, but these metrics are difficult to interpret given the uncertain factor structures. Our findings contribute to a growing body of evidence questioning the reliability and validity of RMET scores.

The Neurocognitive Bases of Meaningful Intransitive Gestures: A Systematic Review and Meta-analysis of Neuropsychological Studies

Researchers and clinicians have long used meaningful intransitive (i.e., not tool-related; MFI) gestures to assess apraxia-a complex and frequent motor-cognitive disorder. Nevertheless, the neurocognitive bases of these gestures remain incompletely understood. Models of apraxia have assumed that meaningful intransitive gestures depend on either long-term memory (i.e., semantic memory and action lexicons) stored in the left hemisphere, or social cognition and the right hemisphere. This meta-analysis of 42 studies reports the performance of 2659 patients with either left or right hemisphere damage in tests of meaningful intransitive gestures, as compared to other gestures (i.e., MFT or meaningful transitive and MLI or meaningless intransitive) and cognitive tests. The key findings are as follows: (1) deficits of meaningful intransitive gestures are more frequent and severe after left than right hemisphere lesions, but they have been reported in both groups; (2) we found a transitivity effect in patients with lesions of the left hemisphere (i.e., meaningful transitive gestures more difficult than meaningful intransitive gestures) but a "reverse" transitivity effect in patients with lesions of the right hemisphere (i.e., meaningful transitive gestures easier than meaningful intransitive gestures); (3) there is a strong association between meaningful intransitive and transitive (but not meaningless) gestures; (4) isolated deficits of meaningful intransitive gestures are more frequent in cases with right than left hemisphere lesions; (5) these deficits may occur in the absence of language and semantic memory impairments; (6) meaningful intransitive gesture performance seems to vary according to the emotional content of gestures (i.e., body-centered gestures and emotional valence-intensity). These findings are partially consistent with the social cognition hypothesis. Methodological recommendations are given for future studies.

Differential Social Cognitive Performance in Older Adults With Mild Cognitive Impairment and Dementia

OBJECTIVE

To study general and subdomain performance in measures of social cognition in individuals with mild cognitive impairment (MCI), and dementia, and to explore associations between social cognitive and neuropsychological subdomains.

DESIGN

Cross-sectional study of participants from the Sydney Memory and Ageing Study (MAS).

SETTING

Current data was collected in 2016-2018.

PARTICIPANTS

Community-dwelling older adults (n=321) aged 80 years and above, with no history of neurological or psychiatric conditions. Participants had dementia, MCI, or no cognitive impairment (NCI).

MEASURES

Social cognition was indexed using the Reading the Mind in the Eyes Test (RMET), the Interpersonal Reactivity Index - Perspective Taking (IRI-PT) and Empathic Concern (IRI-EC) subscales, and the Emotion Recognition Task (ERT). These subdomain scores were used to make a composite social cognition score. Apathy was measured via the Apathy Evaluation Scale (AES). Neurocognitive function was indexed using the Addenbrooke Cognitive Examination v3 (ACE-3).

RESULTS

Dementia was associated with poorer overall social cognitive composite performance. MCI and dementia participants performed poorer on RMET and recognition of anger, disgust and happiness on ERT. RMET and ERT disgust remained significant after controlling for relevant covariates. Dementia participants performed poorer than MCI and NCI on the IRI-PT, IRI-EC, and AES. AES remained significant after regression. RMET was correlated with ACE-3 Fluency and/or Language in all study groups.

CONCLUSIONS

MCI is associated with poorer scores in specific social cognitive assessments. Dementia is somewhat associated with poorer scores in informant-rated social cognition scales, though this is no longer significant after accounting for apathy.

Mental Health, Mentalising and Empathy in Australian Healthcare Workers During COVID-19: A Cross-Sectional Study

Since the outbreak of a Coronavirus Disease (COVID-19), healthcare workers have consistently exhibited increased stress, anxiety and depression. However, no study to date, has yet examined whether these symptoms are associated with social cognitive skills, known to be paramount in delivering high quality patient care. This cross-sectional study aimed to investigate whether the symptoms of stress, anxiety and depression were related to both empathy and mentalising in healthcare workers who worked during the COVID-19 outbreak in Australia. Participants were healthcare workers with an average age of 31.9 years (N = 177). Participants completed the Depression, Anxiety and Stress Scale-21 (DASS-21), the Interpersonal Reactivity Index (IRI) and the Reading the Mind in The Eyes Test (RMET) between May 24th and June 21st, 2021. We found that higher stress levels in healthcare workers were associated with improved abilities in understanding others' emotions and mental states, showing affective empathy and engaging in imaginative thinking. Conversely, increased anxiety was linked to reduced understanding of others' emotions and mental states in this cohort. No other significant associations were observed. Our findings suggest that organisational initiatives are needed to deliver targeted interventions and specialised programs to support social cognitive skills in healthcare workers. Future studies with longitudinal designs are needed to better characterise mental health-social cognition associations and disentangle its directionality.

Harmonizing cross-cultural and transdiagnostic assessment of social cognition by expert panel consensus

Social cognition, the perception and processing of social information, is adversely affected in multiple psychiatric, neurological, and neurodevelopmental disorders, and these impairments negatively impact quality of life for individuals across the globe. Despite the clear importance of social cognition, efforts to advance research via harmonization of data across cultures and diagnoses has been stymied by the lack of uniformly used and suitable assessments. To address this issue, the current study conducted an expert survey and consensus process to identify social cognitive assessments that are best suited for cross-cultural and transdiagnostic use among adults. A large group of experts in social cognition were surveyed to gather nominations for cross-culturally and transdiagnostically appropriate measures. These measures were then critically evaluated by a smaller group of experts using a Delphi consensus process to identify the best existing tasks for each use. Ninety-eight experts, representing 25 countries, responded to the initial survey and nominated a total of 81 tasks. Initial rounds of the Delphi process identified 50 tasks with adequate psychometric properties that were then subdivided into social cognition domains. For each domain, members ranked the five best tasks, once for cross-cultural use and once for transdiagnostic use, and rated the suitability of those tasks for the intended use. No tasks were identified as ideally suited for either use; however, within each domain, 4-5 tasks emerged as the most consistently selected, and all were ranked as having "good" or better suitability for use. While there is still a critical need for social cognitive assessments that are specifically designed for cross-cultural and transdiagnostic use, there does appear to be a handful of existing tasks that are currently available and likely informative. Caution is warranted however, as these still require comprehensive evaluation in cross-cultural and transdiagnostic studies.

Why most research based on the Reading the Mind in the Eyes Test is unsubstantiated and uninterpretable: A response to Murphy and Hall (2024)

Murphy and Hall (2024) present two criticisms of our review of construct validity evidence reporting practices for the Reading the Mind in the Eyes Test (RMET; Higgins, Kaplan, Deschrijver, & Ross, 2024). Namely, they argue that we conflated poor reporting practices with poor validity and that our conclusions about the validity of RMET scores relied too heavily on structural validity evidence at the cost of external validity evidence. Moreover, they argue that the existing external and structural validity evidence indicates that RMET scores are generally valid for assessing emotion recognition ability. In this response, we clarify that our conclusion that RMET scores are unsubstantiated as measurements of social cognitive ability was based on evidence that spans the structural, external, and substantive components of validity. Furthermore, reiterating and expanding on the validity evidence in our review, we argue that, based on existing validity evidence, RMET scores are unlikely to be valid measurements of social cognitive ability. Therefore, we stand by our recommendation that researchers stop using the RMET as a measure of social cognitive ability and re-evaluate research findings that rely on RMET scores as measurements of social cognitive ability.

Investigating trajectories linking social cognitive capacity, bias, and social isolation using computational modeling

Despite theoretical emphasis on loneliness affecting social information processing, empirical studies lack consensus. We previously adopted a clinical science framework to measure the association between social cognitive capacity and bias and both objective and perceived social isolation in nonclinical participants. Our prior study found that while objective social isolation is linked to both social cognitive capacity and social cognitive bias, loneliness is associated only with the latter. This study extended our previous model using a computational approach to capture implicit cognitive processes. We replicated and extended our earlier findings with a new sample of 271 participants, using neuropsychological tasks and a dot-probe paradigm that was analyzed via Drift Diffusion Model. We presented two complementary trajectories of how social cognitive bias may arise: the increased propensity to engage with salient social stimuli or a decreased information processing capacity dependent on the presence or absence of potential social threats. Furthermore, we found evidence that loneliness is associated with the time needed for perceptual processing of stimuli, both directly and indirectly, via social cognitive bias. Taken together, the complex and context-dependent nature of information processing biases observed in the current study suggests that complex and multifaceted interventions should be implemented to counter social information processing biases in lonely individuals.

Increased arterial stiffness is associated with poorer social cognition in older age

It is now well established that vascular aging is a significant predictor of cognitive decline in older age. But what remains less clear is the role that vascular health plays in social cognitive aging. Therefore, we aimed to provide the first test of the relationship between arterial stiffness and theory of mind (ToM) in late adulthood. In a sample of 50 healthy older adults (Age: M = 70.08, SD = 3.93), we measured arterial stiffness via carotid-femoral pulse wave velocity and social cognition using two well validated measures of ToM (RMET, TASIT). The results revealed that arterial stiffness was a significant predictor of ToM performance when indexed via the RMET and the TASIT, accounting for 11% and 9% of unique variance in scores, respectively. These findings add to the broader literature showing that arterial stiffness is a key predictor of cognitive aging and show that this relationship extends to the domain of social cognition.

Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report

BACKGROUND/OBJECTIVES

Prosopagnosia is the inability to recognize people by their faces. Developmental prosopagnosia is the hereditary or congenital variant of the condition. The aim of this study was to demonstrate the assessment of developmental prosopagnosia in a clinical context, using a combination of commercially available clinical assessment tools and experimental tools described in the research literature.

METHODS

We conducted a comprehensive neuropsychological assessment of a man with Tourette syndrome and attention deficit hyperactivity disorder (ADHD). The patient (ON) had experienced difficulties with face identity recognition throughout his life but believed they were caused by a lack of interest in others.

RESULTS

The neuropsychological assessment revealed varying degrees of difficulties primarily related to executive functions, attention, reaction time, and memory processes, as expected in a person with Tourette's syndrome and ADHD. In addition, ON reported severe problems with face recognition on a prosopagnosia questionnaire and demonstrated severely impaired performance on tests of face memory and face perception commonly used to diagnose prosopagnosia. Interestingly, he reported familial face recognition problems on the maternal side of the family, while tics and ADHD symptoms occurred on the paternal side. This suggests that, in this case, the conditions were likely inherited through different genetic pathways.

CONCLUSIONS

Proper assessment of face recognition problems, which includes a broad spectrum of clinical assessment tools, could help patients develop awareness and acceptance of themselves and their difficulties, and could serve as a basis for the development of clinical interventions. While ON's DP, Tourette syndrome, and ADHD may have distinct genetic origins, impairment in face identity recognition has been observed across several neurodevelopmental conditions and is likely more common than currently thought.

An Evaluation of Cross-Cultural Adaptations of Social Cognition Testing: A Systematic Review

Social cognition remains one of the most difficult cognitive domains to assess in diverse populations due to a lack of culturally appropriate tools. This study systematically reviewed literature on neuropsychological tests for social cognition that have been translated, adapted, are cross-cultural, or are assembled for diverse, specifically "Global South," populations. The aim was to identify assessments appropriate for diverse populations, outline and evaluate their methodological approaches, and provide procedural recommendations for future research. The PRISMA systematic review search strategy produced 10,957 articles, of which 287 were selected for full-text screening. The study had to include a neuropsychological assessment of social cognition. The full text of the resulting 287 articles was then screened; the study had to include a translated, adapted, cross-cultural test, or an assembled test for Global South populations. Eighty-four articles were included in this study: 24 for emotion recognition, 45 for theory of mind, 9 for moral reasoning, and six for social cognition in general. Overall, there were 31 translations, 27 adaptations, 14 cross-cultural tests, and 12 assembled tests for Global South populations. Regarding quality, 35 were of low quality, 27 were of moderate quality, and 22 were high quality. This study provides an overview of social cognition tests modified or assembled for diverse populations and gives examples of methodological procedures. It highlights the variability in procedure quality and provides possible reasons for this variability. Finally, it suggests a need to report rigorous modification and assembly procedure in order to have modified and assembled social cognition tests appropriate for diverse populations.

Systematic Review of Gaming and Neuropsychological Assessment of Social Cognition

Playing video games is associated with cognitive changes and possibly psychosocial difficulties. Problematic gaming occurs upon the loss of control over videogame playing; gaming disorder is considered a behavioral addiction in the 11th version of the International Classification of Diseases. Models used to understand behavioral addictions include cognition as an essential factor in the development, maintenance, and relapse of addiction. Nevertheless, some aspects of cognition, such as social cognition, remain underexplored, despite evidence of alterations in cognitive and social function among patients with problematic gaming. This review aimed to describe the current understanding of social cognition in individuals exposed to videogames. We included all studies assessing social cognition in participants of any age with a wide range of exposure to video games (from simple use of video games (such as at least two exposures) to problematic gaming, defined according to the included study). This wide range of exposure allowed us to explore the whole process from repeated exposure to addiction. We included only studies that used neuropsychological tasks to assess social cognition. Patient-reported outcomes that could be biased by subjective self-report data were not included. The search was conducted from inception to January 2022 in three databases (PubMed, PsycINFO, and Web of Science). The systematic search identified 39 studies that assessed facial emotion processing, empathy, theory of mind, social decision-making, aggressive behavior, and moral competence. In general, results have been mixed, and a number of questions remain unanswered. Nevertheless, several studies showed cerebral changes when processing facial emotion that were linked with problematic gaming, while no link was obtained between nonproblematic gaming and empathy alterations. The influences of cooperation patterns, theory of mind, moral competence, and gaming frequency were highlighted. Finally, there was substantial heterogeneity in the population assessed and the methods used.

Poorer representation of minds underpins less accurate mental state inference for out-groups

Societies are becoming more polarised, driven in part by misconceptions about out-groups' beliefs. To understand these effects, one must examine the cognitive processes underlying how people think about others. Here, we investigate whether people are less prone to theorise about the minds of out-groups, or less able to do so. Participants (Study 1: n = 128; Study 2: n = 128) made inferences about social and political beliefs held by real in-group and out-group members, and could choose to receive further information to improve these inferences. Results show: (1) participants sought equivalent or greater information about out-groups relative to in-groups; but despite this, (2) made significantly less accurate inferences for out-groups; and (3) were significantly less aware of their reduced ability. This shows that poorer mental state inference is not underpinned by a reduced propensity to consider out-group minds, but instead by a worse representation of the minds of out-groups.

Effects of tDCS on emotion recognition and brain oscillations

INTRODUCTION

Emotion recognition, the ability to interpret the emotional state of individuals by looking at their facial expressions, is essential for healthy social interactions and communication. There is limited research on the effects of tDCS on emotion recognition in the literature. This study aimed to investigate the effects of anodal stimulation of the ventromedial prefrontal cortex (vmPFC), a key region for emotion recognition from facial expressions, on emotion recognition and brain oscillations.

METHOD

A single-blind randomized-controlled study was conducted with 54 healthy participants. Before and after brain stimulation emotion recognition tasks were administered and resting-state EEG were recorded. The changes in task performances and brain oscillations were analyzed using repeated-measures two-way ANOVA analysis.

RESULTS

There was no significant difference in the emotion recognition tasks between groups in pre-post measurements. The changes in delta, theta, alpha, beta and gamma frequency bands in the frontal, temporal, and posterio-occipital regions, which were determined as regions of interest in resting state EEG data before and after tDCS, were compared between groups. The results showed that there was a significant difference between groups only in delta frequency before and after tDCS in the frontal and temporal regions. While an increase in delta activity was observed in the experimental group in the frontal and temporal regions, a decrease was observed in the control group.

CONCLUSIONS

The tDCS may not have improved emotion recognition because it may not have had the desired effect on the vmPFC, which is in the lower part of the prefrontal lobe. The changes in EEG frequencies observed section tDCS may be similar to those seen in some pathological processes, which could explain the lack of improvement in emotion recognition. Future studies to be carried out for better understand this effect are important.

Construct validity evidence reporting practices for the Reading the Mind in the Eyes Test: A systematic scoping review

The Reading the Mind in the Eyes Test (RMET) is one of the most influential measures of social cognitive ability, and it has been used extensively in clinical populations. However, questions have been raised about the validity of RMET scores. We conducted a systematic scoping review of the validity evidence reported in studies that administered the RMET (n = 1461; of which 804 included at least one clinical sample) with a focus on six key dimensions: internal consistency, test-retest reliability, factor structure, convergent validity, discriminant validity, and known group validity. Strikingly, 63% of these studies failed to provide validity evidence from any of these six categories. Moreover, when evidence was reported, it frequently failed to meet widely accepted validity standards. Overall, our results suggest a troubling conclusion: the validity of RMET scores (and the research findings based on them) are largely unsubstantiated and uninterpretable. More broadly, this project demonstrates how unaddressed measurement issues can undermine a voluminous psychological literature.

Integrating Social Cognition Into Domain-General Control: Interactive Activation and Competition for the Control of Action (ICON)

Social cognition differs from general cognition in its focus on understanding, perceiving, and interpreting social information. However, we argue that the significance of domain-general processes for controlling cognition has been historically undervalued in social cognition and social neuroscience research. We suggest much of social cognition can be characterized as specialized feature representations supported by domain-general cognitive control systems. To test this proposal, we develop a comprehensive working model, based on an interactive activation and competition architecture and applied to the control of action. As such, we label the model "ICON" (interactive activation and competition model for the control of action). We used the ICON model to simulate human performance across various laboratory tasks. Our simulations emphasize that many laboratory-based social tasks do not require socially specific control systems, such as those that are argued to rely on neural networks associated with theory-of-mind. Moreover, our model clarifies that perceived disruptions in social cognition, even in what appears to be disruption to the control of social cognition, can stem from deficits in social representation instead. We advocate for a "default stance" in social cognition, where control is usually general, but representation is specific. This study underscores the importance of integrating social cognition within the broader realm of domain-general control processing, offering a unified perspective on task processing.

Profiles of theory of mind impairments and personality in clinical and community samples: integrating the alternative DSM-5 model for personality disorders

Introduction

Deficits in theory of mind (ToM)-the ability to infer the mental states of others-have been linked to antagonistic traits in community samples. ToM deficits have also been identified in people with personality disorders (PD), although with conflicting evidence, partly due to the use of categorical diagnoses. The DSM-5 Alternative Model for Personality Disorders (AMPD) provides an opportunity for a more precise understanding of the interplay between ToM abilities and personality pathology. Therefore, the study aims to determine whether and how individuals with diverse ToM profiles differ regarding personality impairment (AMPD Criterion A) and pathological facets (AMPD Criterion B).

Method

Adults with PD (n = 39) and from the community (n = 42) completed tests assessing ToM skills and self-reported questionnaires assessing AMPD Criteria A and B. Hierarchical agglomerative and TwoStep cluster analyses were consecutively computed using scores and subscores from ToM tests as clustering variables. Multivariate analyses of variance were subsequently performed to compare the clusters on both AMPD Criteria. Five clinically and conceptually meaningful clusters were found. The most notable differences across clusters were observed for Intimacy and Empathy dysfunctions (Criterion A), as well as for the Deceitfulness, Callousness, and Hostility facets from the Antagonism domain and the Restricted affectivity facet from the Detachment domain (Criterion B).

Discussion

The results support the association between antagonistic personality facets and ToM deficits. However, clusters showing impairments in ToM abilities did not necessarily exhibit high levels of personality dysfunction or pathological facets, emphasizing that both constructs are not isomorphic. Nevertheless, specific profiles can help refine existing interventions to make them more sensitive and specific to the nature of ToM dysfunctions while considering personality functioning and facets.

Seeing emotions in the eyes: a validated test to study individual differences in the perception of basic emotions

People are able to perceive emotions in the eyes of others and can therefore see emotions when individuals wear face masks. Research has been hampered by the lack of a good test to measure basic emotions in the eyes. In two studies respectively with 358 and 200 participants, we developed a test to see anger, disgust, fear, happiness, sadness and surprise in images of eyes. Each emotion is measured with 8 stimuli (4 male actors and 4 female actors), matched in terms of difficulty and item discrimination. Participants reliably differed in their performance on the Seeing Emotions in the Eyes test (SEE-48). The test correlated well not only with Reading the Mind in the Eyes Test (RMET) but also with the Situational Test of Emotion Understanding (STEU), indicating that the SEE-48 not only measures low-level perceptual skills but also broader skills of emotion perception and emotional intelligence. The test is freely available for research and clinical purposes.

Designing a neuroclinical assessment of empathy deficits in psychopathy based on the Zipper Model of Empathy

Ho, M.H., Kemp, B.T., Eisenbarth, H. & Rijnders, R.J.P. Designing a neuroclinical assessment of empathy deficits in psychopathy based on the Zipper Model of Empathy. NEUROSCI BIOBEHAV REV YY(Y) XXX-XXX, 2023. The heterogeneity of the literature on empathy highlights its multidimensional and dynamic nature and affects unclear descriptions of empathy in the context of psychopathology. The Zipper Model of Empathy integrates current theories of empathy and proposes that empathy maturity is dependent on whether contextual and personal factors push affective and cognitive processes together or apart. This concept paper therefore proposes a comprehensive battery of physiological and behavioral measures to empirically assess empathy processing according to this model with an application for psychopathic personality. We propose using the following measures to assess each component of this model: (1) facial electromyography; (2) the Emotion Recognition Task; (3) the Empathy Accuracy task and physiological measures (e.g., heart rate); (4) a selection of Theory of Mind tasks and an adapted Dot Perspective Task, and; (5) an adjusted Charity Task. Ultimately, we hope this paper serves as a starting point for discussion and debate on defining and assessing empathy processing, to encourage research to falsify and update this model to improve our understanding of empathy.