Theory Of Mind Deficits Research Articles

Altered social cognition in early relapsing remitting multiple sclerosis.

People with multiple sclerosis (pwMS) may suffer from some degree of impaired social cognition (SC), the process that integrates the mental operations underlying social interactions. SC is still not clearly characterized in the early stages of MS, and it is not defined whether SC is independent of cognitive impairment. In this cross-sectional study, we aimed to compare SC measures in a population of early (≤5 years) relapsing-remitting MS (RRMS) with an age, sex, and education-matched control group. All participants performed a clinical and a comprehensive neuropsychological assessment. SC evaluation included assessment of facial emotion recognitionn by the Emotion Recognition Task, affective theory of mind (ToM) by the Reading the Mind in the eyes Test (RMET) and cognitive ToM by the Faux Pas test (FPT). Depression, anxiety, fatigue, and quality of life were also assessed. We included 38 pwMS (mean age 34.8 ± 8.7, 78.9% female sex, mean disease duration 1.9±1.3 years) and 38 healthy controls (mean age 34.9 ± 8.4, 81.6% female sex). Altered social cognition was present in 34.2% of pwMS. Participants with MS performed worse than controls on measures of cognitive ToM, and affective ToM. There were no differences regarding FER. Cognitive ToM and FER correlated with cognitive functions, but no correlation was found between affective ToM and cognitive tests. The only clinical factor associated with altered SC was poor quality of life. Social cognition impairment is already present in a significant percentage of early RRMS patients, namely ToM deficits. While cognitive ToM and FER appears to correlate with impaired cognitive results, affective ToM is likely independent of other cognitive functions.

Theory of mind deficits in Parkinson's disease are not modulated by dopaminergic medication.

Patients with Parkinson's disease (PD) exhibit deficits in social cognition, particularly with respect to Theory of Mind (ToM) capacities. It is unclear whether they are associated with PD-related dopamine deficiency and modulated by levodopa replacement therapy. A total of 15 persons with PD and 13 healthy controls (HC) participated in the study. They performed different neuropsychological tasks, including the Faux Pas Recognition Test (FPRT), assessing different dimensions of cognitive ToM (e.g., detection, inappropriateness, intentions), and the Reading the Mind in the Eyes Test (RMET) as an index of affective ToM. Persons with PD were tested twice, once under their regular treatment and another time after at least 18 h of levodopa withdrawal (MED-ON and MED-OFF, respectively). On either occasion, serum drug levels and motor symptom severity [Unified Parkinson's Disease Rating Scale (UPDRS)] were measured. MED-ON and MED-OFF conditions in patients with PD were confirmed by higher serum drug levels in the former than in the latter state and a corresponding amelioration of the motor deficit. In so doing, no performance difference in any ToM-related task was identified as a function of the levodopa therapy. Generally, patients performed worse than controls in both affective and cognitive ToM tests. Patients with PD have deficits in cognitive and affective ToM. Dopamine replacement, effective for improving the motor condition, does not appear to counteract these dysfunctions.

Theory of Mind and Executive Functions in Individuals with Mild Cognitive Impairment or Healthy Aging.

Social cognition involves skills for maintaining harmonious personal and social relationships throughout life. Social cognition issues, including Theory of Mind (ToM), can significantly impact the well-being of older individuals and intensify with the onset of neurological conditions. Mild Cognitive Impairment (MCI) is a state between healthy and pathological neurocognitive aging, where monitoring social functions is crucial. Despite numerous studies on ToM challenges in older adults and cognitive disorders, the underlying mechanisms remain debated. Uncertainty exists regarding whether ToM deficits are related to other cognitive functions, such as Executive Functions (EFs). Our study examined the correlation between EF and ToM performance in 32 MCI patients and 36 healthy elderly controls. The findings revealed a link between EF and ToM performance among healthy elderly individuals. Specifically, within the assessed EFs, the role of the working memory (WM) emerged. The study also highlighted distinctions between the MCI group and the healthy elderly group, showing that despite a general reduction in cognitive performance, the condition could impact these abilities in different ways. The study contributes to the literature, fostering comprehension of the mechanisms underlying ToM difficulties, while also paving the way for targeted interventions and enhanced clinical or preventative care.

Exploring Cognitive-Pragmatic Heterogeneity Following Acquired Brain Injury: A Cluster Analysis of Hint Comprehension.

Difficulties understanding nonliteral language (especially hints) are frequently reported following acquired brain injury (ABI). Several cognitive mechanisms, such as context processing, executive functions, and theory of mind (ToM), may underlie these disorders. However, their role remains controversial, mainly because of the characteristic heterogeneity of this population. Therefore, our study aimed to identify cognitive-pragmatic profiles in individuals with ABI. A new task of hint comprehension, manipulating executive demand, markers of hints, and ToM and neuropsychological tests were administered to 33 participants with frontal ABI and 33 control participants. Cluster analysis, a method sensitive to profile heterogeneity, was applied and coupled with error analysis. We highlighted two cognitive-pragmatic profiles. One subgroup of participants with ABI exhibited contextual insensitivity, leading them to infer the utterance meaning based on linguistic decoding alone-literal meaning. This difficulty in understanding hints was associated with deficits in working memory, inhibition, and ToM. The second subgroup of participants with ABI showed difficulty with literal statements, associated with impaired inhibition and ToM. In addition, the two subgroups differed only on the ToM task. This result suggests that various types of ToM deficit (misunderstanding vs. incorrect attribution of mental states) could contribute to the variability of the pragmatic profiles observed (difficulties in interpreting hints vs. literal statements). The experimental design adopted in this study provides valuable insight into the explanatory hypotheses of nonliteral language comprehension disorders and has important clinical implications. https://doi.org/10.23641/asha.24069516.

The other side of the social interaction: Theory of mind impairments in people with schizophrenia are linked to other people's difficulties in understanding them.

People with schizophrenia (SZ) often present with theory of mind (ToM) deficits and with speech production deficits. While a link has been established between ToM abilities and symptoms of thought disorder, much less is known about other aspects of speech production in SZ. This is a case-control study in which 25 stable outpatients with recent-onset SZ (27.1years, 22 men) and 22 matched healthy controls (25.6years, 16 men) performed a collaborative, verbal production task with a real interaction partner. Blind raters scored how easy participants made it to understand them (Facility ratings), how interesting they were to listen to (Interest ratings) and how expressive they were (Expressivity ratings). ToM was assessed with the Combined Stories Test and Sarfati's cartoon task. Symptoms were assessed with the PANSS five-factor version. Compared to healthy controls, SZ received significantly lower ratings for all three aspects of their verbal productions (Facility, Interest and Expressivity), despite the raters being blind to group membership. Interestingly, the Facility ratings were linked to ToM performance in the SZ group, which suggest that SZ participants who have difficulties understanding others (ToM deficits) also make it harder for others to understand them. Other notable findings include a strong link between the Expressivity ratings and the Interest ratings for both groups, and significant correlations between the Facility ratings and Cognitive/Disorganisation symptoms, and between the Expressivity ratings and both Negative and Depression/Anxiety symptoms in SZ. Studying speech production during real, collaborative social interactions could help move beyond the individual approach to SZ deficits, making it possible to involve the interaction partners to promote more efficient communication for people with schizophrenia.

Social Cognition in Idiopathic Generalized Epilepsies and Nonlesional Temporal Lobe Epilepsy

Objectives. Social cognition (SC) is a multifaceted concept involving mental processes to understand, store, and apply information regarding social relationships. Brain lesions in key areas can impair critical components of SC, but seizures and epileptiform discharges could also be associated with deficits in SC. To verify this hypothesis, this study evaluated SC in persons with generalized or focal epilepsy without detectable brain lesion. Materials and Methods. Forty-eight adult persons with idiopathic generalized epilepsy (IGE) or temporal lobe epilepsy without brain lesion (cryptoTLE) and 24 healthy controls were evaluated by means of the Faux Pas Test (FPT), Social Situation Test (SST), Moral/Conventional Distinction Test (MCDT), and Empathy Questionnaire (EQ) which assess theory of mind (ToM), recognition of social behaviors and moral and conventional rules, and empathy. Clinical work-up included information on age at seizure onset, epilepsy duration, seizure symptoms and frequency, demographic characteristics, and the presence of comorbidities. Results. Compared to controls, persons with IGE or cryptoTLE were impaired in the understanding of existent faux pas on the FPT. On the SST, persons with cryptoTLE also showed significant deficits, whereas the IGE persons only were less accurate in recognizing normative behaviors. In cryptoTLE persons, the capacity to recognize cognitive and affective mental states correlated with seizure frequency and age, whereas, in IGE persons, the SST and MCDT scores correlated with schooling and age, respectively. Conclusions. CryptoTLE can cause extensive deficits in ToM and recognition of social situations, whereas IGE is only associated with deficits in fewer domains. Dysfunction of temporolimbic areas could be related to seizure frequency and associated with more severe SC impairment in cryptoTLE. Older age and poor education may be associated with SC deficits in focal or generalized epilepsy.

Psychological/Personal recovery and its correlates in patients with first episode psychosis.

Recovery in psychosis is a multidimensional construct. The numbers of studies specially focusing on the recovery aspects in patients with first episode psychosis (FEP) are limited, with no study from India. Further, no study has looked specifically into the variables that affect recovery process in patients with FEP and little is known about factors which influence recovery in patients with FEP. To evaluate psychological recovery and its correlates in patients with FEP, currently in clinical remission. One hundred three patients of FEP in clinical remission were assessed on Recovery Assessment Scale (RAS), Positive and Negative Syndrome Scale for Schizophrenia, Calgary Depression Rating Scale for Schizophrenia, Negative Symptom Assessment 16, Rosenberg Self-esteem Scale, Social and Occupational Functioning Assessment Scale, the Alcohol, Smoking and Substance Involvement Screening Test, Beck Cognitive Insight Scale, Internalized Stigma of Mental Illness Scale, the Everyday discrimination Scale, Subjective Scale to Investigate Cognition in Schizophrenia and social cognitive deficits in theory of mind was evaluated on the Social Cognition Rating Tools in Indian Setting-Theory of Mind. The needs of the participants were assessed on the Camberwell Assessment of Needs - Research version and Supplemental Assessment of Needs. Coping, social support, medication adherence were also assessed by standardized scales. The mean weighted score was highest for goal and success orientation subscale followed by seeking and relying on social support, personal confidence and hope, overcome the illness and awareness and control over the illness as assessed by 41 items of the RAS. The main factors identified to affect psychological recovery in patients with FEP were duration of untreated psychosis, greater psychopathology, lower self-esteem, total unmet need, feeling of discrimination and stigmatization. The present study suggests that treatment of FEP should be started at the earliest and issues such as residual psychopathology, lower self-esteem, total unmet need, feeling of discrimination and stigma during the remission phase should be addressed by psychosocial interventions to promote psychological recovery in patients with first episode psychosis.

Increased Functional Connectivity Involving the Parahippocampal Gyrus in Patients with Schizophrenia during Theory of Mind Processing: A Psychophysiological Interaction Study

Theory of Mind (ToM) is an ability to infer the mental state of others, which plays an important role during social events. Previous studies have shown that ToM deficits exist frequently in schizophrenia, which may result from abnormal activity in brain regions related to sociality. However, the interactions between brain regions during ToM processing in schizophrenia are still unclear. Therefore, in this study, we investigated functional connectivity during ToM processing in patients with schizophrenia, using functional magnetic resonance imaging (fMRI). A total of 36 patients with schizophrenia and 33 healthy controls were recruited to complete a ToM task from the Human Connectome Project (HCP) during fMRI scanning. Psychophysiological interaction (PPI) analysis was applied to explore functional connectivity. Patients with schizophrenia were less accurate than healthy controls in judging social stimuli from non-social stimuli (Z = 2.31, p = 0.021), and displayed increased activity in the right inferior frontal gyrus and increased functional connectivity between the bilateral middle temporal gyrus and the ipsilateral parahippocampal gyrus during ToM processing (AlphaSim corrected p < 0.05). Here, we showed that the brain regions related to sociality interact more with the parahippocampal gyrus in patients with schizophrenia during ToM processing, which may reflect a possible compensatory pathway of ToM deficits in schizophrenia. Our study provides a new idea for ToM deficits in schizophrenia, which could be helpful to better understand social cognition of schizophrenia.

Anorexia Nervosa and Autism Spectrum Disorder: what links them?

IntroductionAccording to the literature, about 35% of patients with Anorexia Nervosa (AN) also have a diagnosis of Autism Spectrum Disorder (ASD), and this comorbidity occurs more frequently in males.ObjectivesWith this work, the authors intend to address the characteristics present in this comorbidity and what is the impact of this comorbidity in the diagnosis, approach and prognosis of AN.MethodsNon-systematic research of the literature through the PubMed database with the terms “autism spectrum disorder” and “anorexia nervosa”. Only surveys conducted in the last 10 years were considered for inclusion.ResultsAlthough AN and ASD may seem to be quite distinct conditions, the studies found suggest the existence of four characteristics that overlap the two diagnoses: deficits in theory of mind, inability to switch between courses of action fluently, inability to see the whole pictures to the detriment of detail and alexithymia. Studies also point to greater resistance to treatment in AN when an ASD is present in comorbidity.ConclusionsScientific evidence suggests that autistic characteristics in people with AN are not a consequence of being underweight, but rather stable characteristics present before and after the onset of AN. The studies thus conclude that comorbidity between the two disorders exists and is frequent enough to warrant greater attention to the diagnosis of ASD in people with AN. However, there are still no specific guidelines for the treatment of AN in people with ASD, which leads to a worse response to treatment, evolution and prognosis of AN in people with ASD.Disclosure of InterestNone Declared

The role of the cerebellum in sequencing and predicting social and non-social events in patients with bipolar disorder.

Advances in the operational mode of the cerebellum indicate a role in sequencing and predicting non-social and social events, crucial for individuals to optimize high-order functions, such as Theory of Mind (ToM). ToM deficits have been described in patients with remitted bipolar disorders (BD). The literature on BD patients' pathophysiology reports cerebellar alterations; however, sequential abilities have never been investigated and no study has previously focused on prediction abilities, which are needed to properly interpret events and to adapt to changes. To address this gap, we compared the performance of BD patients in the euthymic phase with healthy controls using two tests that require predictive processing: a ToM test that require implicit sequential processing and a test that explicitly assesses sequential abilities in non-ToM functions. Additionally, patterns of cerebellar gray matter (GM) alterations were compared between BD patients and controls using voxel-based morphometry. Impaired ToM and sequential skills were detected in BD patients, specifically when tasks required a greater predictive load. Behavioral performances might be consistent with patterns of GM reduction in cerebellar lobules Crus I-II, which are involved in advanced human functions. These results highlight the importance of deepening the cerebellar role in sequential and prediction abilities in patients with BD.

Transdiagnostic overlap in brain correlates of affective and cognitive theory of mind deficits.

Social cognitive symptoms characterize multiple neurological disorders, including brain tumours and neurodegeneration. Recently, Campanella and colleagues1 investigated deficits in cognitive and affective theory of mind (TOM) in 105 tumour patients using a non-verbal task of 18 stimuli that required patients to select one out of three possible endings of a cartoon story, i.e. the Story-based Empathy Task (SET).2 The SET includes three conditions [Causal Inference (CI), Intention Attribution (IA) and Emotion Attribution (EA)], reflecting the type of inference the items tap into: inference of physical properties, intentions, or characters’ emotional state, respectively. The behavioural results of Campanella’s study revealed specific EA deficits in patients with temporal lobe tumours. Furthermore, the authors used parcel-based lesion-symptom mapping (PLSM) and reported an association between a right anterior temporal cluster and EA performance. Right amygdalar lesions showed a stronger association with EA than with IA. The association between EA deficits and amygdalar volume has also been also reported in behavioural variant frontotemporal dementia (bvFTD),3 a neurodegenerative disorder, characterized by deficits in social cognition, including cognitive and affective TOM. Consistent with the findings of Campanella, we also observed an association between performance on the EA condition and grey matter volume of the right temporal lobe and amygdala3 (Fig. 1). As documented by Campanella and colleagues, such common neural correlates of EA performance largely overlap with a ‘reasoning about emotions’ network derived from a recent meta-analysis of functional brain imaging studies in healthy participants.4 These combined findings converge in supporting a critical role of the right amygdala and temporal lobe in emotion attribution.

Impairment or difference? The case of Theory of Mind abilities and pragmatic competence in the Autism Spectrum

AbstractPsycholinguistic research on pragmatics in the neurotypical population has increasingly framed pragmatic competence and related cognitive skills in terms of individual differences, co-constructed discourse, and meaning negotiation. However, research on pragmatics in the Autism Spectrum has risen from a wide and biased view of autistic communication as fundamentally compromised and autistic pragmatic abilities as impaired. Mostly due to the impactful theory of a deficit in Theory of Mind, early research on autistic communication presumed a unitary pragmatic impairment, only to find that several pragmatic abilities seem to be “preserved.” However, the interpretation of these findings usually takes an ableist turn, as most studies subsequently suggest that surface-level performance should not be interpreted as competence, but rather as a result of “compensatory” strategies. The raising number of contributions from autistic academics and participatory research enriched the field with new perspectives focusing on differences rather than impairments and drawing hypotheses on communication difficulties between neurotypes rather than within a specific neurotype. However, such contributions are hardly ever cited in the most prominent works. In conclusion, the field would benefit from a higher level of citation of autistic-led research and from an epistemological perspective shift within the mostly neurotypical academic community.

The complexity of theory of mind deficit in schizophrenia: A cross-sectional analysis of baseline data from a longitudinal schizophrenia study

A large number of trials have supported the functional significance of Theory of Mind (ToM) impairment in schizophrenia. However, the nature and the extent of the impairment are still unclear. Reviews on the topic suggest that, in many cases, studies use only one tool to assess the levels of difficulty in the field, limiting the validity of the measurement to one aspect of ToM. On the other hand, the divergence of the used assessment tools makes it hard to compare the result of these studies. Thus, we decided to use additional assessment tools to evaluate the extent of ToM in order to describe several aspects of the phenomenon.A hierarchical cluster analysis of variables was used on a sample of 68 participants with schizophrenia or schizoaffective disorder, to determine the similarity between variances of the assessed ToM subcomponents. Further cross-sectional correlational analysis was then performed to investigate the association between the identified clusters and other used measures (e.g.: neurocognition).The statistical analysis supported a five-cluster model. Identified clusters illustrate the difference between Hypo and HyperToM as well as the degree of ToM task complexity, allowing for a more accurate description of the nature of ToM deficit in schizophrenia.

Comparison of theory of mind and neurocognition in siblings and offspring of female schizophrenia patients

This study aims to compare the Theory of Mind (ToM) functions in the siblings and offspring of female Schizophrenia patients in an evaluation of the association between neurocognitive functions and ToM. A battery of ToM tests (Reading the Mind in the Eyes Test, Hinting Test and Faux Pas Test) and neurocognitive tests (Digit Span Test, Corsi Block Test, Digit Symbol Substitution Test, Rey’s Auditory Verbal Learning Test, Trail Making Test, The Stroop Test, Wisconsin Card Sorting Test) were used to assess 31 offspring, 29 siblings of female schizophrenia patients and 28 healthy controls (HC). When the ToM functions of the offspring, siblings and HC groups in the present study are compared, no significant difference is identified between the offspring and sibling groups in Hinting, Faux Pas and Eyes tests, while Hinting test performance of the sibling group was significantly lower than those of the HCs. Neurocognitive functions are more affected both in offspring and siblings than HC. Although it was determined that ToM deficits of the patients’ relatives were not as prominent as their neurocognitive functions, ToM is an endophenotype candidate in schizophrenia.

A mind-reading puzzle: Autistic people are more efficient at a theory-of-mind task

Theory of Mind (ToM) is essential to adapt in social situations; however, a ToM deficit might be involved in autism. To better understand how ToM reasoning affects problem solving in autistic and non-autistic individuals, we compared autistic and non-autistic children and adults in a series of problems presented in social and non-social framings, using an adapted version of a classical referential communication task. In the social framing, participants were asked to anticipate the behavior of an agent who might ignore some components of the scene. In the non-social framing, the task required participants to consider and ignore similar features of the scene, but an agent was not involved. Simply framing the task as a social one increased the difficulty, particularly for non-autistic participants. Interestingly, the framing had less of an impact on autistic participants, who showed better performance in the social task relative to non-autistics and maintained similar performance across framings. We propose that autistic participants might have translated the social instructions into a general rule that proved more efficient in this situation. Our findings suggest a critical distinction between ToM understanding and the continuous use of a ToM strategy in repeated situations.

Social cognition deficits are associated with lower quality of life in cervical dystonia: A single centre study

Background and objectivesPatients with cervical dystonia (CD) demonstrate significant non-motor symptoms including sensory, psychiatric and cognitive features. It has been shown that the non-motor symptoms have a major influence on quality of life. Social cognition, particularly deficits in Theory of Mind (ToM), can affect the development of interpersonal relationships, understanding of social situations and can affect patient outcomes.We used the “Faux Pas” measure of social cognition to assess ToM in patients with CD and compared this with quality of life, disease severity and psychiatric symptoms. MethodsPatients with adult-onset idiopathic isolated cervical dystonia were assessed using the “Faux Pas” questionnaire. Validated questionnaires were used to assess mood symptoms (BAI/BDI and HADS) and quality of life (CDIP-58). Disease-specific disability, motor severity and psychosocial symptoms were measured using TWSTRS2. Faux pas results were compared with published healthy control values. Results32 participants (19 female) were included with a mean age of 57.7 years. 20 participants met criteria for excess mood symptoms (anxiety and/or depression). Mean CDIP-58 was 31.9. There was no relationship between faux pas outcomes and motor severity. However, correlation analyses showed that participants who performed worse on the faux pas questionnaire had lower quality of life. ConclusionThe non-motor symptoms, including social cognition, are often neglected. We have demonstrated that low quality of life in CD is associated with to abnormal social cognition. Clinicians should be mindful of these symptoms, particularly in patients reporting low treatment satisfaction.

Neurocognitive and behavioral predictors of theory of mind (ToM) in patients with traumatic brain injury (TBI).

Investigating the core component of social cognition, known as the theory of mind (ToM), becomes imperative in patients with moderate-to-severe traumatic brain injury (TBI) as they may present with social cognitive deficit-related disability interfering with patients' functional and behavioral status. This study aimed to investigate the neurocognitive and behavioral predictors of the ToM in patients with traumatic brain injury (PtTBI). Thirty PtTBI and 30 healthy controls (HCs) were assessed on a set of tasks. The assessment included ToM tasks (cognitive and affective, verbal and nonverbal, and first-order and second-order) along with various neuropsychological (NP) assessments to explore their memory, executive functioning, and intelligence. Further, TBI participants also underwent behavioral and functional outcome measures using the Functional Status Examination (FSE) and the Neurobehavioral Rating Scale (NBRS). The obtained data were analyzed using descriptive statistics and regression analyses. Findings confirmed ToM deficit across all modes of ToM tasks in PtTBI and implicated the role of executive function and working memory in the expression of ToM in this group. While cognitive faux pas (FPC) and first-order false belief together could explain poor performance on NBRS, the nonverbal ToM task predicts functional outcome in PtTBI. These findings have practical implications as they promote cognitive remediation intervention focused on restoring ToM, which may improve functional limitations and resulting disability in PtTBI.

Improving social emotional functioning in adolescents with Developmental Language Disorders: A mini review and recommendations.

Adolescents with Developmental Language Disorders (DLD) have more difficulties in social emotional functioning than their typically developing peers (TD), such as shyness and anxiety in social situations, fewer peer relations, greater risk of victimization, social isolation and depression. In addition, they are more likely to report higher levels of hyperactivity and conduct problems. These problems derive from a complex interplay between difficulties in language, social communication, underlying cognitive deficits in Theory of Mind (ToM), Executive Functioning (EF) and self-directed speech (SDS). The aim of this mini review is to provide an overview of studies examining the effectiveness of interventions targeting the factors underlying social emotional functioning of school-aged children and adolescents with DLD. We found that studies dedicated to social emotional functioning in school-aged children and adolescents with DLD were relatively scarce. Based on this overview, we give suggestions to improve social emotional functioning in adolescents with DLD. We propose that intervention programs should target the social, linguistic and cognitive functions underlying social emotional functioning and create opportunities to practice these skills in daily, real-life situations with peers.

The Cerebellum Is a Key Structure in the Neural Network for Mentalizing: An MRI Study in the Behavioral Variant of Frontotemporal Dementia.

The behavioural variant of frontotemporal dementia (bvFTD) is primarily characterized by deficits in social behaviour and theory of mind (ToM). Although a consensus has been reached on the roles of the cerebellum in social cognition and ToM, its specific contribution to social impairments of bvFTD has never been specifically investigated. The aim of this study was to assess cerebellar structural and functional changes in patients with bvFTD and their potential association with ToM deficits of patients. Therefore, 15 patients with bvFTD and 34 healthy subjects underwent an MRI examination. Voxel-based morphometry was used to assess cerebellar (GM) changes, and a seed-based analysis was performed to test cerebello-cerebral functional connectivity (FC). The performance of bvFTD patients in a ToM task was then correlated with FC patterns. Compared to healthy subjects, patients with bvFTD showed significant cerebellar GM loss specifically involving cerebellar Crus I-II. Additionally, FC changes FC were observed between the cerebellum and cerebral regions related to ToM. Interestingly, patterns of changes in cerebello-cerebral FC correlated with altered ToM performances explored using the "Reading the Mind with the Eyes" test (RMET) of patients. The present findings suggest that specific changes in cerebello-cerebral FC may underlie ToM alterations in patients with bvFTD.

Indirect effects of theory of mind on alcohol use and problems in underage drinkers: The role of peer pressure to drink

ObjectivePrior studies demonstrate a link between socio-cognitive deficits and alcohol problems in adolescents and young adults. Researchers have proposed that young people with such deficits may misperceive and over-value peers' attitudes about drinking and consider drinking a way to be accepted by their peer group. We test this hypothesis by investigating whether theory of mind (ToM) deficits in underage (18–20-year-old) drinkers are associated with binge drinking and alcohol problems, and whether these ToM deficits have an indirect effect on alcohol outcomes through perceived peer pressure to drink (i.e., high conformity motives and low perceived ability to refuse alcohol during social pressure). MethodParticipants (N = 472; 91 % female; 71 % White; Mage = 19.28 ± 0.77) were recruited from TurkPrime and completed measures assessing ToM, conformity motives, self-efficacy to resist peer pressure to drink, alcohol problems, and binge drinking. Bivariate correlations were run to examine associations between study variables. Indirect effect models were run in SPSS, using the PROCESS add-on, to assess the indirect effects of ToM on alcohol outcomes through conformity motives and self-efficacy to refuse peer pressure to drink. ResultsToM had indirect effects on binge drinking and alcohol problems through conformity motives (but not self-efficacy to resist peer pressure to drink). Lower ToM was associated with higher conformity motives, which were then associated with more frequent binge drinking and greater alcohol problems. ConclusionsThese findings highlight the role of social cognition in young adult alcohol misuse and suggest more work is needed to understand the potential influence of peer pressure in this association.