Second-order False Belief Research Articles

Exploring theory of mind after severe traumatic brain injury

Previous studies have reported a dissociation between social behavioral impairments after severe traumatic brain injury (TBI) and relatively preserved performances in traditional tasks that investigate cognitive abilities. Theory of mind (ToM) refers to the ability to make inferences about other's mental states and use them to understand and predict others' behavior. We tested a group of 15 patients with severe TBI and 15 matched controls on a series of four verbal and non-verbal ToM tasks: the faux pas test, the first-order and second-order false belief task, the character intention task and the Reading the Mind in the Eyes Test. Participants with severe TBI were also compared to controls on non-ToM inference tasks of indirect speech act from the Montreal Evaluation of Communication (M.E.C.) Protocol and empathy (Davis Interpersonal Reactivity Index – I.R.I.) and tests for executive functions. Subjects with TBI performed worse than control subjects on all ToM tasks, except the first-order false belief task. The findings converge with previous evidence for ToM deficit in TBI and dissociation between ToM and executive functions. We show that ToM deficit is probably distinct from other aspects of social cognition like empathy and pragmatic communication skills.

Associations Between Social Understanding, Sibling Relationship Quality, and Siblings’ Conflict Strategies and Outcomes

Sibling relationship quality and social understanding (second-order false belief, conflict interpretation, and narrative conflict perspective references) were examined as unique and interactive correlates of sibling conflict behavior in 62 dyads (older M age = 8.39 years and younger M age = 6.06 years). High-quality relationships were associated with positive conflict processes. Younger siblings' second-order false belief scores were negatively associated with constructive conflict strategies, and older siblings' narrative self-referential focus was negatively associated with compromise. Associations between younger children's social understanding (conflict interpretation and narrative perspective references) and siblings' dyadic conflict behavior were moderated by relationship quality. Results suggest that links between social understanding and conflict behavior should be considered in conjunction with the quality of children's relationships.

Children's understanding of counterfactual emotions: Age differences, individual differences, and the effects of counterfactual‐information salience

The present study investigated developmental trends in the effects of the salience of counterfactual alternatives on judgments of others' counterfactual-thinking-based emotions. We also examined possible correlates of individual differences in the understanding of these emotions. Thirty-four adults and 102 children, 5-8 years of age, were presented scenarios in which characters would be expected to experience regret. In one version of each scenario, the regret-relevant counterfactual alternative was made more salient than was the case with the other version. Adults consistently judged that a character for whom a counterfactual course of events would have resulted in a better outcome would feel worse than a character for whom an alternative course of events would not have resulted in a more positive outcome. The majority of the children's judgments were not affected by the counterfactual alternatives. However, the judgments of the oldest children (the 8-year-olds) were significantly more adult-like in the high-salience than in the low-salience condition. Although the three predictors examined in the present study (verbal ability, working memory capacity, second-order false belief task performance) together accounted for significant variance in performance on the emotions judgment task, no single predictor alone accounted for significant unique variance in performance. The importance of different social cognitive abilities for understanding people's affective responses is discussed.

Children’s understanding of second-order mental states.

The most popular topic in theory-of-mind research has been first-order false belief: the realization that it is possible to hold false beliefs about events in the world. A more advanced development is second-order false belief: the realization that it is possible to hold a false belief about someone else's belief. This article reviews research directed to second-order false belief and other forms of higher order, recursive mentalistic reasoning. Three general issues are considered. Research directed to developmental changes indicates that preschoolers typically fail second-order tasks and that success emerges at about age 5 or 6, although results vary some with method of assessment. Research directed to the consequences of second-order competence has revealed positive relations with a number of other aspects of children's development. Finally, measures of both language and executive function relate positively to performance on second-order tasks; the causal bases for the correlations, however, remain to be established. This article concludes with suggestions for future research.

The relationship between second‐order false belief and display rules reasoning: the integration of cognitive and affective social understanding

To investigate the relation between cognitive and affective social understanding, Japanese 4- to 8-year-olds received tasks of first- and second-order false beliefs and prosocial and self-presentational display rules. From 6 to 8 years, children comprehended display rules, as well as second-order false belief, using social pressures justifications decreasingly and motivational justifications with embedded perspectives increasingly with age. Although not related to either type of display across ages, second-order tasks were associated with both types of display tasks only at 8 years when examined in each age group. Results suggest that children base their second-order theory of mind and display rules understanding on distinct reasoning until middle childhood, during which time the originally distinct aspects of social understanding are integrated.

Children’s Application of Theory of Mind in Reasoning and Language

Many social situations require a mental model of the knowledge, beliefs, goals, and intentions of others: a Theory of Mind (ToM). If a person can reason about other people's beliefs about his own beliefs or intentions, he is demonstrating second-order ToM reasoning. A standard task to test second-order ToM reasoning is the second-order false belief task. A different approach to investigating ToM reasoning is through its application in a strategic game. Another task that is believed to involve the application of second-order ToM is the comprehension of sentences that the hearer can only understand by considering the speaker's alternatives. In this study we tested 40 children between 8 and 10 years old and 27 adult controls on (adaptations of) the three tasks mentioned above: the false belief task, a strategic game, and a sentence comprehension task. The results show interesting differences between adults and children, between the three tasks, and between this study and previous research.

Pragmatic Language and Theory of Mind Deficits in People with Schizophrenia and Their Relatives

Background: Deficits in theory of mind have frequently been observed in people affected by illnesses characterized by disrupted social behaviour like autism and psychoses. In schizophrenia, a pragmatic deficit in expressive language can also be observed. The present study was designed in order to assess the suitability of theory of mind and pragmatic conversation abilities as possible cognitive endophenotypes of schizophrenia. Methods: First- and second-order false belief tasks and pragmatic deficits in expressive language were examined in 38 patients with schizophrenia, in 34 non-psychotic relatives and in 44 healthy controls. An extensive clinical and neuropsychological assessment was also conducted. Results: Schizophrenic people and their first-degree relatives performedworse than the normal control subjects in false belief and pragmatic conversation tasks. General cognitive ability and neuropsychological measures of executive functions were not related to social cognition tasks. Conclusions: Theory of mind disorders and failing to understand the gricean conversational maxims are associated with schizophrenia liability.

Niños que leen, niños que comprenden intenciones: relación entre la comprensión lectora y la teoría de la mente

La teoría de la mente se relaciona con la capacidad que tenemos de representarnos intenciones y creencias de los otros. Esta habilidad implica el desarrollo de teorías en una recursividad cada vez más compleja y es fundamental para la comunicación oral (Meltzoff, 1999). La literatura sitúa su desarrollo entre los 6 y 7 años, justo cuando empieza de manera formal el aprendizaje de la lectoescritura. A partir de allí, el presente trabajo tiene como propósito examinar la relación entre la teoría de la mente y la comprensión de textos narrativos en niños normales que cursan tercer año de educación básica. Para evaluar la teoría de la mente se diseñó un instrumento basado en las tareas clásicas de falsas creencias de segundo orden (Sullivan y Tager-Flusberg, 1999 y Perner y Wimmer, 1985), y para la evaluación de la comprensión de lectura de texto narrativo se creó un instrumento sustentado en el modelo de comprensión de van Dijk y Kinstch (1983).

Development of Understanding False Beliefs about Apparent Crying in Elementary School Children, in Relationship to the Acquisition of Second-Order False Beliefs

Development of Understanding False Beliefs about Apparent Crying in Elementary School Children, in Relationship to the Acquisition of Second-Order False Beliefs

Comprehension of metaphor and irony in schizophrenia during remission: The role of theory of mind and IQ

The study reported herein explored the comprehension of metaphor and irony in schizophrenia during remission, and examined the role of IQ and a theory of mind. Performance of 29 Schizophrenic patients in remission and 22 healthy controls was compared on metaphor and irony comprehension tasks and first- and second-order theory of mind tasks. Participants' IQs were measured using the Wechsler Adult Intelligence Scale-Revised, and the symptoms of individuals with schizophrenia were assessed using the Positive and Negative Syndrome Scale. The results showed that patients with schizophrenia were impaired in their comprehension of metaphor and irony as compared with healthy controls. A theory of mind deficit was found in patients with remitted schizophrenia. The comprehension of metaphor was significantly correlated with second-order false belief understanding and the comprehension of irony was not significantly related to theory of mind. IQ and verbal IQ did not explain the deficit of metaphor and irony comprehension. These findings were not explained by Happé's [Happé, F.G.E., 1993. Communication competence and theory of mind in autism: a test of relevance theory. Cognition 48, 101–119] theory and the shared semantic understanding requirement was discussed.

A Study of Theory of Mind in a Group of Schizophrenic Patients Using a Mental Verb Extension Task

An individual has a theory of mind (ToM) if he imputes mental states to himself and others and applies this system to make predictions about the behaviours of others. Findings of cognitive impairment could help us to understand faulty processing mechanisms in schizophrenia. The proposition is that individuals with schizophrenia may be unable to internalize adequately the points of view of others. We tested 27 schizophrenic patients (ICD; WHO). The positive and negative symptom scale (PANSS) was used to assess psychopathology, and the three ToM tasks – first- and second-order false belief tasks and the mental verb extension task – were administered to each subject. Patients who perform well on the ToM first and second order stories do not show problems in the verb extension task. However, the mistakes made in the first and second order stories are also reflected in the verb extension task. The group having difficulties with the first-order story presented more problems in the mental verbs task than the group showing difficulties with the second-order story. This leads us to conclude that the impairments found on the first-order false belief task are more severe and profound than those on the second-order task, and such specific deficits are also seen in the organization of verbs of knowing. It would seem that some schizophrenic patients do not impute mental states to themselves and others, and therefore use the mental verbs wrongly.

Knowledge About the Mind: Links Between Theory of Mind and Later Metamemory

This longitudinal study combined, in a single study, different aspects of children's knowledge about mental phenomena and thus could investigate relations among the development of language, theory of mind, and later metamemory. In total, 183 German children were tested at ages 3, 4, and 5. Each time of testing included a set of theory-of-mind tasks, a battery of language development, and additionally, at Time 3, a set of metamemory questions. The findings demonstrate strong relationships between children's language abilities and their theory of mind (both first- and second-order false beliefs). Moreover, both theory-of-mind and language competencies significantly predicted later metamemory, with their relative contribution changing over time. Language may influence metamemory developmentally both directly and indirectly (through theory of mind).

YOUNG CHILDREN'S UNDERSTANDING OF ANOTHER'S APPARENT CRYING AND ITS RELATIONSHIP TO THEORY OF MIND

This study examined young children’s understanding of apparent crying and its potentially misleading consequences. Gross and Harris (1988) showed that 6-year-olds can understand that one can simulate an emotion while feeling another, and that such a display can mislead others. In this study, 69 children aged 4, 5, and 6 were given “crying tasks” and “Standard and Second-order False Belief tasks”. In “crying tasks”, participants were asked to identify whether the protagonist was actually crying, and whether the other character believed that the protagonist was actually crying. The results indicate that children’s understanding of apparent crying develops between the ages of 4 and 6. However, most of the children did not understand its misleading consequences. Furthermore, relationships were found between the understanding of apparent crying and the False Belief tasks. This finding suggests that the development of young children’s understanding of apparent crying relates to the development of theory of mind.

YOUNG CHILDREN'S UNDERSTANDING OF SECOND-ORDER MENTAL STATES

This study examined young children’s understanding of second-order mental states, which have embedded structures such as beliefs about beliefs. Participants were 4-, 5-, and 6-year-olds. First-order and second-order false belief tasks were prepared with similar structures to minimize the difference between them. The results showed that over half of the 6-year-olds were successful on both tasks, while the 5-year-olds were successful on the first-order but not the second-order false belief task. This time lag between understanding first-order and second-order mental states is consistent with the findings of previous studies. These findings suggest that information processing of embedded mental states is a significant factor for understanding second-order mental states.

Intact first- and second-order false belief reasoning in a patient with severely impaired grammar

The retention of first-order theory of mind (ToM) despite severe loss of grammar has been reported in two patients with left hemisphere brain damage (Varley & Siegal, 2000; Varley, Siegal, & Want, 2001). We report a third, and more detailed, case study. Patient PH shows significant general language impairment, and severe grammatical impairment similar to that reported in previous studies. In addition we were able to show that PH's impairment extends to grammatical constructions most closely related to ToM in studies of children (embedded complement clauses and relative clauses). Despite this, PH performed almost perfectly on first-order false belief tasks and on a novel nonverbal second-order false belief task. PH was also successful on a novel test of “ToM semantics” that required evaluation of the certainty implied by different mental state terms. The data strongly suggest that grammar is not a necessary source of structure for explicit ToM reasoning in adults, but do not rule out a critical role for “ToM semantics.” In turn this suggests that the relationship observed between grammar and ToM in studies of children is the result of an exclusively developmental process.

Impaired “Affective Theory of Mind” Is Associated with Right Ventromedial Prefrontal Damage

To examine the hypothesis that patients with ventromedial (VM) frontal lesions are impaired in the affective rather than cognitive facets of theory of mind (ToM). Prefrontal brain damage may result in impaired social behavior, especially when the damage involves the orbitofrontal/VM prefrontal cortex (PFC). It has been previously suggested that deficits in ToM may account for such aberrant behavior. However, inconsistent results have been reported, and different regions within the frontal cortex have been associated with ToM impairment. The performance of 26 patients with localized lesions in the PFC was compared with responses of 13 patients with posterior lesions and 13 normal control subjects. Three ToM tasks differing in the level of emotional processing involved were used: second-order false belief task, understanding ironic utterances, and identifying social faux pas. The results indicated that patients with VM (but not dorsolateral) prefrontal lesions were significantly impaired in irony and faux pas but not in second-order false belief as compared with patients with posterior lesions and normal control subjects. Lesions in the right VM area were associated with the most severe ToM deficit. These results are discussed in terms of the cognitive and affective facets of "mind-reading" processes mediated by the VM cortex.

Deficiency of theory of mind in patients with remitted mood disorder

Background: Recent researches on theory of mind (ToM) in patients with mood disorders have revealed deficits of ToM ability during episodes. In this study, we aimed to test ToM ability among patients with unipolar or bipolar depression currently in remission. Methods: ToM ability and IQ obtained by Wechsler Adult Intelligence Scale-Revised (WAIS-R) were evaluated in 50 patients with remitted depression, who met the criteria of mood disorders of DSM-IV, and 50 matched healthy controls. Results: The patients with mood disorders showed statistically significant impairment in a second-order false question (Fisher's Exact Test p<0.0001). No significant difference was shown in the other three areas of ToM between the patients and the controls. In addition, no correlation of the four areas of ToM with IQ obtained by WAIS-R was found. Limitations: The relation of ToM deficit to other specific cognitive impairment was not examined. Conclusions: Our results suggest that depressive patients in symptomatic remission have a lower ability of second-order false belief. The ToM impairment suggests a decline of skillful social relationships. Evaluation of ToM ability in depressive patients in remission may be useful to provide treatment for better social adjustment.

A New Look at Performance on Theory-of-Mind Tasks by Adolescents With Autism Spectrum Disorder.

A hallmark of autistic spectrum disorder (ASD) is disruption in theory-of-mind development, including the understanding of false beliefs. Previous studies have typically assessed the development of first- and second-order false belief concepts in ASD, with tasks primarily emphasizing physical causality and logical inferencing. The present study investigated how preadolescents and adolescents with ASD performed on false belief tasks that included social inferencing of psychological states as well as logical inferencing of physical states. Two categories of tasks were administered: four traditional logical inferencing tasks and four social inferencing tasks specifically developed for this study. In addition, a prompt hierarchy was included to ascertain if performance on both task types improved. Participants were 45 children and adolescents primarily selected from three urban school districts: 15 adolescents with a previous diagnosis of ASD (ASD group); 15 typically developing children matched for age, gender, and ethnicity (CA group); and 15 typically developing children matched for language age, gender, and ethnicity (LA group). Three findings were pertinent. First, the CA group performed at higher levels than did the LA group and the ASD group on both task sets. Second, although the CA and the LA groups performed equally well on both the logical and the social inferencing tasks, the ASD group performed better on the social inferencing tasks. Finally, the prompt hierarchy significantly improved overall task performance for the ASD and LA groups. These findings indicate that task type, variations in vocabulary ability, and the provision of support influenced performance on the false belief tasks.

Theory of mind and epistemological development: the relation between children's second-order false-belief understanding and their ability to reason about evidence

The study investigates the hypothesis that children's ability to attribute second-order beliefs facilitates their understanding of evidence, as seen in the ability to distinguish between causes and reasons. Seventy-four children 5–7 yr old were given belief and evidence tests. The belief tests assessed their ability to represent and reason from second-order false-beliefs, and the evidence tests assessed their ability to distinguish between the cause of a situation and a person's reason for believing it. The relation between performance on the two tests was determined, taking into account general language and non-verbal reasoning abilities. Results show that performance on the belief test and on the evidence part of the evidence test improved significantly over the age range, and that a significant proportion of variance in the evidence test scores is accounted for by second-order false-belief understanding, over and above that accounted for by general language and non-verbal abilities. The argument is made that second-order false-belief understanding is fundamental to children's epistemological development, underlying not just their understanding of evidence, but also their understanding of inference and truth.

Theory of mind impairments in schizophrenia: symptomatology, severity and specificity.

Several studies have examined the ability of schizophrenic patients to represent mental states ('theory of mind': ToM). There is consensus that some patients have impaired ToM, but there is disagreement about the relation between ToM and symptomatology, and about the severity and specificity of the deficit. Two first-order and one second-order false belief tests of ToM were given to groups of schizophrenic patients and psychiatric and normal controls. The relation between ToM and symptomatology was explored using regression and symptom subgroup analyses. Severity was investigated by using the same task methodology as in autism research, to enable direct comparison with that disorder. Specificity was investigated using matched control tasks which were as difficult as the ToM tasks, but did not require ToM. Symptom subgroup analysis showed that schizophrenic patients with behavioural signs were impaired relative to controls on ToM, and that remitted patients and a single case with passivity symptoms performed as well as controls. Regression analysis showed that ratings of behavioural signs predicted impaired ToM in schizophrenia. There was weak evidence that a subgroup with paranoid symptoms had ToM impairments, although these were associated with low IQ. Schizophrenic patients only showed ToM deficits on the second-order task. No impairments appeared on the matched control tasks which did not require ToM. There is a clear association between ToM impairment and behavioural signs in schizophrenia. Deficits in paranoid patients are harder to detect with current tasks and may be compensated for by IQ-dependent problem-solving skills. ToM impairments in schizophrenia are less severe than in autism, but are specific and not a reflection of general cognitive deficits.