Spanish Adaptation of the Mentalization Questionnaire (MZQ) in Community Adolescents and Adults.

BACKGROUND: Despite the role of mentalization in mental health outcomes and prevention, psychometrically-evaluated screening measures for mentalization remain sparse. One widely-used mentalization questionnaire is the Mentalization Questionnaire (MZQ; Hausberg et al., 2012), which we aimed to adapt and validate for use in Spanish. METHOD: We adapted the MZQ to European Spanish and evaluated its psychometric properties in both adolescent (n = 389, ages 12-19, M = 14.5) and adult community samples (n = 382, M = 48). RESULTS: Confirmatory factor analysis resulted in a unidimensional structure including all items. This model had better goodness of fit than the original and other adaptations. Invariance analysis showed the same structure in adolescents compared by sex and age, and additionally in the adult versus adolescent samples. Evidence for convergent and discriminant validity was found. Internal consistency values in both adolescents and parents were fair and in the adolescent sample the MZQ scores remained moderately stable after re-test. CONCLUSIONS: The Spanish adaptation of the MZQ presents similar evidence of reliability and validity in the adolescent and adult samples. The results support this being a suitable version for evaluating mentalization in the general population.

The longitudinal relations between mental state talk and theory of mind.

BACKGROUND: Previous investigations of associations between children's Theory of Mind (ToM) and parents' use of words relating to mental states (or mental state talk; MST) have predominantly been performed using cross-sectional designs and false belief tasks as indicators of ToM. METHODS: We here report a longitudinal study of 3-5 year-olds (n = 80) investigating ToM development using the ToM scale and three different parental MST types: the absolute frequency of words, the proportions of words, and the vocabulary size. RESULTS: Our results revealed significant relations between all parental MST types and later child ToM. Proportions of parental MST were most often related to the children's ToM at 4 years of age. However, the rate at which the children developed ToM from 3 to 5 years of age was associated with the other two parental MST type measures, namely, absolute frequency and vocabulary size. Additionally, our analyses revealed that parents' use of cognitive MST words (e.g., think, or know) were most frequently associated with children's ToM at 4 years of age compared to emotion and desire-related MST words. CONCLUSIONS: We conclude that the parental ability to capture the thoughts, beliefs, and knowledge present in different scenarios is associated with children's ability to understand other minds. Moreover, parents' way of talking about the mental states of others is associated with their children's ability to understand and further develop ToM.

The relationship between theory of mind and moral sensitivity among Chinese preschool children: the mediating role of empathy.

BACKGROUND: Identifying moral behavior in complex situations is the key ability for children to develop prosocial behavior. The theory of mind (ToM) and empathy provide the cognition and emotional motivation required for the development of moral sensitivity. In this study, we investigated the associations among ToM, empathy, and moral sensitivity and explored the possible differences between Chinese preschool children aged 4 and 5 years. METHODS: One hundred and thirty children completed the unexpected-content and change-of-location tasks as well as questionnaires about empathy and moral sensitivity individually. A one-way analysis of variance and the multi-group mediation SEM were used to examine the associations of the three variables and age differences. RESULTS: The scores of 5-year-old children in the dimensions of care, fairness, authority, and sanctity and the total score were higher than those of 4-year-old children. Moral sensitivity was positively correlated with both ToM and empathy after we controlled for verbal IQ and gender. Multigroup mediation analyses showed age-based differences in the associations among moral sensitivity, ToM, and empathy. Empathy's mediation effect was partial among 4-year-old children and complete among 5-year-old children. CONCLUSIONS: These findings contribute to understanding the cognitive and emotional factors in the formation of children's moral sensitivity. They also point to a promising approach to promoting the development of moral sensitivity and evidence for educators to understand the process of children's socialization.

Working memory load impairs tacit coordination but not inter-brain EEG synchronization.

Coordinating actions with others is thought to require Theory of Mind (ToM): the ability to take perspective by attributing underlying intentions and beliefs to observed behavior. However, researchers have yet to establish a causal role for specific cognitive processes in coordinated action. Since working memory load impairs ToM in single-participant paradigms, we tested whether load manipulation affects two-person coordination. We used EEG to measure P3, an assessment of working memory encoding, as well as inter-brain synchronization (IBS), which is thought to capture mutual adjustment of behavior and mental states during coordinated action. In a computerized coordination task, dyads were presented with novel abstract images and tried selecting the same image, with selections shown at the end of each trial. High working memory load was implemented by a concurrent n-back task. Compared with a low-load control condition, high load significantly diminished coordination performance and P3 amplitude. A significant relationship between P3 and performance was found. Load did not affect IBS, nor did IBS affect performance. These findings suggest a causal role for working memory in two-person coordination, adding to a growing body of evidence challenging earlier claims that social alignment is domain-specific and does not require executive control in adults.

Influence of transient emotional episodes on affective and cognitive theory of mind.

Our emotions may influence how we interact with others. Previous studies have shown an important role of emotion induction in generating empathic reactions towards others' affect. However, it remains unclear whether (and to which extent) our own emotions can influence the ability to infer people's mental states, a process associated with Theory of Mind (ToM) and implicated in the representation of both cognitive (e.g. beliefs and intentions) and affective conditions. We engaged 59 participants in two emotion-induction experiments where they saw joyful, neutral and fearful clips. Subsequently, they were asked to infer other individuals' joy, fear (affective ToM) or beliefs (cognitive ToM) from verbal scenarios. Using functional magnetic resonance imaging, we found that brain activity in the superior temporal gyrus, precuneus and sensorimotor cortices were modulated by the preceding emotional induction, with lower response when the to-be-inferred emotion was incongruent with the one induced in the observer (affective ToM). Instead, we found no effect of emotion induction on the appraisal of people's beliefs (cognitive ToM). These findings are consistent with embodied accounts of affective ToM, whereby our own emotions alter the engagement of key brain regions for social cognition, depending on the compatibility between one's own and others' affect.

Theory of Mind in Huntington's Disease: A Systematic Review of 20 Years of Research.

Background: People with Huntington's disease (HD) exhibit neurocognitive alterations throughout the disease, including deficits in social cognitive processes such as Theory of Mind (ToM). Objective: The aim is to identify methodologies and ToM instruments employed in HD, alongside relevant findings, within the scientific literature of the past two decades. Methods: We conducted a comprehensive search for relevant papers in the SCOPUS, PubMed, APA-PsyArticles, Web of Science, Redalyc, and SciELO databases. In the selection process, we specifically focused on studies that included individuals with a confirmed genetic status of HD and investigated ToM functioning in patients with and without motor symptoms. The systematic review followed the PRISMA protocol. Results: A total of 27 papers were selected for this systematic review, covering the period from 2003 to 2023. The findings consistently indicate that ToM is globally affected in patients with manifest motor symptoms. In individuals without motor symptoms, impairments are focused on the affective dimensions of ToM. Conclusions: Based on our analysis, affective ToM could be considered a potential biomarker for HD. Therefore, it is recommended that ToM assessment be included as part of neuropsychological evaluation protocols in clinical settings. Suchinclusion could aid in the identification of early stages of the disease and provide new opportunities for treatment, particularly with emerging drugs like antisense oligomers. The Prospero registration number for this review is CRD42020209769.

Childrens' attachment story-completions and their theory of mind in three Turkish contexts: Seasonal migrant agricultural worker communities, residential group homes, and rural villages.

This study examines the association between attachment story-completions, as evaluated by a representational attachment measure, and theory of mind (ToM) among 204 socioeconomically disadvantaged children aged four to six years living in three distinct Turkish contexts: Seasonal migrant agricultural worker (SMAW) communities, residential group homes (RGHs), and rural villages. Attachment story-completions and ToM were found to be related to the distinct contexts children were living in. In the SMAW communities, higher number of children showed insecure dominant attachment, with only one in four having secure dominant attachment. About half of the children in the RGHs had insecure dominant attachment. However, the majority of village children exhibited secure dominant attachment. Furthermore, irrespective of the context, secure dominant attachment was found to have a substantial positive influence on children's ToM. Findings suggest that early intervention programs tailored to address emotional needs and support cognitive skills may be the most effective in helping children in these contexts.

Are Communication Skills, Emotion Regulation and Theory of Mind Skills Impaired in Adolescents with Developmental Dyslexia?

This study investigates pragmatic language impairment, Theory of Mind (ToM), and emotion regulation in adolescents with Developmental Dyslexia(DD). The Social Responsiveness Scale-2(SRS) and Children's Communication Checklist-2(CCC-2) scores were found to be statistically significantly higher in the DD group than in healthy controls. DD group had lower performance in ToM skills and they have more difficulties in emotion regulation. We also found that CCC-2 and ToM scores were significantly correlated in adolescents with DD. These results may be important in understanding the difficulties experienced in social functioning and interpersonal relationships in adolescents with DD.

Music and the mind.

When I was chancellor of the University of North Carolina at Chapel Hill, I tried never to miss the annual concert of the Triangle Youth Symphony. When people asked me why I was such a regular, I complimented the music but also suggested that there were potential future college science majors on the stage. The strong correlation between scientific and musical ability is an association familiar to many scientists, but in recent years, the connections between music and the mind have begun receiving broader attention, partly because of an unexpected partnership between the former long-time director of the US National Institutes of Health Francis Collins, and soprano opera superstar Renée Fleming. I caught up with Collins and Fleming for an extended chat about their shared curiosity regarding the science of music and health.

Theory of mind in chronic migraine with medication overuse assessed with the MASC.

Theory of Mind (ToM) is the ability to infer one's own and others' mental states. Growing research indicates that ToM is impaired in Chronic Migraine with Medication Overuse (CM + MO). However, the research in this field has been conducted using static scenario-based tasks, often failing to test mentalization in everyday situations and measuring only performance accuracy. We filled this gap by administering the Movie for the Assessment of Social Cognition (MASC) to subjects with CM + MO compared to episodic migraine (EM). This test allows us to assess both affective and cognitive ToM and which, in addition to being accurate, also analyzes the type of error in attribution of mental states, distinguishing between hypo-mentalization and hyper-mentalization. Thirty patients suffering from CM + MO and 42 from EM were enrolled. Results showed that CM + MO patients were less accurate in mental state attribution than EM. In addition, compared to EM, CM + MO individuals were more impaired in the affective ToM dimensions and committed more errors of hypo-mentalization. In conclusion, the application of MASC in patients with CM + MO allowed for the detection of an alteration in their ability to correctly draw conclusions about other people's mental states. This latter contributes critically to appropriate social reactions and also, possibly, to satisfactory social interactions.

Teoría de la mente en trastornos del neurodesarrollo: más allá del trastorno del espectro autista / Theory of mind in neurodevelopmental disorders: Beyond autistic spectrum disorder

Introducción La teoría de la mente (ToM) es la capacidad humana de percibir, interpretar y atribuir los estados mentales de las otras personas y la alteración de esta función cognitiva es un síntoma nuclear del trastorno del espectro autista (TEA). Hay otros trastornos del neurodesarrollo como el trastorno obsesivo-compulsivo de inicio en la infancia (TOC) y el síndrome de Tourette (ST), que pueden presentarse con disfunciones cognitivas, y en los que la ToM ha sido menos estudiada, especialmente en población juvenil. El objetivo de este estudio fue comparar la ToM avanzada entre grupos de jóvenes con diagnóstico de TOC, ST o TEA y un grupo de controles sanos. Métodos Se entrevistaron clínicamente a varones de entre 11 y 17 años con diagnóstico principal de TOC (n = 19), ST (n = 14), TEA (n = 18), y un grupo control de sujetos sanos (n = 20). Se les administró instrumentos de estimación de cociente intelectual, severidad de los síntomas psiquiátricos y las pruebas para evaluar la ToM: la tarea Historias de la vida cotidiana y el Test de la mirada. Resultados Los jóvenes con ST presentan dificultades similares para resolver tareas de ToM avanzada al nivel de los pacientes con TEA, a diferencia de los pacientes con TOC de inicio en la infancia que presentan resultados similares a los controles sanos. Conclusiones La ToM está alterada en otros trastornos del neurodesarrollo más allá del TEA, como en el ST. (AU)

Introduction Theory of mind (ToM) is the human ability to perceive, interpret, and attribute the mental states of other people, and the alteration of this cognitive function is a core symptom of autistic spectrum disorder (ASD). In such other neurodevelopmental disorders as childhood-onset obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) that can present with cognitive dysfunctions, ToM has been less extensively studied, especially in the young population. The aim of the study was to compare advanced ToM between groups of young people diagnosed with OCD, TS, or ASD and a control group. Methods Clinical interviews were conducted with male patients aged between 11 and 17 years with a main diagnosis of OCD (n = 19), TS (n = 14), or ASD (n = 18), and a control group (n = 20). We administered instruments for estimating intelligence quotient and severity of psychiatric symptoms, and tasks to evaluate ToM (the “Stories from everyday life” task and the “Reading the mind in the eyes” test). Results Young people with TS and with ASD present similar difficulties in solving advanced ToM tasks, whereas patients with childhood-onset OCD present similar results to controls. Conclusions ToM is altered in other neurodevelopmental disorders beyond ASD, such as TS. (AU)

Understanding the link between theory of mind and loneliness among primary school students: A cross-lagged panel model analysis.

This study aimed to investigate the longitudinal association between theory of mind (ToM) and loneliness as well as the potential moderating effects of parenting style on this association. A total of 689 Chinese third-grade students (341 girls and 348 boys; Mage = 9.23 years, SD = 0.66) were recruited from eight primary schools and were followed from Grade 3 to Grade 5. These students reported their primary caregivers' parenting style in third grade and completed the same ToM task and loneliness questionnaire at each time point from Grade 3 to Grade 5. The study's results indicated a bidirectional relationship between ToM and loneliness, implying that children with less developed ToM abilities tend to feel lonelier and, conversely, that higher levels of loneliness are associated with lower ToM skills. Moreover, the study demonstrated that parenting style influenced the association between ToM and loneliness. Specifically, the impact of ToM at Grade 3 on reducing loneliness at Grade 4 was greater among children who experienced high levels of rejection from their caregivers compared with those with low levels of rejection. In addition, this study found that loneliness at Grade 3 had a greater influence on ToM at Grade 5 for children experiencing low levels of emotional warmth from their caregivers than for those who experienced high levels of emotional warmth. These findings highlight the significance of ToM as both a precursor and consequence of children's loneliness and emphasize the variation in these longitudinal relationships based on the parenting styles of primary caregivers.

From mindreading to originality: Exploring the relationship between Theory of Mind and Creativity across the lifespan.

In the previous psychoeducational literature, many theorists have argued that creativity and originality require the ability to make predictions and assumptions regarding other individuals' ideas. Thus, it has been widely hypothesized that social cognition and theory of mind (ToM) might be a fundamental component or even a prerequisite of creativity. Despite their common grounds, the empirical evidence examining the potential link between ToM and creative thinking throughout their development seems to be indirect, limited, and fragmented. In this respect, this scoping review aimed to collect and synthesize the existing knowledge about the relationship between ToM and creativity at different ages to identify significant literature gaps and generate updated research questions that might guide future research. The search process led to the inclusion, analysis, and collation of 6 relevant studies only, indicating that this research topic has been poorly investigated. Results demonstrated that ToM and creativity are strongly correlated even after partialling out significant mediators, such as age and intelligence. Such a strong association should be further investigated and explained.

Pragmatic Skills in Late Adulthood.

Research investigating pragmatic abilities in healthy aging suggests that both production and comprehension might be compromised; however, it is not clear how pragmatic abilities evolve in late adulthood, as well as when difficulties are more likely to arise. The aim of this study is to investigate the decline of pragmatic skills in aging, and to explore what cognitive and demographic factors support pragmatic competence. We assessed pragmatic production skills, including discourse abilities such as speech, informativeness, information flow, paralinguistic aspects, as well as the ability to produce informative descriptions of pictures, and pragmatic comprehension skills, which encompassed the ability to understand discourse and the main aspects of a narrative text, to infer non-literal meanings and to comprehend verbal humor in a group of elderly individuals and in a sample of younger participants. Moreover, specific cognitive functions (short-term memory, verbal and visuospatial working memory, inhibition Theory of Mind, and Cognitive Reserve) were assessed in both groups. Pragmatic difficulties seem to occur in late adulthood, likely around 70 years, and emerge more prominently when participants are asked to understand verbal humor. Age was the only predictor of general pragmatic performance in a sample of cognitively unimpaired older adults; conversely, when elderly individuals with less intact inhibitory control are considered, a general role of inhibition emerged, in addition to working memory and ToM in specific tasks.

Agreeableness modulates mental state decoding: Electrophysiological evidence.

Agreeableness is one of the five personality traits which is associated with theory of mind (ToM) abilities. One of the critical processes involved in ToM is the decoding of emotional cues. In the present study, we investigated whether this process is modulated by agreeableness using electroencephalography (EEG) while taking into account task complexity and sex differences that are expected to moderate the relationship between emotional decoding and agreeableness. This approach allowed us to identify at which stage of the neural processing agreeableness kicks in, in order to distinguish the impact on early, perceptual processes from slower, inferential processing. Two tasks were employed and submitted to 62 participants during EEG recording: the reading the mind in the eyes (RME) task, requiring the decoding of complex mental states from eye expressions, and the biological (e)motion task, involving the perception of basic emotional actions through point-light body stimuli. Event-related potential (ERP) results showed a significant correlation between agreeableness and the contrast for emotional and non-emotional trials in a late time window only during the RME task. Specifically, higher levels of agreeableness were associated with a deeper neural processing of emotional versus non-emotional trials within the whole and male samples. In contrast, the modulation in females was negligible. The source analysis highlighted that this ERP-agreeableness association engages the ventromedial prefrontal cortex. Our findings expand previous research on personality and social processing and confirm that sex modulates this relationship.

Adverse childhood experiences differently affect Theory of Mind brain networks in schizophrenia and healthy controls.

Patients with schizophrenia (SZ) show impairments in both affective and cognitive dimensions of theory of mind (ToM). SZ are also particularly vulnerable to detrimental effect of adverse childhood experiences (ACE), influencing the overall course of the disorder and fostering poor social functioning. ACE associate with long-lasting detrimental effects on brain structure, function, and connectivity in regions involved in ToM. Here, we investigated whether ToM networks are differentially affected by ACEs in healthy controls (HC) and SZ, and if these effects can predict the disorder clinical outcome. 26 HC and 33 SZ performed a ToM task during an fMRI session. Whole-brain functional response and connectivity (FC) were extracted, investigating the interaction between ACEs and diagnosis. FC values significantly affected by ACEs were entered in a cross-validated LASSO regression predicting Positive and Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index (IRI), and task performance. ACEs and diagnosis showed a widespread interaction at both affective and cognitive tasks, including connectivity between vmPFC, ACC, precentral and postcentral gyri, insula, PCC, precuneus, parahippocampal gyrus, temporal pole, thalamus, and cerebellum, and functional response in the ACC, thalamus, parahippocampal gyrus and putamen. FC predicted the PANSS score, the fantasy dimension of IRI, and the AToM response latency. Our results highlight the crucial role of early stress in differentially shaping ToM related brain networks in HC and SZ. These effects can also partially explain the clinical and behavioral outcomes of the disorder, extending our knowledge of the effects of ACEs.

The roots of compassion in early childhood: Relationships between theory of mind and attachment representations with empathic concern and prosocial behavior.

This study focused on attachment representations and theory of mind as potential developmental origins of individual differences in preschoolers' peer- and adult-directed empathic concern and prosocial behavior. In two experiments, 3- to 6-year-olds were exposed to either a high-distressed or low-distressed adult or child using a laboratory setting (Experiment 1; N = 263) or hypothetical vignettes (Experiment 2; N = 202). Self-reported and coded expressions of empathic concern and prosocial behaviors were used as early indicators of compassion. The findings indicated that children expressed more empathic concern and engaged in more prosocial behavior in the high-distress condition than in the low-distress condition. Children's empathic concern and prosocial behavior increased with age. Secure attachment and theory of mind abilities played significant moderating roles in the association between distress conditions and empathic concern. Children with more advanced theory of mind abilities and secure attachment were better at recognizing the concerns of distressed peers or adults and showed significantly more empathic concern. Resistant and disorganized children exhibited more self-distress in response to others' distress. The implications for early interventions directed at increasing empathic concern and prosocial behavior are discussed.

Aging, cingulate cortex, and cognition: insights from structural MRI, emotional recognition, and theory of mind.

The cingulate cortex is a limbic structure involved in multiple functions, including emotional processing, pain, cognition, memory, and spatial orientation. The main goal of this structural Magnetic Resonance Imaging (MRI) study was to investigate whether age affects the cingulate cortex uniformly across its anteroposterior dimensions and determine if the effects of age differ based on sex, hemisphere, and regional cingulate anatomy, in a large cohort of healthy individuals across the adult lifespan. The second objective aimed to explore whether the decline in emotional recognition accuracy and Theory of Mind (ToM) is linked to the potential age-related reductions in the pregenual anterior cingulate (ACC) and anterior midcingulate (MCC) cortices. We recruited 126 healthy participants (18-85 years) for this study. MRI datasets were acquired on a 4.7 T system. The cingulate cortex was manually segmented into the pregenual ACC, anterior MCC, posterior MCC, and posterior cingulate cortex (PCC). We observed negative relationships between the presence and length of the superior cingulate gyrus and bilateral volumes of pregenual ACC and anterior MCC. Age showed negative effects on the volume of all cingulate cortical subregions bilaterally except for the right anterior MCC. Most of the associations between age and the cingulate subregional volumes were linear. We did not find a significant effect of sex on cingulate cortical volumes. However, stronger effects of age were observed in men compared to women. This study also demonstrated that performance on an emotional recognition task was linked to pregenual ACC volume, whist the ToM capabilities were related to the size of pregenual ACC and anterior MCC. These results suggest that the cingulate cortex contributes to emotional recognition ability and ToM across the adult lifespan.

Topical Review: Getting into the head of youth with chronic pain: how theory of mind deficits may relate to the development and maintenance of pediatric pain.

OBJECTIVE: Theory of mind (ToM) is the ability to understand the thoughts, feelings, and mental states of others and is critical for effective social and psychological functioning. ToM deficits have been associated with various psychological disorders and identified in adult pain populations. For youth with chronic pain, ToM deficits may underlie the biological, psychological, and social factors that contribute to their experience of pain, but this remains poorly understood. METHODS: This topical review explored the extant literature in the areas of ToM and chronic pain, particularly for pediatric populations, with respect to biological, psychological, and social elements of the biopsychosocial model of pain. RESULTS: ToM deficits may be present alongside previously identified biological, psychological, and social correlates of pediatric pain, as a vulnerability, mechanism, and/or consequence. Biologically, ToM deficits may relate to cortisol abnormalities and neurobiological substrates of pain processing. Psychologically, ToM deficits may stem from pain-focused cognitions, thus impacting relationships and fueling impairment. Socially, chronic pain may preclude normative development of ToM abilities through social withdrawal, thereby exacerbating the experience of pain. CONCLUSION: Taken together, ToM deficits may be associated with increased risk for the development and/or maintenance of pediatric chronic pain, and pediatric chronic pain may similarly confer risk for ToM deficits. Future research should investigate the nature of ToM abilities in youth with chronic pain to test these hypotheses and ultimately inform ToM-focused and pain-based interventions, as this ability has been demonstrated to be modifiable.