Picture Sequencing Task Research Articles

Assessing Theory of Mind in Children: A Tablet-Based Adaptation of a Classic Picture Sequencing Task.

Correctly assessing children's theory of mind (TOM) is essential to clinical practice. Yet, most tasks heavily rely on language, which is an obstacle for several populations. Langdon and Coltheart's (Cognition 71(1):43-71, 1999) Picture Sequencing Task (PST), developed for research purposes, avoids this limitation through a minimally-verbal procedure. We thus developed a tablet adaptation of this task for individual application, engaging children's motivation and allowing response times collection. To assess this tablet-PST, we first tested a large sample of neurotypical children (6-11 years-old, N = 248), whose results confirmed the task's structural and content validity, and permitted the construction of three standardized clinical indices. In a second experiment, we applied those to previously diagnosed autistic children (N = 23), who were expected to show atypical TOM performance. Children's outcomes were consistent with what was hypothesized and confirmed the task's external validity and moderate clinical sensitivity. The tablet-PST thus appears as a suitable tool, providing detailed profiles to inform clinical decisions.

21 Neurocognitive Differences Between Lifestyle Profiles of Women Across the Menopausal Transition

Objective:Women are at greater risk of developing Alzheimer’s disease (AD) than men. The menopausal transition, which involves a neuroendocrine shift, is a potential contributor to this sex difference. Multiple estrogen-regulated systems (i.e., circadian rhythms) are disrupted during this transition which affects cognitive functioning (Barha & Liu-Ambrose, 2020), most notably verbal learning and memory. Little is known about how lifestyle factors (i.e., sleep, physical activity (PA), stress) may promote neurocognitive functioning across this transition (Maki & Weber, 2021). Utilizing data from the Human Connectome Aging project (HCP-A), the current study will examine whether distinct lifestyle profiles including sleep, PA, and stress relate to multiple domains of cognitive performance among a sample of perimenopausal/menopausal women.Participants and Methods:Perimenopausal/menopausal women (ages 45 to 65) from the HCP-A were included (n =150, M age = 54.6, SD = 5.5). Demographic information, menopausal status, sleep problems (Pittsburgh Sleep Quality Index), PA (International Physical Activity Questionnaire), stress (Distress subscale of the Perceived Stress Scale) were assessed with surveys, and participants completed several lab-based tasks including: dimensional change card sort (DCCS), flanker, pattern recognition processing speed (PS), working memory (WM), picture sequencing, oral reading, Trails Making Test A and B (TMT), and Rey Auditory Verbal Learning (RAVLT) tasks. Using latent profile analysis (LPA), lifestyle profiles were identified via sleep problems, PA, and stress levels. A MANOVA compared cognitive performance between these lifestyle profiles, above and beyond age and education status.Results:Fit indices indicated that a three-class solution fit the sample best: high PA, low stress and sleep problems (Class 1, n=38), high PA, stress, and sleep problems (Class 2, n= 17), and low PA, high stress and sleep problems (Class 3, n= 95) which were not significantly different based on age or menopausal status (p>0.05). A significant multivariate effect of age and education on cognitive performance (p<.001) emerged. There was a significant multivariate effect of lifestyle profile on cognitive performance, F (18, 260) = 1.73, p=.034, eta squared = .11, after controlling for age and education. Univariate analyses determined that certain lifestyle profiles were associated with better performance on all cognitive tasks except verbal memory. Contrary to expectation, Class 3 performed better on TMT A & B, DCCS, flanker, WM, and PS tasks as compared to Class 1. Class 3 performed better on reading and picture sequencing tasks than Class 2. There was no difference in performance between Class 1 and 2.Conclusions:Results suggest three distinct lifestyle profiles exist in this analytic sample. After controlling for age and education, cognitive performance on all tasks except for verbal memory significantly differed between lifestyle profiles. The profile characterized by low PA and high stress and sleep problems demonstrated superior performance as compared to other classes. These findings provide preliminary evidence that women who have high levels of stress and sleep problems with low PA are performing better on cognitive tasks, but replication of these findings utilizing longitudinal designs are needed.

Sex differences in autistic adults: A preliminary study showing differences in mentalizing, but not in narrative coherence

Studying autism might be a complex endeavor due to its clinical heterogeneity. Little is currently known about potential sex differences in autistic adults, especially regarding mentalizing and narrative coherence. In this study, male and female participants told a personal story about one of their most positive and most negative life events and performed two mentalizing tasks. One of these mentalizing tasks was a recently developed Picture and Verbal Sequencing task that has shown cerebellar recruitment, and which requires mentalizing in a sequential context (i.e., participants chronologically ordered scenarios that required true and false belief mentalizing). Our preliminary comparison shows that males were faster and more accurate on the Picture Sequencing task compared to female participants when ordering sequences involving false beliefs, but not true beliefs. No sex differences were found for the other mentalizing and narrative tasks. These results highlight the importance of looking at sex differences in autistic adults and provide a possible explanation for sex-related differences in daily life mentalizing functions, which suggest a need for more sensitive diagnosis and tailored support.

Impaired sequence generation: a preliminary comparison between high functioning autistic and neurotypical adults.

Earlier research demonstrated robust cerebellar involvement in sequencing, including high-level social information sequencing that requires mental state attributions, termed mentalizing. Earlier research also found cerebellar deficiencies in autism spectrum disorders (ASD) which are characterized by social difficulties. However, studies on high-level social sequencing functionality by persons with ASD are almost non-existent. In this study, we, therefore, perform a comparison between behavioral performances of high-functioning ASD and neurotypical participants on the Picture and Verbal Sequencing Tasks. In these tasks, participants are requested to put separate events (depicted in cartoon-like pictures or behavioral sentences, respectively) in their correct chronological order. To do so, some of these events require understanding of high-level social beliefs, of social routines (i.e., scripts), or nonsocial mechanical functionality. As expected, on the Picture Sequencing task, we observed longer response times for persons with ASD (in comparison with neurotypical controls) when ordering sequences requiring an understanding of social beliefs and social scripts, but not when ordering nonsocial mechanical events. This confirms our hypotheses that social sequence processing is impaired in ASD. The verbal version of this task did not reveal differences between groups. Our results are the first step toward new theoretical insights for social impairments of persons with ASD. They highlight the importance of taking into account sequence processing, and indirectly the cerebellum when investigating ASD difficulties.

Cognitive and Affective Theory of Mind across Adulthood.

Background: Theory of mind (ToM) is a fundamental aspect of social cognition. Previous studies on age-related changes in mentalizing processes have provided conflicting results. This study aims to investigate the age-related changes in the cognitive and affective components of ToM throughout adulthood. Methods: Two hundred and thirty-eight healthy participants divided into five age groups (18–40 years old; 41–50 years old; 51–60 years old; 61–70 years; 71–80 years old) underwent tasks assessing the cognitive (ToM Picture Sequencing Task, TMPS, and the Advanced Test of ToM, ATT) and affective (Reading the Mind in the Eyes Task, RMET, and the Emotion Attribution Task, EAT) components of ToM, in both verbal and nonverbal modality. Results: Regarding affective ToM, both the youngest- and middle-old adult groups (61 to 80 years) performed worse than the young and youngest-middle adult groups (18 to 50 years) in the RMET, but no significant differences were found in the EAT. Regarding cognitive ToM, the middle-old adult group (71 to 80 years) performed worse than the young adult group (18 to 40 years) only in the TMPS, but no significant differences were found in the ATT. Conclusion: Rather than a general decline in ToM, our results provide evidence regarding selective changes in ToM in older adults, further confirming the dissociation of cognitive and affective ToM.

The Role of the Cerebellum in Social and Non-Social Action Sequences: A Preliminary LF-rTMS Study.

An increasing number of studies demonstrated the involvement of the cerebellum in (social) sequence processing. The current preliminary study is the first to investigate the causal involvement of the cerebellum in sequence generation, using low-frequency repetitive transcranial magnetic stimulation (LF-rTMS). By targeting the posterior cerebellum, we hypothesized that the induced neuro-excitability modulation would lead to altered performance on a Picture and Story sequencing task, which involve the generation of the correct chronological order of various social and non-social stories depicted in cartoons or sentences. Our results indicate that participants receiving LF-rTMS over the cerebellum, as compared to sham participants, showed a stronger learning effect from pre to post stimulation for both tasks and for all types of sequences (i.e. mechanical, social scripts, false belief, true belief). No differences between sequence types were observed. Our results suggest a positive effect of LF-rTMS on sequence generation. We conclude that the cerebellum is causally involved in the generation of sequences of social and nonsocial events. Our discussion focuses on recommendations for future studies.

Diabetes, Obesity-Associated Comorbidities and NIH-Toolbox Neurocognitive Performance

Background/Objectives: Severe obesity is associated with cognitive deficits in adults without current or past neurological brain disturbances. This study examined the relationship between specific metabolic and vascular risk factors and cognitive performance on a computerized neurocognitive assessment battery in adults with BMI > 35. Subjects/Methods: 123 adults with Class II or III obesity, ages 20-75, were enrolled in a study of the cognitive and brain effects of reduced BMI and improved diabetes mellitus (DM) following bariatric surgery. Baseline clinical/cognitive assessments were conducted with the NIH Toolbox (NIH-TB) cognitive module prior to surgery, and in severely obese controls recruited from the community. Global, Fluid and Crystallized indices were derived from performance across nine tasks. Hierarchical regression analyses examined six obesity-associated clinical factors (BMI, HbA1c, and DM, hypertension, sleep apnea, and osteoarthritis diagnoses) relative to NIH-TB performance. Results: Fluid Cognition deficits were observed, greatest on attention-executive and cognitive processing speed tasks (Flanker and Pattern Comparison). DM diagnosis was most strongly associated with weaker cognitive performance (Global and Fluid Cognition), and with poorer performance on the Flanker, Pattern Comparison, Picture Sequencing, Verbal Learning, and Symbol Coding tasks. Elevated HbA1c was associated with weaker Card Sorting and Symbol Coding performance, hypertension with poorer Fluid Cognition, and osteoarthritis with lower List Sorting performance. Elevated BMI was only associated with Flanker performance, though DM was more strongly associated with this measure. Conclusion: Deficits of fluid cognitive functions (attention-executive, processing speed) exist among adults with Class II and III obesity. DM was most consistently associated with weaker NIH-TB performance. BMI was not as strongly associated with NIH-TB performance, perhaps reflecting the elevated BMI of the entire sample. That cognitive deficits were linked to specific obesity-associated comorbidities support the validity and potential clinical utility of the NIH-TB for the assessment and management of adults with severe obesity.

Cognitive theory of mind in bipolar disorder: Comparisons with healthy controls and associations with function

Cognitive forms of Theory of Mind (ToM) have been linked to social function in Bipolar Disorder (BD). To explore this social functioning was assessed with the GAF and cognitive ToM was assessed with the Hinting Task and the Picture Sequencing Task (PST) in 45 patients with BP and 45 healthy controls. As predicted, the BD group took longer to complete the PST. The BD group did not offer more incorrect responses to either cognitive ToM task. Greater latency on the PST predicted poorer social function after controlling for symptoms, partially supporting a relationship between ToM and social function in BD.

DO BIPOLAR PATIENTS LACK MIND READING; AN ATTEMPT TO ASSESS THROUGH PICTURE SEQUENCING TASK

Background: This paper reports the performance of ICD-10 diagnosed Bipolar affective disorder (BPAD) patients on a well recognised measure of theory of mind (ToM) that commonly elicits group related differences in schizophrenia research.
 Aims: (1) To assess Theory of mind in patients of Bipolar Affective Disorder. 
 (2) To examine effect of mood on Theory of Mind.
 Method: Three groups were formed namely Control, BPAD (M) and BPAD (D). Each group was socio-demographically suitably matched and had 30 participants. Active symptomatology was assessed by using YMRS and MADRS in BPAD(M) and BPAD(D) cases respectively. Theory of mind was calculated using Landon and Clotheart (1999) Picture Sequencing Task.
 Results: Relative to controls, bipolar patients performed significantly worse on the ToM relevant false belief script in picture sequencing task but not on other types of task stories. No significant difference was observed in the ToM performance between the phase of bipolarity.
 Conclusion: The results support previous evidence of ToM deficit in BPAD and indicate a potential endophenotypic overlap in the phenomenology of both Schizophrenia and BPAD.
 Keywords: Theory of Mind, YMRS, MADRS, Picture Sequence Task

Theory of mind in Parkinson's disease: evidences in drug-naïve patients and longitudinal effects of dopaminergic therapy.

Theory of mind (ToM) is the ability to attribute mental states to one self and others and to understand that others have beliefs different from one's own. Different subcomponents of ToM have also been identified: cognitive and affective. Cognitive ToM refers to the capacity to infer others' beliefs and intentions, while affective ToM implies the ability to appreciate others' emotional states. The aim of this study was to explore ToM in drug-naïve Parkinson's disease (PD) patients and to investigate the effects of chronic dopaminergic therapy on different subcomponents of ToM during a 3months and 1year of follow-up. We examined 16 PD patients in three conditions: before (un-medicated) and after dopaminergic therapy (medicated 3months: T1 and medicated 1year: T2). We also compared our PD's ToM abilities with 11 healthy individuals. ToM was explored with 5 different tasks: Faux Pas Test, Picture Sequencing Task Capture Story, Emotion Attribution Task, Strange Stories Task, and Karolinska Directed Emotional Faces. Our study confirms that PD patients present deficits in cognitive components of ToM and preserved performances in the affective ones in early stages of disease. We also find a significant effect of dopaminergic therapy on ToM already after 3months with a good persistency after 1year of treatment.

Autistic traits in psychotic disorders: prevalence, familial risk, and impact on social functioning.

Prevalence estimates of autistic traits in individuals with psychotic disorders (PD) vary greatly and it is unclear whether individuals with a familial risk (FR) for psychosis have an increased propensity to display autistic traits. Furthermore, it is unknown whether the presence of comorbid autism traits disproportionally affects the cognitive and behavioral aspects of social functioning in PD. In total, 504 individuals with PD, 587 unaffected siblings with FR, and 337 typical comparison (TC) individuals (16-50 years) were included. Autistic and psychotic traits were measured with the Autism Spectrum Quotient (AQ) and the Community Assessment of Psychic Experiences (CAPE). Social cognition was assessed with the Picture Sequencing Task (PST) and social behavior with the Social Functioning Scale (SFS). For PD 6.5% scored above AQ clinical cut-off (⩾32), 1.0% for FR, and 1.2% for TC. After accounting for age, sex, and IQ, the PD group showed significantly more autistic traits and alterations in social behavior and cognition, while FR and TC only displayed marginal differences. Within the PD group autistic traits were a robust predictor of social behavior and there were no interactions with positive psychotic symptoms. Levels of autistic traits are substantially elevated in PD and have a profoundly negative association with social functioning. In contrast, autistic traits above the clinical cut-off are not elevated in those with FR, and only marginally on a dimensional level. These findings warrant specific clinical guidelines for psychotic patients who present themselves with autistic comorbidity to help address their social needs.

Cross-cultural comparison of theory of mind deficits in patients with schizophrenia from China and Denmark: different aspects of ToM show different results

Introduction: Theory of mind (ToM) has been established as one of the most investigated and pronounced social cognitive deficits in schizophrenia. Yet, knowledge on whether measures of ToM can be used and compared across cultures is sparse. In this study, we used two simple, non-verbal ToM tests in patients with schizophrenia and non-clinical controls from China and Denmark to investigate whether culture has an impact on ToM performance.Methods: Sixty-six patients with schizophrenia (35 Chinese) and 67 matched non-clinical controls (38 Chinese) from China and Denmark were tested with Brünés Picture Sequencing Task and Animated Triangles Task. We compared three models for each outcome variable in order to investigate which model best fitted the data: the first model included group (controls, patients) as a predictor variable, the second included group and nationality (Chinese, Danish), and the third included both predictors and their interaction.Results: On most ToM subtests, culture seemed to play a role. Only performance on Brüne’s 1st order ToM were best described as similar in both countries. The second model had the best fit for most of the subtests indicating that the difference between patients and controls in China and Denmark, respectively, is similar.Conclusions: Caution to cultural differences should be taken when comparing ToM in Asian and Western patients with schizophrenia as well as healthy individuals.

Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis \u2013 a secondary analysis of a randomized-controlled therapy trial

BackgroundCognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients’ social life: the quality of their therapeutic relationship.MethodsPatients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy.ResultsIn comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist.ConclusionsCognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and patients with problems in ER are more likely to be viewed as problematic by their therapists. Nevertheless, training ER might be a way to improve the quality of the therapeutic relationship and potentially the effectiveness of CBT or other interventions for patients with psychosis.

The role of the cerebellum in reconstructing social action sequences: a pilot study.

Recent research has revealed that the cerebellum plays a critical role in social reasoning and in particular in understanding false beliefs and making trait attributions. One hypothesis is that the cerebellum is responsible for the understanding of sequences of motions and actions, which may be a prerequisite for social understanding. To investigate the role of action sequencing in mentalizing, we tested patients with generalized cerebellar degenerative lesions on tests of social understanding and compared their performance with matched healthy volunteers. The tests involved understanding violations of social norms making trait and causal attributions on the basis of short behavioral sentences and generating the correct chronological order of social actions depicted in cartoons (picture sequencing task). Cerebellar patients showed clear deficits only on the picture sequencing task when generating the correct order of cartoons depicting false belief stories and showed at or close to normal performance for mechanical stories and overlearned social scripts. In addition, they performed marginally worse on trait attributions inferred from verbal behavioral descriptions. We conclude that inferring the mental state of others through understanding the correct sequences of their actions requires the support of the cerebellum.

Recasts and Prompts in Dyadic Interaction: Explicitness of Feedback and Learner Proficiency

The study investigated the effects of recasts and prompts on learning language forms that arose incidentally in dyadic interaction, focusing on the degree of explicitness of each type of feedback and learner proficiency levels. The data were collected from 64 beginning and upper-intermediate English learners of Korean. Thirty-one beginning learners were randomly assigned to a feedback group and to a control group, and thirtythree upper-intermediate learners were also assigned to a feedback group and to a control group. Each learner was paired with an English speaker and worked on a picture-sequencing task. The learners in the feedback groups received recasts or prompts on their erroneous utterances while the learners in the control groups did not. The effects of feedback were measured by pre-interaction picture descriptions and immediate and delayed post-interaction correction tasks. The study found that both recasts and prompts had some effects on learning the targeted forms, and more explicit forms of each feedback resulted in a higher rate of correction. The beginning learners took more advantages of recasts relative to the upper-intermediate learners, and explicit prompts worked better for the upper-intermediate learners. The effects of prompts sustained longer than recasts in both levels.

Modelling the executive components involved in processing false belief and mechanical/intentional sequences.

To understand the executive demands of the false-belief (FB) task relative to an alternative theory-of-mind (or mechanical causality) task, picture sequencing, the present study used path analyses. One hundred and sixty-six children between 3 and 6years old completed the FB and picture-sequencing tasks, three executive function tasks (updating, inhibition, and shifting), and the receptive language test. The model with the best fit indicated that FB performance had a direct contribution from shifting of attention and inhibitory control, which was independent of the significant contribution made by picture sequencing. This model indicates that FB inference requires more executive processing than picture sequencing, which is used as an alternative task to measure theory of mind. Statement of contribution What is already known on this subject? The majority of researchers use the false-belief task to assess mentalizing ability in young children. Sources of information used in various different mentalizing tasks require different levels of cognitive demand. Many executive functions (EFs) are involved in children's judgements of false belief. What does this study add? A statistical model was created to compare processing requirements of false-belief and picture-sequencing tasks. The model supported the claim that the false-belief task involves considerably more than just mentalizing. Shifting the focus of attention was an EF that was found to be a key component of performance in the false-belief task.

Preschoolers' Development of Theory of Mind: The Contribution of Understanding Psychological Causality in Stories.

This study investigated the relationship between children’s abilities to understand causal sequences and another’s false belief. In Experiment 1, we tested 3-, 4-, 5-, and 6-year-old children (n = 28, 28, 27, and 27, respectively) using false belief and picture sequencing tasks involving mechanical, behavioral, and psychological causality. Understanding causal sequences in mechanical, behavioral, and psychological stories was related to understanding other’s false beliefs. In Experiment 2, children who failed the initial false belief task (n = 50) were reassessed 5 months later. High scorers in the sequencing of the psychological stories in Experiment 1 were more likely to pass the standard false belief task than were the low scorers. Conversely, understanding causal sequences in the mechanical and behavioral stories in Experiment 1 did not predict passing the false belief task in Experiment 2. Thus, children may understand psychological causality before they are able to use it to understand false beliefs.

Effect of proficiency on Vietnamese EFL learners’ engagement in peer interaction

To expand previous interaction research that investigated only the impact of proficiency on occurrence of language related episodes or pair dynamics, this study explored the effect of proficiency on a range of cognitive, social and emotional features of interaction through the lens of engagement. Fifteen core EFL learners interacted with peers of higher and lower proficiency to complete picture sequencing tasks. The core learners’ degree of engagement when interacting with the lower and the higher proficiency partners was compared. Results revealed that the core learners showed greater cognitive and social engagement and reported higher emotional engagement when interacting with higher proficiency partners. The results are discussed in terms of the role of proficiency pairing in fostering learner engagement in interaction.

The Usefulness of Picture Sequencing Tasks in Developmental Assessment

The Usefulness of Picture Sequencing Tasks in Developmental Assessment

The application of the abbreviated metacognitive assessment scale in patients with schizophrenia and neurosis in China

Objective To explore the application of the abbreviated metacognitive assessment scale(MAS-A) in patients with schizophrenia and neurosis. Methods With the aid of the Indiana Psychiatric Illness Interview (IPII), 115 schizophrenic patients and 89 neurotic patients were assessed using the MAS-A, and compared the group difference of MAS-A scores. All patients were also tested with the theory of mind picture sequencing task (ToM-PST). The criterion-related validity was evaluated using of correlated MAS-A total-score with ToM-PST total-score. 31 neurotic patients and 34 schizophrenic patients were measured after one month to compute the test-retest reliability. Results The reliability analysis showed that the Cronbach α-coefficients for MAS-A of total sample, schizophrenic group and neurotic group were 0.829, 0.826, 0.823, respectively. The test-retest reliability of MAS-A and four factors were 0.722, 0.541, 0.650, 0.615 and 0.525 (all P<0.01). The validity analysis also showed that the correlation coefficient between the total scores of MAS-A and ToM-PST were 0.470, 0.383, 0.292 (all P<0.01) in total sample, schizophrenia and neuroses patients, respectively. Additionally, the scores of MAS-A of schizophrenia patients were significantly lower than that of neurotic patients. Conclusion MAS-A has good reliability and validity and is a valuable tool in application to metacognitive assessment for chinese mental population. Key words: Metacognition; Schizophrenia; Neuroses; Reliability; Validity