Studying social cognition in patients with schizophrenia and patients with frontotemporal dementia: theory of mind and the perception of sarcasm

We investigated social cognition and theory of mind in patients with schizophrenia and in patients with frontotemporal dementia in order to elucidate the cognitive mechanisms involved in the breakdown of these skills in psychiatric and neurological patients. Our tasks included videotaped scenarios of social interactions depicting sincere, sarcastic and paradoxical remarks, as well as lies. We found impaired performance of the schizophrenia group on all theory of mind conditions despite their intact understanding of sincere statements. In contrast, the FTD group performed poorly only when they had to rely on paralinguistic cues indicating sarcasm or lies, and not on paradoxical remarks or sarcasm when given additional verbal cues. Our findings suggest that, while current deficits in social and interpersonal functioning in patients with FTD may reflect a decrement in previously acquired skills, similar deficits in patients with schizophrenia may reflect an altogether inadequately learned process.     

生物运动及其在社会认知障碍研究中的应用

人类对生物运动具有较强的视觉敏感性,即使在视觉线索有限的情况下,仍能提取其中的社会性信息。本研究系统梳理了当前生物运动视知觉实验研究涉及的各类社会性信息,并归纳分析社会认知缺陷与生物运动视知觉加工之间的内在联系,以期促进对生物运动视知觉加工心理机制问题的深入探讨     

Theory of mind and its relationship with executive functions and emotion recognition in borderline personality disorder

Impaired social cognition has been claimed to be a mechanism underlying the development and maintenance of borderline personality disorder (BPD). One important aspect of social cognition is the theory of mind (ToM), a complex skill that seems to be influenced by more basic processes, such as executive functions (EF) and emotion recognition. Previous ToM studies in BPD have yielded inconsistent results. This study assessed the performance of BPD adults on ToM, emotion recognition, and EF tasks. We also examined whether EF and emotion recognition could predict the performance on ToM tasks. We evaluated 15 adults with BPD and 15 matched healthy controls using different tasks of EF, emotion recognition, and ToM. The results showed that BPD adults exhibited deficits in the three domains, which seem to be task‐dependent. Furthermore, we found that EF and emotion recognition predicted the performance on ToM. Our results suggest that tasks that involve real‐life social scenarios and contextual cues are more sensitive to detect ToM and emotion recognition deficits in BPD individuals. Our findings also indicate that (a) ToM variability in BPD is partially explained by individual differences on EF and emotion recognition; and (b) ToM deficits of BPD patients are partially explained by the capacity to integrate cues from face, prosody, gesture, and social context to identify the emotions and others' beliefs.     

Impaired Interpretation of Others’ Behavior is Associated with Difficulties in Recognizing Pragmatic Language in Patients with Schizophrenia

Much attention has been paid to the pragmatic language function in schizophrenia. This study of Japanese patients with schizophrenia examined the relationship between impaired interpretation of the behaviors of other people in social contexts and the ability to recognize metaphor and irony. We assessed 34 patients with schizophrenia and 34 normal subjects using first- and second-order theory of mind tasks, the Metaphor and Sarcasm Scenario Test, and the Dewey Story Test (which tests the ability to judge others’ social behaviors). We compared the performance between the groups and analyzed correlations between the tasks. All tasks revealed significant deficits in the patients compared with the controls. In the patient group, metaphor comprehension was correlated with the ability to judge normal behaviors, and irony comprehension was correlated with the ability to judge abnormal behaviors, suggesting that deficits of social cognition in schizophrenia include these two types of factors associated with pragmatic language.     

The non-specificity of theory of mind deficits: Evidence from children with communicative disabilities

The aim of the present paper was to investigate the performance on theory of mind tasks of four different clinical groups: children with deficits in attention, motor control and perception (DAMP), children with autism, children with Asperger syndrome, and non-vocal cerebral-palsied children. The children with DAMP performed on the same level as the comparison group on the first and second order theory of mind task. The children with autism and Asperger syndrome performed somewhat lower than the children with DAMP and the comparison group. However, in respect of the specifcity issue, only 6 out of 14 of the non-vocal participants successfully solved the first order theory of mind task, while 13 out of 14 children in a comparison group did. The children were matched for chronological age and IQ. The findings suggest that deficits in theory of mind are not specific to the autistic continuum, but can be found in other groups with communicative disabilities, implying that linguistic and communicative skills are important precursors in the development of theory of mind. The study also shows that severe dysfunction in attention, motor control, and perception is not associated with any theory of mind difficulties.     

Social Cognition in Multiple Sclerosis: a Meta-Analysis

Multiple sclerosis (MS) is associated with cognitive decline and impairment in social functioning. Accumulating evidence suggests that patients with MS are impaired in social cognition, including theory of mind (ToM) and emotion recognition. In this meta-analysis of 24 studies, facial emotion recognition and ToM performances of 989 patients with MS and 836 healthy controls were compared. MS was associated with significant impairments with medium effect sizes in ToM (d?=?0.57) and facial emotion recognition (d?=?0.61). Among individual emotions recognition of fear and anger were particularly impaired. The severity of social cognitive deficits was significantly associated with non-social cognitive impairment. These deficits in social cognition may underpin difficulties in social functioning in MS. However, there is a need for further studies investigating the longitudinal evolution of social cognitive deficits and their neural correlates in MS.     

Do children with autism recognise surprise? A research note

Abstract

We take a fresh look at emotion recognition in autistic children, by testing their recognition of three different emotions (happy, sad, and surprise). The interest in selecting these is that whereas the first two are typical “simple” emotions (caused by situations), the third is typically a “cognitive” emotion (caused by beliefs). Because subjects with autism have clear difficulties in understanding beliefs, we predicted they would show more difficulty in recognising surprise. In contrast, as they have no difficulty in understanding situations as causes of emotion, we predicted they would not show deficits in recognising happy and sad. These predictions were borne out, in a comparison with a group of normal children and in a group of subjects with mental handicap. This result shows the importance of fine-grain analysis in emotion-recognition tasks, and is discussed in relation to affective and theory of mind models of autism.     

Evaluating the Theory-of-Mind Hypothesis of Autism

ABSTRACT— Two decades ago, the theory-of-mind hypothesis of autism was introduced by Baron-Cohen and his colleagues; this theory provided a unified cognitive explanation for the key social and communication symptoms in that disorder. I evaluate the theory-of-mind hypothesis in light of studies that have addressed several key questions: Do children with autism develop theory-of-mind concepts? How can we explain why some children with autism pass theory-of-mind tasks? Do deficits in theory of mind account for the major impairments that characterize autistic disorder? Current research supports the view that autism involves delays and deficits not only in the development of a theory of mind but also in additional aspects of social-affective information processing that extend beyond the traditional boundaries of theory of mind.     

Cognition–emotion interactions in schizophrenia: Emerging evidence on working memory load and implicit facial-affective processing

Although much is known about working memory (WM) and emotion perception deficits in schizophrenia, little is known of how these deficits interact. We sought to address this gap by conducting a narrative review of relevant literatures and distilling core themes. First, people with schizophrenia have difficulty with high load and during initial phases of WM (e.g., encoding, early rehearsal), yet are able to activate WM-related prefrontal brain regions to the same maximal degree as comparison controls under certain circumstances. Second, people with schizophrenia have difficulty identifying and expressing facial emotions, yet demonstrate heightened automatic/implicit processing of facial emotions. Third, people with schizophrenia behaviourally demonstrate intact cognition–emotion interactions on laboratory tasks wherein emotional processing is automatic/implicit, yet demonstrate cognition–emotion disconnections in other levels of analysis. Insights are drawn from basic science showing interdependency between WM load and implicit emotion. Future research questions are raised regarding interactions between WM load and implicit facial-affective processing in schizophrenia.     

Social cognition and social functioning in patients with amnestic mild cognitive impairment or Alzheimer’s dementia

The aim of the present study was to examine social cognition and social functioning in a group of amnestic mild cognitive impairment (aMCI) and Alzheimer’s dementia (AD) patients. Thirty one people with aMCI, 29 individuals with AD, and 45 healthy older adults participated in the study. Facial expressions of happiness, anger, fear, disgust, and surprise presented in different intensities had to be labelled. Mentalizing was assessed using first-order belief theory of mind (ToM) stories and everyday social functioning by the Inventory of Interpersonal Situations (IIS), completed by an informant. aMCI patients were impaired in recognizing the emotions anger, disgust, and fear, while AD patients were impaired in recognizing the emotions anger, disgust, and surprise. More importantly, no significant differences between aMCI and AD patients were found on overall emotion recognition. Both the aMCI and AD patients were impaired on the ToM task, but no differences between the aMCI and AD patients were found. On everyday social functioning, only the AD patients showed impairments. No associations between the IIS and ToM were found, but the IIS and emotion perception were significantly correlated. Regression analysis taking all potentially confounding variables into account showed that only mood, but not the social-cognitive task performance or any other cognitive variable, predicted social functioning. aMCI and AD patients demonstrated impairments in mentalizing and facial emotion perception, and showed decrements in everyday social functioning. Informing caregivers about these deficits may help them to understand deficits in social cognition that may be present already in the MCI stage of Alzheimer’s disease.     

Continuity in social cognition from infancy to childhood

Research examining the development of social cognition has largely been divided into two areas: infant perception of intentional agents, and preschoolers’ understanding of others’ mental states and beliefs (theory of mind). Many researchers have suggested that there is continuity in social cognitive development such that the abilities observed in infancy are related to later preschool ability, yet little empirical evidence exists for this claim. Here, we present preliminary evidence that capacities specific to the social domain contribute to performance in social cognition tasks both during infancy and in early childhood. Specifically, looking time patterns in an infant social cognition task correlated with preschool theory of mind; however, no such relationship was found for infants in a nonsocial cognition task.     

Enhancing Empathy and Theory of Mind

Social cognitive skills such as empathy and theory of mind are crucial for everyday interactions, cooperation, and cultural learning, and deficits in these skills have been implicated in pathologies such as autism spectrum disorder, sociopathy, and nonverbal learning disorders. Little research has examined how these skills develop after early childhood and how they may be trained. We tested the hypothesis that experience in acting, an activity in which one must step into the shoes of others, leads to growth in both empathy and theory of mind. In two studies, we followed children (elementary school aged) and adolescents (high school freshmen) receiving 1 year of either acting or other arts training (visual arts, music) and assessed empathy and theory of mind before and after training. In both studies, those receiving acting (but not other arts) training showed significant gains in empathy scores; in Study 2, adolescents receiving acting training also showed significant gains on a naturalistic measure of theory of mind, the Empathic Accuracy Paradigm. These findings demonstrate plasticity in empathy and theory of mind long past the watershed age of 3 to 4 years and suggest that both capacities are enhanced by role-playing.     

The relationship of clinical, cognitive and social measures in schizophrenia: a preliminary finding combining measures in probands and relatives

This study examines performance of schizophrenia patients, unaffected relatives and controls in social cognition, cognitive and psychiatric scales looking for possible markers of vulnerability in schizophrenia. Performance of schizophrenia patients from multiplex families, first-degree relatives, and matched controls was compared and, subsequently, discriminant analysis method was used for identifying the best predictors for group membership. By using Multigroup Discriminant Analyses on the three groups, the best predictors were PANSS, Premorbid Adjustment Scale, Faux Pas test, and a face/emotion categorizing task. This model obtained 82% correct global classification, suggesting that the combination of psychiatric scales and neuropsychological/social cognition tasks are the best approach for characterizing this disease. Although preliminary, our results suggest that social cognition tasks are robust markers of schizophrenia family impairments, and that combining clinical, social and neuropsychological measures is the best approach to asses patients and relatives vulnerability.     

Autism Overflows: Increasing Prevalence and Proliferating Theories

This selective review examines the lack of an explanation for the sharply increasing prevalence of autism, and the lack of any synthesis of the proliferating theories of autism. The most controversial and most widely disseminated notion for increasing prevalence is the measles–mumps–rubella/thimerosal vaccine theory. Less controversial causes that have been proposed include changes in autism diagnostic criteria, increasing services for autism, and growing awareness of the disorder. Regardless of its causes, the increasing prevalence of autism has put pressure on the field of autism research to generate productive and predictive theories of autism. However, the heterogeneity of brain deficits, impaired behaviors, and genetic variants in autism have challenged researchers and theorists, and despite 45 years of research, no standard causal synthesis has emerged. Research going forward should assume that autism is an aggregation of myriad independent disorders of impaired sociality, social cognition, communication, and motor and cognitive skills.     

Exploring face perception in disorders of development: Evidence from Williams syndrome and autism

Individuals with Williams syndrome (WS) and autism are characterized by different social phenotypes but have been said to show similar atypicalities of face‐processing style. Although the structural encoding of faces may be similarly atypical in these two developmental disorders, there are clear differences in overall face skills. The inclusion of both populations in the same study can address how the profile of face skills varies across disorders. The current paper explored the processing of identity, eye‐gaze, lip‐reading, and expressions of emotion using the same participants across face domains. The tasks had previously been used to make claims of a modular structure to face perception in typical development. Participants with WS (N=15) and autism (N=20) could be dissociated from each other, and from individuals with general developmental delay, in the domains of eye‐gaze and expression processing. Individuals with WS were stronger at these skills than individuals with autism. Even if the structural encoding of faces appears similarly atypical in these groups, the overall profile of face skills, as well as the underlying architecture of face perception, varies greatly. The research provides insights into typical and atypical models of face perception in WS and autism.     

A review of the role of empathy in violence risk in mental disorders

Despite an established link between certain mental disorders and violence, the origins of this are not always clear. Recent work has suggested a role for social cognition deficits in this relationship. We conducted a systematic literature search using EMBASE, SCOPUS, PsychINFO, Science Direct and Ovid Medline databases and search terms relating to empathy, violence and mental disorders. 15 studies were classified as assessing either theory of mind (ToM) (n = 6) or facial affect recognition (FAR) (n = 10). Better mentalizing ability may be linked with violence. Violent patients with schizophrenia perform worse than those with personality disorder, but outperform their non-violent counterparts on complex theory of mind tasks. Six studies examined facial affect recognition in violent psychopathy patients, three of which found impairments in high psychopathy patients. Four studies investigated FAR in violent schizophrenia patients, who again tended to outperform non-violent patients, though the evidence for specificity of emotion remains mixed. Empathy may play a mediating role in the relationship between violence and mental disorder. Current findings are limited by methodological inconsistencies. Future studies would benefit from more comprehensive assessments of violence and co-morbidities, and more standardized measures across studies.     

Why specific developmental disorders are not specific: On-line and developmental effects in autism and dyslexia

In this paper we will suggest that impairments in domain-specific functions may have wide-ranging developmental effects which mimic domain-general impairments. This may explain why ‘pure’ cases of developmental disorders are rare. The understanding of autism and dyslexia has been advanced by theories postulating failure of a specific mechanism against a background of unimpaired general processing. Impairment in the mechanisms underlying ‘theory of mind’ in autism, and ‘phonology’ in dyslexia, predict and explain the pattern of poor and good performance on a range of experimental and real-life tasks. However, existing accounts deal largely with the on-line effects of modular deficits, and can be criticised as not truly developmental. Here we attempt to trace developmental or down-stream effects of specific impairments in mentalising and phonological processing. We argue that these modules act as vital gatekeepers in development. Important in this process is the interaction of cognition with socio-cultural environment, an effect well-illustrated by cross-language differences in dyslexia. We claim that consideration of these developmental effects makes clear why postulating specific impairments may be sufficient for explaining more general deficits.     

Neuroanatomical substrates of social cognition dysfunction in autism

In this review article, we summarize recent progress toward understanding the neural structures and circuitry underlying dysfunctional social cognition in autism. We review selected studies from the growing literature that has used the functional neuroimaging techniques of cognitive neuroscience to map out the neuroanatomical substrates of social cognition in autism. We also draw upon functional neuroimaging studies with neurologically normal individuals and individuals with brain lesions to highlight the insights these studies offer that may help elucidate the search for the neural basis of social cognition deficits in autism. We organize this review around key brain structures that have been implicated in the social cognition deficits in autism: (1) the amygdala, (2) the superior temporal sulcus region, and (3) the fusiform gyrus. We review some of what is known about the contribution of each structure to social cognition and then review autism studies that implicate that particular structure. We conclude with a discussion of several potential future directions in the cognitive neuroscience of social deficits in autism.     

CANTAB explicit memory is less impaired in addicted schizophrenia patients

It has been suggested that in order to sustain the lifestyle of substance abuse, addicted schizophrenia patients would have less negative symptoms, better social skills, and less cognitive impairments. Mounting evidence supports the first two assumptions, but data lack regarding cognition in dual diagnosis schizophrenia. Seventy-six schizophrenia outpatients (DSM-IV) were divided into two groups: with (n = 44) and without (n = 32) a substance use disorder. Motor speed and visuo-spatial explicit memory were investigated using CANTAB. As expected, dual diagnosis patients showed a better cognitive performance. Our results suggest either that substance abuse relieves the cognitive deficits of schizophrenia or that the patients with less cognitive deficits are more prone to substance abuse.     

Ongoing development of social cognition in adolescence

Age differences in social cognition between adolescents and young adults were investigated. Two large groups of adolescents and young adults were given tasks of theory of mind and emotion recognition. In addition, to control for possibly related basic cognitive development, working memory, speed of processing, and verbal ability were assessed. A strong age effect was revealed across both measures of social cognition. Adolescents performed with a lower accuracy than adults. Further analyses indicated that those age differences remained significant even after controlling for basic cognitive abilities. Exploratory analyses indicated no influence of pubertal phase on social cognition. Results suggest ongoing development of social cognition across adolescence, independent of individual differences in more basic cognitive abilities.