Second-order False Belief Research Articles

Late, but not early, arriving younger siblings foster firstborns’ understanding of second-order false belief

This study examined the influence of younger siblings on children’s understanding of second-order false belief. In a representative community sample of firstborn children (N=229) with a mean age of 7years (SD=4.58), false belief was assessed during a home visit using an adaptation of a well-established second-order false belief narrative enacted with Playmobil figures. Children’s responses were coded to establish performance on second-order false belief questions. When controlling for verbal IQ and age, the existence of a younger sibling predicted a twofold advantage in children’s second-order false belief performance, yet this was the case only for firstborns who experienced the arrival of a sibling after their second birthday. These findings provide a foundation for future research on family influences on social cognition.

Reliability and validity of advanced theory-of-mind measures in middle childhood and adolescence.

Although theory-of-mind (ToM) development is well documented for early childhood, there is increasing research investigating changes in ToM reasoning in middle childhood and adolescence. However, the psychometric properties of most advanced ToM measures for use with older children and adolescents have not been firmly established. We report on the reliability and validity of widely used, conventional measures of advanced ToM with this age group. Notable issues with both reliability and validity of several of the measures were evident in the findings. With regard to construct validity, results do not reveal a clear empirical commonality between tasks, and, after accounting for comprehension, developmental trends were evident in only one of the tasks investigated. Statement of contribution What is already known on this subject? Second-order false belief tasks have acceptable internal consistency. The Eyes Test has poor internal consistency. Validity of advanced theory-of-mind tasks is often based on the ability to distinguish clinical from typical groups. What does this study add? This study examines internal consistency across six widely used advanced theory-of-mind tasks. It investigates validity of tasks based on comprehension of items by typically developing individuals. It further assesses construct validity, or commonality between tasks.

Testing the validity of a continuous false belief task in 3- to 7-year-old children

In two studies, we examined young children’s performance on the paper-and-pencil version of the Sandbox task, a continuous measure of false belief, and its relations with other false belief and inhibition tasks. In Study 1, 96 children aged 3 to 7years completed three false belief tasks (Sandbox, Unexpected Contents, and Appearance/Reality) and two inhibition tasks (Head–Shoulders–Knees–Toes and Grass/Snow). Results revealed that false belief bias—a measure of egocentrism—on the Sandbox task correlated with age but not with the Unexpected Contents or Appearance/Reality task or with measures of inhibition after controlling for age. In Study 2, 90 3- to 7-year-olds completed five false belief tasks (Sandbox, Unexpected Contents, Appearance/Reality, Change of Location, and a second-order false belief task), two inhibition tasks (Simon Says and Grass/Snow), and a receptive vocabulary task (Peabody Picture Vocabulary Test). Results showed that false belief bias on the Sandbox task correlated negatively with age and with the Change of Location task but not with the other false belief or inhibition tasks after controlling for age and receptive vocabulary. The Sandbox task shows promise as an age-sensitive measure of false belief performance during early childhood and shows convergent and discriminant validity.

Theory of Mind Impairments in Women With Cocaine Addiction.

This study investigates the Theory of Mind performance of female cocaine-dependent users (CDUs) and possible associations between theory of mind performance and features of cocaine use. Sixty women controlled for age, education, individual income, and IQ participated in this study: 30 in the CDU group and 30 in the healthy control group. Participants were assessed for theory of mind with the Reading the Mind in the Eyes Test (RMET), a test of understanding of first-order and second-order false beliefs, and the Hinting task. Drug use parameters, clinical symptoms, and neuropsychological functioning were also assessed. Analyses of covariance indicated Theory of Mind impairments in negative mental states within the RMET and second-order false-belief understanding of Theory of Mind stories. In addition, Theory of Mind impairment was associated with drug use characteristics, including craving and number of hospitalizations. High-demand Theory of Mind is suggested to be impaired in CDU women, and the deficits appear to be related to drug addiction severity. We found associations between Theory of Mind deficits and worse clinical and social outcomes.

Five-Year-Olds' Systematic Errors in Second-Order False Belief Tasks Are Due to First-Order Theory of Mind Strategy Selection: A Computational Modeling Study.

The focus of studies on second-order false belief reasoning generally was on investigating the roles of executive functions and language with correlational studies. Different from those studies, we focus on the question how 5-year-olds select and revise reasoning strategies in second-order false belief tasks by constructing two computational cognitive models of this process: an instance-based learning model and a reinforcement learning model. Unlike the reinforcement learning model, the instance-based learning model predicted that children who fail second-order false belief tasks would give answers based on first-order theory of mind (ToM) reasoning as opposed to zero-order reasoning. This prediction was confirmed with an empirical study that we conducted with 72 5- to 6-year-old children. The results showed that 17% of the answers were correct and 83% of the answers were wrong. In line with our prediction, 65% of the wrong answers were based on a first-order ToM strategy, while only 29% of them were based on a zero-order strategy (the remaining 6% of subjects did not provide any answer). Based on our instance-based learning model, we propose that when children get feedback “Wrong,” they explicitly revise their strategy to a higher level instead of implicitly selecting one of the available ToM strategies. Moreover, we predict that children’s failures are due to lack of experience and that with exposure to second-order false belief reasoning, children can revise their wrong first-order reasoning strategy to a correct second-order reasoning strategy.

Syntactic Recursion Facilitates and Working Memory Predicts Recursive Theory of Mind.

In this study, we focus on the possible roles of second-order syntactic recursion and working memory in terms of simple and complex span tasks in the development of second-order false belief reasoning. We tested 89 Turkish children in two age groups, one younger (4;6–6;5 years) and one older (6;7–8;10 years). Although second-order syntactic recursion is significantly correlated with the second-order false belief task, results of ordinal logistic regressions revealed that the main predictor of second-order false belief reasoning is complex working memory span. Unlike simple working memory and second-order syntactic recursion tasks, the complex working memory task required processing information serially with additional reasoning demands that require complex working memory strategies. Based on our results, we propose that children’s second-order theory of mind develops when they have efficient reasoning rules to process embedded beliefs serially, thus overcoming a possible serial processing bottleneck.

Correlates of social functioning in autism spectrum disorder: The role of social cognition

BackgroundIndividuals with autism spectrum disorder (ASD) experience marked challenges with social function by definition, but few modifiable predictors of social functioning in ASD have been identified in extant research. This study hypothesized that deficits in social cognition and motor function may help to explain poor social functioning in individuals with ASD. MethodCross-sectional data from 108 individuals with ASD and without intellectual disability ages 9 through 27.5 were used to assess the relationship between social cognition and motor function, and social functioning. ResultsResults of hierarchical multiple regression analyses revealed that greater social cognition, but not motor function, was significantly associated with better social functioning when controlling for sex, age, and intelligence quotient. Post-hoc analyses revealed that better performance on second-order false belief tasks was associated with higher levels of socially adaptive behavior and lower levels of social problems. ConclusionsOur findings support the development and testing of interventions that target social cognition in order to improve social functioning in individuals with ASD. Interventions that teach generalizable skills to help people with ASD better understand social situations and develop competency in advanced perspective taking have the potential to create more durable change because their effects can be applied to a wide and varied set of situations and not simply a prescribed set of rehearsed situations.

Social Cognition in Schizophrenia Patients and Their First-Degree Relatives.

Social cognition is a person's ability to configure the designs of relationships between themselves and others and to use these designs to guide social behaviors in a flexible manner. The models that are the most studied and describe social cognition are the theory of mind (ToM) and emotion recognition. This study was aimed to detect ToM and emotion recognition disorders in schizophrenia patients and their first-degree relatives. Thirty schizophrenia patients in remission, the first-degree relatives of schizophrenia patients (n=30), and 30 healthy volunteers who were paired with the patients in terms of age and duration of education were included in the study. The Positive and Negative Symptom Scale (PANSS), Dokuz-Eylül Theory of Mind Scale (DEToMS), Reading the Mind in the Eyes test, Facial Emotion Identification Test (FEIT), and Facial Emotion Discrimination Test (FEDT) were performed by the patients participating in this study. ToM and emotion recognition were found to be defective in the schizophrenia patients and their relatives. The performances of ToM and emotion recognition were ranked as the schizophrenia group, family group, and control group, from the worst to the best. The schizophrenia group showed poor performance in all sub-components except irony. In the family group, the empathy subcomponent showed similar performance with the control group, whereas the subcomponents of the second-order false belief, metaphor, and faux pas tests showed similar performance with the patient group. There were differences among the three groups in the first-order false belief subscale as well as the total DEToMS. The patient and family groups showed the poorest performances, whereas the control group showed the best performance. The detection of ToM and emotion recognition disorders in the remission period, regardless of the attack period and asymptomatic first-degree relatives, may support the view that the period of schizophrenia is an independent continuous variable.

The Comparison of Deficits in the Theory of Mind in Patients with Bipolar Disorder Type 1 in Remission Period

Introduction: Recent studies on theory of mind (ToM) in patients with bipolar disorder have revealed deficits of ToM ability during episodes. This study was aimed to assess deficits in levels of ToM in patients with bipolar disorder type 1 in remission Period. Materials and Methods: Thirty men with bipolar disorder and 30 healthy men were selected by available sampling method. The questionnaires included Kessler Psychological Distress Scale (K10) and theory of mind picture stories task. Results: Our results indicated a significant difference between bipolar disorder patients vs. healthy individuals with regard to the total score of theory of mind picture stories task. Regarding ToM’s levels, there was a significant difference between bipolar disorder patients and healthy individuals in five subscales included: second-order false beliefs, third-order false beliefs, reciprocity, deception, and detection of cheating. However, data indicated that there is no significant difference in first-order false belief. Conclusion: Bipolar patients spent their remission period showed a weaker performance in complex ToM’s levels and false belief than healthy people. They were weak in cognitive understanding of others’ mind states, like opinions and ambitions, and emotional mind states, like feelings and emotions. The deficit in complex levels of ToM in bipolar patients in remission period can be the result of the malfunction of cognitive infrastructures in the brain.

The contribution of theory of mind, counterfactual reasoning, and executive function to pre-readers’ language comprehension and later reading awareness and comprehension in elementary school

The current longitudinal study examined the roles of theory of mind, counterfactual reasoning, and executive function in children’s pre-reading skills, reading awareness, and reading comprehension. It is the first to examine this set of variables with preschool and school-aged children. A sample of 31 children completed language comprehension, working memory, cognitive flexibility, first-order false belief, and counterfactual reasoning measures when they were 3 to 5years of age and completed second-order false belief, cognitive flexibility, reading comprehension, and reading awareness measures at 6 to 9years of age. Results indicated that false belief understanding contributed to phrase and sentence comprehension and reading awareness, whereas cognitive flexibility and counterfactual reasoning accounted for unique variance in reading comprehension. Implications of the results for the development of reading skill are discussed.

Theory of mind ability predicts prognosis of outpatients with major depressive disorder

A theory of mind (ToM) deficit in patients with major depressive episodes is associated with difficulty in social adjustment, and thus may indicate a poorer prognosis. We investigated the association between ToM deficits and the outcome in patients who had recovered from major depressive episodes. We evaluated ToM abilities of 100 patients with major depressive disorder during a period of remission. The patients were followed up for one year and their outcomes observed. After one year, patients who had a ToM deficit according to a second-order false belief question relapsed significantly more frequently than did patients who did not have a deficit (Fisher's exact test P<0.0001; relative risk (RR)=8.286; CI 2.608, 26.324). Significant differences between these two groups were shown in scores of the Global Assessment of Functioning Scale (P<0.0001). Our results suggest that a ToM deficit after symptom remission in patients with major depressive disorder predicts a higher relapse rate and lower social function one year after recovering from a major depressive episode.

Religious Cognition and Behaviour in Autism: The Role of Mentalizing

ABSTRACTMentalizing, or theory of mind, has been argued to be critical for supporting religious beliefs and practices involving supernatural agents. As individuals with autism spectrum conditions have been found to have deficits in mentalizing, this raises the question as to how they may conceive of gods and behave in relation to gods. To examine this, we compared high-functioning individuals with autism spectrum conditions (HFA) to typically developing individuals across seven key aspects of religious cognition and behaviour: (a) strength of belief, (b) anthropomorphism of god concepts, (c) felt closeness toward the god, (d) prayer habits, (e) attraction to prayer, (f) efficacy of prayer, and (g) a sense of agency while praying. A battery of mentalizing tasks was administered to measure mentalizing ability, along with the Autism-Spectrum Quotient. As expected, typically developing subjects performed better than HFA subjects in the advanced mentalizing task. However, no statistically significant differences were found with first-order and second-order false belief tasks. In contrast to our predictions and previous research on the religiosity of HFA, we found very little differences between the groups in their religious cognition and behaviour. Moreover, the relationship between mentalizing ability and most of our measures of religious cognition and behaviour was weak and negative. Our data suggest that HFA's deficits in mentalizing appear to have only minimal impact on the way they interact and think about gods. We end the article by reevaluating the role mentalizing may have in religious cognition and behaviour.

Maltreatment and Advanced Theory of Mind Development in School-aged Children

Theory of mind (ToM), the understanding of people’s beliefs and states of mind underpins effective communication and social relationships throughout life. Plausibly, the experience of being maltreated could delay the child’s development of ToM. However empirical evidence for this is scanty, especially in children age five and over. The present study aimed to fill this void. 105 Australian children were tested on first- and second-order false belief tests and a developmentally-sequenced ToM Scale. Of this sample, 52 children had experienced maltreatment and were receiving therapy and 53 children were matched nonclinic controls. As predicted, controls outperformed the maltreated on first-order changed-locations, misleading container false belief tests, and on an advanced belief-emotion test. Furthermore, maltreatment severity was an independent negative predictor of ToM understanding after controlling other variables. Findings reveal the persistence of problems in understanding others’ minds for maltreated children with implications both for social cognition and for applied interventions.

Association of the COMT and DRD2 Genes with the Ability of Schizophrenia Patients to Understand the Mental State of Other People

With the aim of identifying the role of dopamine transmission in impairments to the ability of schizophrenia patients to understand the mental state of other people, we searched for associations between this component of social cognition and genes encoding the DRD2 receptor and the enzyme COMT in 209 schizophrenia patients and 172 healthy people. Neuropsychological assessment of subjects consisted of solving verbal tasks involving second-order false beliefs (FB2) and assessment of the ability to detect faux pas. An association was found between the Val158Met polymorphism of the COMT gene and success in solving FB2 tasks by schizophrenia patients. This association was linked with sexual dimorphism. Impairments were seen in female patients carrying the Met allele. In male patients, a tendency to more marked impairment was linked with the ValVal genotype. Analysis of correlations between the COMT Val158Met marker and the ability to solve FB2 tasks and neurocognitive and clinical symptoms suggested that the association detected in female patients was mediated, at least partly, by increased stress reactivity in carriers of the Met allele due to the acuteness of patients’ status and its consequences for cognitive functioning.

Sex differences in the neural basis of false-belief and pragmatic language comprehension

Increasing research evidence suggests that women are more advanced than men in pragmatic language comprehension and Theory of Mind (ToM), which is a cognitive component of empathy. We measured the hemodynamic responses of men and women while they performed a second-order false-belief (FB) task and a coherent story (CS) task. During the FB condition relative to the baseline (unlinked sentences [US]), we found convergent activity in ToM network regions, such as the temporoparietal junction (TPJ) bilaterally and precuneus, in both sexes. We also found a greater activity in the left medial prefrontal cortex (mPFC) and a greater deactivation in the ventromedial prefrontal cortex (vmPFC)/orbitofrontal cortex (OFC) bilaterally in women compared to men. However, we did not find difference in the brain activity between the sexes during the FB condition relative to the CS condition. The results suggest a significant overlap between neural bases of pragmatic language comprehension and ToM in both men and women. Taken together, these results are in line with the extreme male brain (EMB) hypothesis by demonstrating sex difference in the neural basis of ToM and pragmatic language, both of which are found to be impaired in individuals with Autism Spectrum Conditions (ASC). In addition, the results also suggest that on average women use both cognitive empathy (dorsal mPFC) and affective empathy (vmPFC) networks more than men for false-belief reasoning.

Do children understand that people selectively conceal or express emotion?

This study examined whether children understand that people selectively conceal or express emotion depending upon the context. We prepared two contexts for a verbal display task for 70 first-graders, 80 third-graders, 64 fifth-graders, and 71 adults. In both contexts, protagonists had negative feelings because of the behavior of the other character. In the prosocial context, children were instructed that the protagonist wished to spare the other character’s feelings. In contrast, in the real-emotion context, children were told that the protagonist was fed up with the other character’s behavior. Participants were asked to imagine what the protagonists would say. Adults selected utterances with positive or neutral emotion in the prosocial context but chose utterances with negative emotion in the real-emotion context, whereas first-graders selected utterances with negative emotion in both contexts. In the prosocial context, the proportion of utterances with negative emotion decreased from first-graders to adults, whereas in the real-emotion context the proportion was U-shaped, decreasing from first- to third-graders and increasing from fifth-graders to adults. Further, performance on both contexts was associated with second-order false beliefs as well as second-order intention understanding. These results indicate that children begin to understand that people selectively conceal or express emotion depending upon context after 8 to 9 years. This ability is also related to second-order theory of mind.

Social cognition in ADHD: irony understanding and recursive theory of mind.

The main goal of the present study was to characterise the social cognition abilities of French children with ADHD, in terms of their understanding of people's recursive mental states and their irony comprehension. We hypothesised that these children have difficulty understanding second-order false beliefs and ironic remarks, owing to the executive dysfunction that is characteristic of ADHD. We therefore conducted an experiment in which children with ADHD and typically developing matched controls performed second-order false-belief and executive function tasks. They then listened to ironic stories and answered questions about the ironic comments and about the speakers' beliefs and attitudes. The groups differed significantly on second-order theory of mind, irony comprehension and executive functions, confirming that children with ADHD have impaired social cognition.

Oxytocin improves behavioural and neural deficits in inferring others' social emotions in autism.

Recent studies have suggested oxytocin's therapeutic effects on deficits in social communication and interaction in autism spectrum disorder through improvement of emotion recognition with direct emotional cues, such as facial expression and voice prosody. Although difficulty in understanding of others' social emotions and beliefs under conditions without direct emotional cues also plays an important role in autism spectrum disorder, no study has examined the potential effect of oxytocin on this difficulty. Here, we sequentially conducted both a case-control study and a clinical trial to investigate the potential effects of oxytocin on this difficulty at behavioural and neural levels measured using functional magnetic resonance imaging during a psychological task. This task was modified from the Sally-Anne Task, a well-known first-order false belief task. The task was optimized for investigation of the abilities to infer another person's social emotions and beliefs distinctively so as to test the hypothesis that oxytocin improves deficit in inferring others' social emotions rather than beliefs, under conditions without direct emotional cues. In the case-control study, 17 males with autism spectrum disorder showed significant behavioural deficits in inferring others' social emotions (P = 0.018) but not in inferring others' beliefs (P = 0.064) compared with 17 typically developing demographically-matched male participants. They also showed significantly less activity in the right anterior insula and posterior superior temporal sulcus during inferring others' social emotions, and in the dorsomedial prefrontal cortex during inferring others' beliefs compared with the typically developing participants (P < 0.001 and cluster size > 10 voxels). Then, to investigate potential effects of oxytocin on these behavioural and neural deficits, we conducted a double-blind placebo-controlled crossover within-subject trial for single-dose intranasal administration of 24 IU oxytocin in an independent group of 20 males with autism spectrum disorder. Behaviourally, oxytocin significantly increased the correct rate in inferring others' social emotions (P = 0.043, one-tail). At the neural level, the peptide significantly enhanced the originally-diminished brain activity in the right anterior insula during inferring others' social emotions (P = 0.004), but not in the dorsomedial prefrontal cortex during inferring others' beliefs (P = 0.858). The present findings suggest that oxytocin enhances the ability to understand others' social emotions that have also required second-order false belief rather than first-order false beliefs under conditions without direct emotional cues in autism spectrum disorder at both the behaviour and neural levels.

Sarcasm and advanced theory of mind understanding in children and adults with prelingual deafness.

Two studies addressed key theoretical debates in theory of mind (ToM) development by comparing (a) deaf native signers (n = 18), (b) deaf late signers (n = 59), and (c) age-matched hearing persons (n = 74) in childhood (Study 1: n = 81) and adulthood (Study 2: n = 70) on tests of first- and second-order false belief and conversational sarcasm. Results showed ToM development to be a life span phenomenon for deaf and hearing people alike. Native and late signers were outperformed by hearing peers on advanced ToM in childhood (M = 9 years), but in adulthood (M = 40 years), native signers had caught up, whereas late signers had not. Findings highlight the extended importance of conversational interaction for ToM growth.

An exploratory study of the relationship between neurological soft signs and theory of mind deficits in schizophrenia

Indirect evidence suggests partially common pathogenetic mechanisms for Neurological Soft Signs (NSS), neurocognition, and social cognition in schizophrenia. However, the possible association between NSS and mentalizing impairments has not yet been examined. In the present study, we assessed the ability to attribute mental states to others in patients with schizophrenia and predicted that the presence of theory of mind deficits would be significantly related to NSS. Participants were 90 clinically stable patients with a DSM-IV diagnosis of schizophrenia. NSS were assessed using the Neurological Evaluation Scale (NES). Theory of mind deficits were assessed using short verbal stories designed to measure false belief understanding. The findings of the study confirmed our hypothesis. Impaired sequencing of complex motor acts was the only neurological abnormality correlated with theory of mind deficits. By contrast, sensory integration, motor coordination and the NES Others subscale had no association with patients׳ ability to pass first- or second-order false belief tasks. If confirmed by future studies, the current findings provide the first preliminary evidence for the claim that specific NSS and theory of mind deficits may reflect overlapping neural substrates.