Comprehension of insincere communication in neurodegenerative disease: Lies, sarcasm, and theory of mind

Department of Neurology, University of California, San Francisco, USA.
Cortex (Impact Factor: 6.04). 09/2011; 48(10):1329-41. DOI: 10.1016/j.cortex.2011.08.003
Source: PubMed

ABSTRACT Comprehension of insincere communication is an important aspect of social cognition requiring visual perspective taking, emotion reading, and understanding others' thoughts, opinions, and intentions. Someone who is lying intends to hide their insincerity from the listener, while a sarcastic speaker wants the listener to recognize they are speaking insincerely. We investigated whether face-to-face testing of comprehending insincere communication would effectively discriminate among neurodegenerative disease patients with different patterns of real-life social deficits. We examined ability to comprehend lies and sarcasm from a third-person perspective, using contextual cues, in 102 patients with one of four neurodegenerative diseases (behavioral variant frontotemporal dementia [bvFTD], Alzheimer's disease [AD], progressive supranuclear palsy [PSP], and vascular cognitive impairment) and 77 healthy older adults (normal controls - NCs). Participants answered questions about videos depicting social interactions involving deceptive, sarcastic, or sincere speech using The Awareness of Social Inference Test. All subjects equally understood sincere remarks, but bvFTD patients displayed impaired comprehension of lies and sarcasm compared with NCs. In other groups, impairment was not disease-specific but was proportionate to general cognitive impairment. Analysis of the task components revealed that only bvFTD patients were impaired on perspective taking and emotion reading elements and that both bvFTD and PSP patients had impaired ability to represent others' opinions and intentions (i.e., theory of mind). Test performance correlated with informants' ratings of subjects' empathy, perspective taking and neuropsychiatric symptoms in everyday life. Comprehending insincere communication is complex and requires multiple cognitive and emotional processes vulnerable across neurodegenerative diseases. However, bvFTD patients show uniquely focal and severe impairments at every level of theory of mind and emotion reading, leading to an inability to identify obvious examples of deception and sarcasm. This is consistent with studies suggesting this disease targets a specific neural network necessary for perceiving social salience and predicting negative social outcomes.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To navigate successfully through their complex social environment, humans need both empathic and mnemonic skills. Little is known on how these two types of psychological abilities relate to each other in humans. Although initial clinical findings suggest a positive association, systematic investigations in healthy subject samples have not yet been performed. Differentiating cognitive and affective aspects of empathy, we assumed that cognitive empathy would be positively associated with general memory performance, while affective empathy, due to enhanced other-related emotional reactions, would be related to a relative memory advantage for information of social as compared to non-social relevance. We investigated in young healthy participants the relationship between dispositional cognitive and affective empathy, as measured by Davis' Interpersonal Reactivity Index (Journal of Personality and Social Psychology, 44, 113-126, 1983), and memory formation for stimuli (numbers presented in a lottery choice task) that could be encoded in either a social (other-related) or a non-social (self-related) way within the task. Cognitive empathy, specifically perspective taking, correlated with overall memory performance (regardless of encoding condition), while affective empathy, specifically empathic personal distress, predicted differential memory for socially vs. non-socially encoded information. Both cognitive and affective empathy are associated with memory formation, but in different ways, depending on the social nature of the memory content. These results open new and so far widely neglected avenues of psychological research on the relationship between social and cognitive skills.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Individuals with schizophrenia have functionally significant deficits in automatic and controlled social cognition, but no currently available pharmacologic treatments reduce these deficits. The neuropeptide oxytocin has multiple prosocial effects when administered intranasally in humans and there is growing interest in its therapeutic potential in schizophrenia. Methods We administered 40 IU of oxytocin and saline placebo intranasally to 29 male subjects with schizophrenia and 31 age-matched, healthy controls in a randomized, double-blind, placebo-controlled, cross-over study. Social cognition was assessed with The Awareness of Social Inference Test (TASIT) and the Reading the Mind in the Eyes Test (RMET). We examined the effects of oxytocin administration on automatic social cognition (the ability to rapidly interpret and understand emotional cues from the voice, face, and body); controlled social cognition (the ability to comprehend indirectly expressed emotions, thoughts, and intentions through complex deliberations over longer time periods); and a control task (the ability to comprehend truthful dialog and perform general task procedures) in individuals with and without schizophrenia using mixed factorial analysis of variance models. Results Patients with schizophrenia showed significant impairments in automatic and controlled social cognition compared to healthy controls, and administration of oxytocin significantly improved their controlled, but not automatic, social cognition, F(1, 58) = 8.75; p = 0.004. Conversely, oxytocin administration had limited effects on social cognition in healthy participants. Patients and controls performed equally well and there were no effects of oxytocin administration on the control task. Discussion Intact social cognitive abilities are associated with better functional outcomes in individuals with schizophrenia. Our data highlight the potentially complex effects of oxytocin on some but not all aspects of social cognition, and support the exploration of intranasal oxytocin as a potential adjunct treatment to improve controlled social cognition in schizophrenia.
    Psychoneuroendocrinology 09/2014; 47. DOI:10.1016/j.psyneuen.2014.04.024 · 5.59 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We now know that amyotrophic lateral sclerosis (ALS) is not restricted to the motor system. Indeed, a large proportion of patients with ALS exhibit cognitive impairment, especially executive dysfunction or language impairment. Although researchers have recently turned their attention to theory of mind (ToM) in ALS, only five studies have been performed so far, and they reported somewhat contradictory results. Moreover, the neural basis of the potential ToM deficit in ALS remains largely unknown. The present study was therefore designed to clarify whether a cognitive ToM deficit is indeed associated with ALS, specify the putative link between cognitive ToM deficits and executive dysfunction in ALS, and identify the dysfunctional brain regions responsible for any social cognition deficits. We investigated cognitive ToM and executive functions in a group of 23 patients with ALS and matched healthy controls, using an original false-belief task and a specially designed battery of executive tasks. We also performed an 18F-fluorodeoxyglucose positron emission tomography examination. Results confirmed the presence of cognitive ToM deficits in patients compared with controls, and revealed significant correlations between ToM and executive functions, although the cognitive ToM deficit persisted when a composite executive function score was entered as a covariate. Using statistical parametric mapping, we calculated positive correlations between tracer uptake and false-belief scores on a voxel-by-voxel basis in the patient sample. Results showed that the cognitive ToM deficit correlated with the dorsomedial and dorsolateral prefrontal cortices, as well as the supplementary motor area. Our findings provide compelling clinical and imaging evidence for the presence of a genuine cognitive ToM deficit in patients with ALS.
    Cortex 12/2014; 65:19-30. DOI:10.1016/j.cortex.2014.12.010 · 6.04 Impact Factor


Available from