Picture Sequencing Task Research Articles

Theory of mind in children with Neurofibromatosis Type 1.

Neurofibromatosis Type I (NF1) is a single gene disorder associated with cognitive and behavioral deficits. While there is clear evidence for poorer social outcomes in NF1, the factors underlying reduced social function are not well understood. This study examined theory of mind (ToM) in children with NF1 and unaffected controls. ToM was assessed in children with NF1 (n = 26) and unaffected controls (n = 36) aged 4-12 years using a nonverbal picture sequencing task. The task assessed understanding of ToM (unrealized goals, false belief, pretence, intention), while controlling for social script knowledge and physical cause-and-effect reasoning. Children with NF1 made significantly more errors than unaffected controls on most ToM stories while demonstrating no difficulty sequencing physical cause-and-effect stories. Performance on the picture sequencing task was not related to lower intellectual function, symptoms of attention deficit-hyperactivity disorder (ADHD), or parent ratings of executive function. Results suggest a generalized ToM deficit in children with NF1 that appears to be independent of general cognitive abilities and ADHD symptoms. The study refines understanding of the clinical presentation of NF1 and identifies psychological constructs that may contribute to the higher prevalence of social dysfunction in children with NF1. (PsycINFO Database Record

Theory of Mind in Schizophrenia: Associations With Clinical and Cognitive Insight Controlling for Levels of Psychopathology.

Poor insight in schizophrenia is a risk factor for both poor outcomes and treatment adherence. Accordingly, interest in identifying causes of poor insight has increased. This study explored whether theory of mind (ToM) impairments are linked to poor clinical and cognitive insight independent of psychopathology. Participants with schizophrenia (n = 37) and control subjects (n = 40) completed assessments of ToM with the Hinting Task and the Brüne Picture Sequencing Task, clinical insight and psychopathology with the Positive and Negative Syndrome Scale, and cognitive insight with the Beck Cognitive Insight Scale. Results indicated that the schizophrenia group had greater impairments in ToM relative to control subjects. In the schizophrenia group, the Hinting Task performance was related to both cognitive and clinical insight, with only the relationship with cognitive insight persisting after controlling for psychopathology. Picture Sequencing Task performance was related to cognitive insight only. Future research directions and clinical implications are discussed.

Theory of Mind and social functioning in schizophrenia: correlation with figurative language abnormalities, clinical symptoms and general intelligence.

Over past few decades, studies displayed Theory of Mind (ToM) as a system, including cognitive and affective features, rather than an unitary process. Within domains defining social cognition, ToM stands for the best predictor of poor social functioning in schizophrenia. The current study aimed to explore competence in ToM tasks, in metaphorical and idiomatic language identification tasks and in a conversational rules observance test, as well as relationship with social functioning, in a group of outpatients suffering from schizophrenia. METHODS.: 30 outpatients diagnosed with schizophrenia and 24 healthy subjects have been recruited. Both groups underwent TIB as premorbid IQ evaluation, PANSS, Theory of Mind Picture Sequencing Task, a metaphors and idiomatic expressions comprehension test and a conversational test. Social functioning was assessed with PSP. Results.Mean values of premorbid IQ showed no significant difference between patients and control group. In ToM and pragmatic competence tasks, differences between groups resulted in high significance, due to patients' lower performance. A correlation between metaphors and idiomatic expressions comprehension and second order false beliefs was detected. PSP showed a correlation with PANSS and cognitive-ToM, whereas leaving aside affective-ToM. Results showed how people affected with schizophrenia, in stable clinical condition, do have clear impairments in ToM and figurative language comprehension assignments. In our theoretical framework, correlation arisen between cognitive-ToM, pragmatic deficits, clinical status and social functioning level suggests usefulness of rehabilitative interventions to recover metacognitive functions and pragmatic abilities, in order to reduce social disability in schizophrenia.

An experimental investigation of mentalization ability in borderline personality disorder

ObjectiveDeficits in mentalization ability have been theorized to underlie borderline personality disorder (BPD) and have led to mentalization-based treatments. Yet there has been little empirical investigation into whether mentalization deficits do differentiate the BPD population from healthy controls, and the specific nature of these differences. MethodFive pre-existing Theory of Mind (ToM) tasks that assessed simple to complex mentalization capacity in both the affective and cognitive domains were administered to the same groups of age and gender matched patients with BPD and controls. Self-report measures assessed cognitive and affective empathy and childhood trauma and abuse. ResultsThe BPD group did not differ significantly from the healthy control group on basic cognitive false-belief picture-sequencing tasks, or on overall accuracy when discriminating mental states from viewing images of eyes, and attributing emotions based on social events. They were, however, significantly less accurate in identifying positive mental states on the Reading the Mind in the Eyes (RME) task and showed significantly more mentalization errors on affective and cognitive understanding of faux pas (faux pas total score p<.01) and on a Joke Appreciation task (p=.01), that required integration of multiple perspectives. They also self-reported less empathic perspective taking (p<.01). Observation of patterns of performance hinted at specific underlying biases (e.g. a default tendency to use superficial black-and-white attributions to others, such as, “he is mean”, when explaining behavior). It was also found that as childhood experiences of punishment increased, adulthood mentalization ability decreased on all affective ToM tasks and on the cognitive and affective components of understanding faux pas. ConclusionsThe BPD group was as capable as controls in undertaking simple mentalization. However, deficits in mentalization capacity became evident when mentalization tasks became more complex and required the integration of multiple perspectives. Increasing childhood experiences of punishment were related to decreasing mentalization ability in adulthood. Findings support the use of treatments to improve mentalization skills in BPD, however, further research is needed to better specify the nature of underlying mentalizing biases in this population.

An Empirical Research on the Noticing Function of Oral Output

Based on Swain’s Output Hypothesis, the paper reports an experimental study that investigated the noticing function of oral output and its effect on the acquisition of English past hypothetical conditional. Twenty sophomores majoring in economics participated in this study, with ten of them assigned to the experimental group and the other to the control group. The experimental group was engaged in picture description tasks, which tended to elicit their oral production. The control group was only required to do comprehension tasks (ie. picture sequencing task) with the same material. The data collected from the immediate posttest and the delayed posttest were analyzed by SPSS11.5. The results indicated that the experimental group made significant improvement in using the target form in both the immediate posttest and the delayed posttest. Moreover, in both of the posttests the experimental group performed significantly better than the control group in using the target form. These results lend support to Swain’s Output Hypothesis and have important pedagogical implications.

Study of faux pas recognition and belief understanding in early-onset schizophrenia

Objective To explore the cognitive function of the theory of mind(TOM) in early-onset schizophrenia from faux pas recognition and belief understanding dimensions. Methods 41 early-onset schizophrenias(EOS)and 40 normal adolescents were interviewed by the Chinese version of faux pas recognition task and theory of mind picture-sequencing task(ToM-PST), then early-onset schizophrenias cognitive features were analyzed. Results ①In faux pas recognition task, compared with healthy subjects, EOS showed significantly less total scores (16.11±6.34 vs 20.86±7.79, P 0.05). ②In ToM-PST task, early-onset schizophrenic patients also had significantly less total score(17.29±3.38 vs 21.48±1.73, P 0.05)except the subscores of understanding the first order belief(P<0.01). Conclusion The theory of mind is apparent damage in early onset schizophrenia and non-significant correlation is found with psychiatric symptoms. Key words: Early onset schizophrenia; Theory of mind; Faux pas recognition; Belief understanding

Social cognition dysfunction in adolescents with 22q11.2 deletion syndrome (velo-cardio-facial syndrome): relationship with executive functioning and social competence/functioning.

Social difficulties are often noted among people with intellectual disabilities. Children and adults with 22q.11.2 deletion syndrome (22q11DS) often have poorer social competence as well as poorer performance on measures of executive and social-cognitive skills compared with typically developing young people. However, the relationship between social functioning and more basic processes of social cognition and executive functioning are not well understood in 22q11DS. The present study examined the relationship between social-cognitive measures of emotion attribution and theory of mind with executive functioning and their contribution to social competence in 22q11DS. The present cross-sectional study measured social cognition and executive performance of 24 adolescents with 22q11DS compared with 27 age-matched typically developing controls. Social cognition was tested using the emotion attribution task (EAT) and a picture sequencing task (PST), which tested mentalising (false-belief), sequencing, cause and effect, and inhibition. Executive functioning was assessed using computerised versions of the Tower of London task and working memory measures of spatial and non-spatial ability. Social competence was also assessed using the parent-reported Strengths and Difficulties Questionnaire. Adolescents with 22q11DS showed impaired false-belief, emotion attribution and executive functioning compared with typically developing control participants. Poorer performance was reported on all story types in the PST, although, patterns of errors and response times across story types were similar in both groups. General sequencing ability was the strongest predictor of false-belief, and performance on the false-belief task predicted emotion attribution accuracy. Intellectual functioning, rather than theory of mind or executive functioning, predicted social competence in 22q11DS. Performance on social-cognitive tasks of theory of mind indicate evidence of a general underlying dysfunction in 22q11DS that includes executive ability to understand cause and effect, to logically reason about social scenarios and also to inhibit responses to salient, but misleading cues. However, general intellectual ability is closely related to actual social competence suggesting that a generalised intellectual deficit coupled with more specific executive impairments may best explain poor social cognition in 22q11DS.

A correlation study of humor experience and theory of mind in schizophrenia

Objective To explore humor experience and its relationship with theory of mind in patients with schizophrenia. Methods sixty-one schizophrenic patients without treatment and sixty-three healthy subjects were assessed with the Humor Picture Test (HPT), Humor Video Test (HVT) and the Theory-of-Mind Picture-Sequencing Task (ToM-PST). Results Compared with healthy subject in HPT, schizophrenic patients showed significantly higher non-humor picture rating score (24.41 ± 8.82 vs 28.41 ± 11.56, P<0.05), and less humor picture rating score (45.65 ± 11.49 vs 34.41 ± 13.06, P<0.05). Compared with healthy subject in HVT, schizophrenic patients also showed significantly less humor video rating score (3.56 ± 0.57 vs 2.46 ± 0.79, P<0.01) and the number of standard humorous moments (3.68 ± 1.19 vs 2.42 ± 1.40, P<0.01) and the sensitivity of standard humorous moments-d’(humor) score (1.11 ± 0.46 vs 0.47 ± 0.42, P<0.01). Schizophrenic patients had significantly less total score (39.89 ± 12.33 vs 58.76 ± 0.64, P<0.01) of ToM-PST compared to normal control. Correlation analysis showed a negative correlation between d’(humor) score and the Positive and Negative Syndrome Scale (PANSS) total score (r=-0.380, P<0.01) for the patients. There was significantly negative correlation between non-humor picture rating score and ToM-PST total score (r=-0.316, P<0.05), and positive correlation between d’(humor) score and ToM-PST total score (r=0.400, P<0.01) in schizophrenic patient. After controlling for the PANSS total score, the correlation between d’(humor) score and ToM-PST total score remained significant. Conclusion Schizophrenic patients have poor humor experience, which is related to the impairments of theory of mind.Humor experience deficit may share a common neuropsychological base with the impairment of theory of mind. Key words: Humor experience; Theory of mind; Schizophrenia

Picture sequencing task performance indicates theory of mind deficit in bipolar disorder

BackgroundThis paper reports the performance of DSM-IV-TR diagnosed bipolar disorder (BD) patients on a well-recognised measure of theory of mind (ToM) that commonly elicits group-related differences in schizophrenia research. MethodsForty-nine BD patients and 49 age and gender matched controls completed Langdon and Coltheart (1999)Picture Sequencing Task. ResultsRelative to controls, patients with BD performed significantly worse on the ToM relevant false-belief stories of the picture sequencing task, but not on the control stories requiring social script knowledge, executive control or an understanding of causal connexions. There were no differences in the ToM performance of symptomatic versus euthymic patients or those categorised as having BD I or BD II. LimitationsAs sub group sizes were small, data suggesting a trait-like deficit in ToM should be interpreted with caution. ConclusionsThe results support previous evidence of ToM impairment in BD and indicate a potential endophenotypic overlap in the phenomenology of both schizophrenia and BD.

Making sense of theory of mind and paranoia: The psychometric properties and reasoning requirements of a false belief sequencing task

Introduction. This study used Item–Response Theory (IRT) to model the psychometric properties of a false belief picture sequencing task. Consistent with the mental time travel hypothesis of paranoia, we anticipated that performance on this deductive theory of mind (ToM) task would not be associated with the presence of persecutory delusions but would be related to other clinical, cognitive, and demographic factors. Method. A large (N=237) and diverse clinical and nonclinical sample differing in levels of depression and paranoid ideation performed 2 ToM tasks: the false belief sequencing task and a ToM stories task that was used to assess the validity of the false belief sequencing task as a measure of ToM. Results. A unidimensional IRT model was found to fit the data well. Latent ToM ability as measured by the false belief sequencing task was negatively related with age and positively with IQ. In contrast to the ToM stories measure, there was no association between clinical diagnosis or symptoms and false belief picture sequencing after controlling for age and IQ. Conclusions. In line with mental time travel hypothesis of paranoia (Corcoran, 2010), performance on this deductive nonverbal ToM task is not related to the presence of paranoid symptoms. This measure is best suited for assessing ToM functioning where participants’ performance falls just short of the average latent ToM ability. Furthermore, it is sensitive to the effects of increasing age and decreasing IQ.

The relationship between theory of mind and insight in psychosis: Evidence for specificity

We predicted that mentalizing relates to social aspects of insight in psychosis. Thirty participants experiencing psychosis and presenting poor to moderate insight undertook a false belief picture sequencing task with control sequences. We used an improved scoring system that accounted simultaneously for speed and accuracy of mentalizing. While mentalizing was not significantly related to global insight, “awareness of psychosis”, “re‐labelling symptoms as abnormal”, or “understanding need for treatment”, it was positively related to the influence of the opinions of unspecified “others” on insight. Participants were insightful in predicting their doctor’s opinion, but this was unrelated to mentalizing. Intact social knowledge about doctors, rather than mentalizing, may be used to understand the doctor’s opinion. However, mentalizing is needed to incorporate others’ opinions about psychosis into one’s own insight, as the perspectives of unspecified “others” would likely vary more than that of medical professionals. The results suggest that medical professionals should be careful to distinguish simple recognition of their views from genuine insight.

‘Theory’ of mind impairment in patients affected by schizophrenia and in their parents

“Theory of mind” (ToM) is the ability to judge the mental states of the self and others. It is currently considered as a part of the broader concept of social cognition, known to influence the social behaviour of patients affected by schizophrenia. Recently it has been hypothesized that the impairment of ToM is a trait that can be detected both in patients with schizophrenia and in non-psychotic relatives of patients, but it still not clear what the contribution of the familial patterns of cognitive impairment is.The aim of this study is to assess parental impairments of ToM performance considering the effects of the neurocognitive abilities known to be impaired in their first-degree relatives and to influence ToM in schizophrenic patients.Patients, their parents and control trios were assessed with the Wisconsin Card Sorting Test (WCST), the Symbol Coding Task and the ToM Picture Sequencing Task. The ANCOVA analysis on 47 trios including a schizophrenic offspring and 47 healthy trios showed a statistically significant poorer performance of patients and their parents in comparison to control trios at Symbol Coding Task and ToM task. Moreover a regression analysis showed that the neuropsychological abilities tested were significant predictors of ToM performance only in patients. Results confirm a ToM impairment among parents of patients with schizophrenia that is not directly correlated to other aspects of neurocognitive functioning.

Brain activation associated with theory of mind

Theory of Mind (ToM) which the ability to attribute mental states to others are important processes in social cognition. Brain imaging studies in healthy subjects have described a brain system involving medial prefrontal cortex, superior temporal sulcus and temporal pole in ToM processing. In this functional magnetic resonance imaging (fMRI) study, we used the picture sequencing tasks with both intentional story (ToM story) and physical story in order to allow comparison of brain activations in these two processes. Participants were ten right-handed healthy Japanese volunteers (male = 5, female = 5; mean age was 24.9 years, s.d. = 1.4). Functional images were acquired using a 1.5 T Siemens Magnetom Vision. Our results showed that the ToM story compared to the physical story revealed increased activations in bilateral superior frontal gyrus, medial frontal gyrus, and right middle frontal gyrus. Correct responses in the ToM story were associated with enhanced activations of right middle frontal gyrus, bilateral superior frontal gyrus, right orbital gyrus, and left inferior frontal gyrus. These activations are common to a part of results in previous brain imaging studies on ToM and social cognitive functions using various tasks. The present study suggests that social cognition in a nonverbal task is especially associated with the medial and right middle frontal function. These results have implications for our understanding of disorders characterized by impairments of social cognition which are related to making references about mental states of others, such as schizophrenia and autism.

Can only intelligent children do mind reading: The relationship between intelligence and theory of mind in 8 to 11 years old

BackgroundThe mind reading ability of children has evoked wide interest, but its relationship with general cognitive abilities remains obscure.MethodsWe studied the relationship between the mind reading ability and general intelligence. Children (N = 105) between 8 to 11 years from educational institutions were assessed for the mind reading ability using Picture Sequencing Task and Unexpected Contents Theory of Mind task. We used Strengths and Difficulties Questionnaire to rule out psychiatric morbidity. An independent investigator quantified intelligence and adaptive behavior with Binet- Kamat Test of intelligence and Vineland Adaptive Behavior Scale respectively. We employed bivariate and multivariate statistical tests.ResultsWe demonstrated that mind reading ability was not significantly related to general intelligence or its domains except for the social intelligence after controlling the confounders methodologically and statistically.ConclusionThese findings argue that mind reading skill exists as an independent cognitive domain and has clinical, research as well as educational implications.

EXPLORATORY STUDY OF THE ASSOCIATION BETWEEN INSIGHT AND THEORY OF MIND (TOM) IN STABLE SCHIZOPHRENIA PATIENTS

Background. Poor insight and impairment in Theory of Mind (ToM) reasoning are common in schizophrenia, predicting poorer clinical and functional outcomes. The present study aimed to explore the relationship between these phenomena. Methods. 61 individuals with a DSM-IV diagnosis of schizophrenia during a stable phase were included. ToM was assessed using a picture sequencing task developed by Langdon and Coltheart (1999), and insight with the Scale to Assess Unawareness of Mental Disorder (SUMD; Amador et al., 1993). Multivariate linear regression analysis was carried out to estimate the predictive value of insight on ToM, taking into account several possible confounders and interaction variables. Results. No direct significant associations were found between any of the insight dimensions and ToM using bivariate analysis. However, a significant linear regression model which explained 48% of the variance in ToM was revealed in the multivariate analysis. This included the 5 insight dimensions and 3 interact...

Taking the Perspective of the Other Contributes to Awareness of Illness in Schizophrenia

Two approaches dominate research on the lack of awareness of illness that characterizes schizophrenia. The "deficit" approach uses standardized neuropsychological batteries to identify the neural underpinnings of intact insight; the "nondeficit" approach investigates the psychological defense mechanisms that motivate denial of illness. We adopt, instead, a cognitive neuropsychological approach to model the cognitive processes which underpin insight and which might be either damaged (because of neuropathology) or not used (because of motivational forces). We conceive of these processes in terms of a metacognitive capacity "to see ourselves as others see us." We predict that a general difficulty with adopting other mental perspectives (with "seeing the world as others do"), indexed by performance deficits on theory of mind (ToM) tasks, will impair insight in schizophrenia. Thirty schizophrenic patients (also assessed for insight) and 26 healthy controls completed a battery of ToM tasks which varied presentation modality, response mode and instruction type (picture sequencing, joke appreciation and story comprehension tasks). While patients performed more poorly than controls on all ToM tasks, impairment in patients was not concordant across tasks. ToM scores from the picture sequencing and joke appreciation tasks, and not the story comprehension task, intercorrelated significantly in patients and predicted insight. Findings support the view that insight relies upon a cognitive capacity to adopt the other perspective, which, if intact, contributes to the metacognitive capacity to reflect upon "one's own" mental health from the other perspective. Findings also suggest that the nature of perspective-taking difficulty which disrupts insight in schizophrenia is best revealed using ToM tasks with "indirect" instructions.

Exploratory study of the association between insight and Theory of Mind (ToM) in stable schizophrenia patients

Background. Poor insight and impairment in Theory of Mind (ToM) reasoning are common in schizophrenia, predicting poorer clinical and functional outcomes. The present study aimed to explore the relationship between these phenomena. Methods. 61 individuals with a DSM-IV diagnosis of schizophrenia during a stable phase were included. ToM was assessed using a picture sequencing task developed by Langdon and Coltheart (1999), and insight with the Scale to Assess Unawareness of Mental Disorder (SUMD; Amador et al., 1993). Multivariate linear regression analysis was carried out to estimate the predictive value of insight on ToM, taking into account several possible confounders and interaction variables. Results. No direct significant associations were found between any of the insight dimensions and ToM using bivariate analysis. However, a significant linear regression model which explained 48% of the variance in ToM was revealed in the multivariate analysis. This included the 5 insight dimensions and 3 interaction variables. Misattribution of symptoms—in aware patients with age at onset >20 years—and unawareness of need for medication—in patients with GAF >60—were significantly predictive of better ToM. Conclusion. Insight and ToM are two complex and distinct phenomena in schizophrenia. Relationships between them are mediated by psychosocial, clinical, and neurocognitive variables. Intact ToM may be a prerequisite for aware patients to attribute their symptoms to causes other than mental illness, which could in turn be associated with denial of need for medication.

Theory of mind deficits in chronic schizophrenia: Evidence for state dependence

There is evidence that people with schizophrenia show specific deficits in theory of mind (ToM). However, it is a matter of debate whether these are trait or state dependent, and the nature of the relationship between ToM deficits and particular symptoms is controversial. This study aimed to shed further light on these issues by (1) examining ToM abilities in 61 individuals with chronic schizophrenia during a stable phase as compared with 51 healthy controls matched by gender, age, educational level and current IQ, and (2) exploring the relationship between ToM and symptoms. Second order verbal stories and a non-verbal picture-sequencing task were used as ToM measures. Results showed no differences in ToM performance between patients and controls on either measure. Subsequent subgrouping of patients into remitted and non-remitted showed a worse performance of non-remitted patients only on second order ToM tasks. Specific ToM deficits were found associated with delusions. Association with negative symptoms was found to be less specific and accounted for by illness chronicity and general cognitive impairment. The results from the present study are in line with models which hypothesise that specific ToM deficits in schizophrenia are state dependent and associated with delusions. Such associations may also be task specific.

Theory of Mind in Williams Syndrome Assessed Using a Nonverbal Task

This study examined Theory of Mind in Williams syndrome (WS) and in normal chronological age-matched and mental age-matched control groups, using a picture sequencing task. This task assesses understanding of pretence, intention and false belief, while controlling for social-script knowledge and physical cause-and-effect reasoning. The task was selected because it is entirely non-verbal, so that the WS individuals could not rely on their good verbal skills when performing the task. Results indicated a specific deficit in understanding of false belief within the WS group. There was also evidence of heterogeneity in the WS group, with the false belief impairment restricted to only a particular subgroup of WS individuals identified originally by Porter, M., & Coltheart, M. (2005). Cognitive heterogeneity in Williams syndrome. Developmental Neuropsychology, 27(2), 275-306.

Theory of mind and its relation to schizotypy

Introduction. Frith (1992) suggested that many psychotic symptoms are associated with impaired theory of mind (ToM), the ability to represent the mental states of others. Langdon and Coltheart (1999) found an association in a nonclinical adult population between schizotypal traits and poorer ToM on a picture-sequencing task. The present study attempted to replicate and extend this finding using a ToM story task. Methods. A total of 62 nonclinical individuals completed a schizotypy questionnaire (the Oxford-Liverpool Inventory of Feelings and Experiences; O-LIFE) and a set of ToM stories. Matched “physical” control stories were administered to control for general reasoning ability. Executive function and current verbal IQ were assessed using the Cognitive Estimates Test and the Quick Test, respectively. Results. Schizotypal traits analogous to positive symptoms of schizophrenia (UE scale of the O-LIFE) predicted poorer scores on the ToM task, but were unrelated to scores on physical stories. Individuals with high scores for total schizotypy on the O-LIFE did not differ in ToM from those with low total scores. There was no association between poorer ToM and schizotypal traits analogous to the “behavioural signs” of schizophrenia. Executive function and verbal IQ did not significantly predict story scores. Conclusions. Positive schizotypal traits in the normal population are associated with subtle impairments in ToM, independent of reasoning ability, executive function, or verbal IQ. A strong association between poor ToM and “behavioural signs” may only appear in studies of schizophrenic patients, and not in studies of nonclinical individuals. The findings are discussed in relation to Frith's (1992) cognitive neuropsychological model of schizophrenia.