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Cognition & Emotion
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Sex differences in theory of mind: A male advantage on
Happé's “cartoon” task
Tamara A. Russell
ab
; Kate Tchanturia
a
; Qazi Rahman
c
; Ulrike Schmidt
a
a
Institute of Psychiatry, Kings College London, London, UK
b
Macquarie Centre for Cognitive Science, Sydney, New South Wales, Australia
c
University of East London, London, UK
First Published on: 13 June 2007
To cite this Article: Russell, Tamara A., Tchanturia, Kate, Rahman, Qazi and
Schmidt, Ulrike (2007) 'Sex differences in theory of mind: A male advantage on
Happé's “cartoon” task', Cognition & Emotion, 21:7, 1554 — 1564
To link to this article: DOI: 10.1080/02699930601117096
URL: http://dx.doi.org/10.1080/02699930601117096
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BRIEF REPORT
Sex differences in theory of mind: A male advantage on
Happe
´
’s ‘‘cartoon’’ task
Tamara A. Russell
Institute of Psychiatry, Kings College London, London, UK, and Macquarie
Centre for Cognitive Science, Sydney, New South Wales, Australia
Kate Tchanturia
Institute of Psychiatry, Kings College London, London, UK
Qazi Rahman
University of East London, London, UK
Ulrike Schmidt
Institute of Psychiatry, Kings College London, London, UK
It is a commonly held stereotype that women show superior performance on tests of
social cognition such as face processing and theory of mind (ToM) compared to
men. However, such purported differences have not been empirically tested. In this
study 40 healthy men and 40 women matched for age and years of education
completed a well-known experimental ToM test requiring the attribution of either
physical or mental states (Happe´’s cartoon task). Men showed superior performance
compared to women, with a medium effect size, on both the mental state and
physical state cartoons. It is suggested that men may use a cognitive systemising
strategy during these tasks. The results emphasise the task-specific nature of sex
differences in social cognition and necessitate future work to elucidate individual
differences at the interface of cognitive and affective processes.
Correspondence should be addressed to: Dr Tamara Russell, Section of Neuroscience and
Emotion, PO Box 69, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK.
E-mail: T.Russell@iop.kcl.ac.uk
COGNITION AND EMOTION
2007, 21 (7), 1554 1564
#
2007 Psychology Press, an imprint of the Taylor & Francis Group, an Informa business
www.psypress.com/cogemotion DOI: 10.1080/02699930601117096
Downloaded By: [King's College London] At: 20:37 14 June 2008
INTRODUCTION
Sex differences in human cognitive abilities are well established. Males are
typically found to excel on certain tests of mathematical reasoning and
visuo-spatial processing, in particular on tests of mental rotation, while
females excel on tests of verbal fluency, perceptual speed and spatial memory
for object locations (Kimura, 1999; Voyer, Voyer, & Bryden, 1995). However,
these differences are also task specific. For example, although males achieve
higher scores on tests of mathematical aptitude, females do better on tests
involving computation (Kimura, 1999). Additionally, females excel at one
type of spatial memory task *the encoding and retrieval of object locations,
while the oft-cited female superiority in ‘‘verbal abilities’’ is limited to tests
of verbal fluency*the generation of words or categories to phonetic or
semantic exemplars (Eals & Silverman, 1994; Kimura, 1999; Rahman,
Wilson, & Abrahams, 2003). However, while these ‘‘cold cognitive’’ abilities
have been dealt with at some length, the less-defined interaction between
cognitive processes on the one hand, and emotional processes on the other,
has received almost no attention in this and other individual differences
literature. These unique processes, which we refer to as ‘‘hot cognitive’’ or
‘‘social-cognitive’’ abilities, are the focus of the current work. The presence
of sex differences in ‘‘social-cognitive’’ functions (or ‘‘hot’’/affective cogni-
tion) is less well established. Nonetheless, several reviews and empirical
studies suggest a female advantage in the recognition of facial affect
(Campbell et al., 2002; Erwin et al., 1992; Hall, 1978; McClure, 2000;
Thayer & Johnsen, 2000). A popular assumption regarding sex differences in
social cognition is the notion that females are better than males at the
attribution of mental states to others, and in appropriate affective responses
to another’s affective state. The ability to make inferences about others’
mental states and the use of these inferences to predict and explain
behaviours has been termed ‘‘theory of mind’’ (ToM). It underlies humans’
ability to engage in complex social interaction, and may be the product of an
evolved, innately predisposed, and domain-specific cognitive mechanism
(Leslie, 1995). Although environmental effects on the rate of ToM
development have been reported, it is striking that children across different
cultures and backgrounds develop insight into others’ mental states at
approximately age four (Wellman & Lagattuta, 2000). Little is known about
how ToM develops beyond childhood, although one study suggests that
performance on ToM tasks may improve over the later adult years (Happe´,
Winner, & Brownell, 1998).
ToM is selectively impaired in the developmental disorder autism, while
other aspects of cognition are relatively spared (Happe´, 1994). ToM is
compromised in healthy adults following acquired damage to frontal regions
or areas of the non-dominant hemisphere (Brownell, Griffin, Winner,
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Friedman, & Happe´, 2000; Happe´, Brownell, & Winner, 1999; Rowe,
Bullock, Polkey, & Morris, 2001; Stuss, Gallup, & Alexander, 2001; Winner,
Brownell, Happe´, Blum, & Pincus, 1998;) and impairments are also seen in
the course of dementia (Gregory et al., 2002; Lough, Gregory, & Hodges,
2001). These findings concur with neuroimaging data implicating frontal
and temporal regions in healthy adults attempting to ‘‘read’’ a character’s
mind (Brunet, Sarfati, Hardy-Bayle, & Decety, 2000; Castelli, Frith,
Happe´, & Frith, 2002; Fletcher et al., 1995; Gallagher et al., 2000). It
should be noted, however, that the majority of these imaging studies have
been conducted using exclusively male subjects and as such can really only
provide information about the neural basis of ToM in the male brain. If we
plan to make inferences about mental function and neural organisation
relating to ToM on the basis of these results, it is important to ascertain if
sex differences are present on these types of tasks.
In his recent conceptualisation of the ‘‘extreme male brain theory of
autism’’, Baron-Cohen (2002) has cited several lines of evidence for a female
advantage on social cognitive tests, including the Reading the Mind in the
Eyes test in adults (Baron-Cohen, Jolliffe, Mortimore, & Robertson, 1997),
and the Faux Pas test (Baron-Cohen, O’Riordan, Stone, Jones, & Plaisted,
1999), false belief tasks (Happe´, 1995), perspective-taking and affective
labelling (Dunn, Brown, Slomkowski, Tesla, & Youngblade, 1991) in
children. Women also score higher on a psychometric construct called
‘‘empathising’’ (which involves identifying another’s thoughts and emotions
and responding appropriately) compared to men who score higher on
‘‘systemising’’ (the analysis of rule-driven behaviour in systems; Baron-
Cohen, Richler, Bisarya, Gurunathan, & Wheelwright, 2003). However, few
of these studies explicitly explored male and female ability profiles outside of
the context of experimental comparison with the performance of individuals
with autism or Asperger’s syndrome on these tests. Moreover, there are
almost no experimental studies on adults.
It is uncertain whether sex differences in either ‘‘cold’’ or ‘‘hot’’ cognition
stem from biological or psychosocial determinants, although recent interest
has focused on the role of organisational and activational effects of gonadal
hormones and variation in neural substrates underlying performance on
these tasks (Baron-Cohen, 2002; Collaer & Hines, 1995; Frederiske, Lu,
Aylward, Barta, & Pearlson,1999; Grimshaw, Sitarenios, & Finegan, 1995;
Gur et al., 2000; Hines, 2000). Lutchmaya, Baron-Cohen, and Raggatt
(2002) reported sex differences in social and non-social orienting responses
as early as 12 months in human infants, suggesting that maturational factors
on social cognition operate early in development.
The question of sex differences in ToM is particularly pertinent with the
increased attention in the psychiatric literature to social cognition. Several
psychiatric disorders show sexually dimorphic clinical and developmental
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characteristics and ToM impairments. In schizophrenia attention has begun
to turn to the profile of the social cognitive deficits seen in this group, given
that it is these types of difficulties that are a good predictor of outcome
(Penn, Combs, & Mohamed, 2001; Rocone et al., 2002). Although the
prevalence of schizophrenia is equivalent across the sexes, there are
differences in the age of onset, with male onset peaking between 20 to
24 years, while in females a smaller peak is seen at approximately 35 years of
age (World Health Organization, 1979; Hafner, Maurer, Loffler, & Reicher-
Rosslet, 1993). One effect of this sex dimorphic onset is that the majority of
studies reported in the literature are based on predominantly male samples.
Psychopathic personality disorder, attention deficit hyperactivity disorder
and conduct disorder are also far more common in males and there are
several reports of social cognitive deficits in these conditions (Blair, Jones,
Clark, & Smith, 1997; Hughes, Dunn, & White, 1998; Biederman et al.,
2002; cf. Richell et al., 2003; Widom, 1976). Also, and by far the clearest
example, is autism, characterised by a high male prevalence and pervasive
deficits in social cognition. As has already been alluded, Baron-Cohen
(2002) has suggested that autism is evidenced by a very male-typical
cognitive ability profile, including impaired ToM, communication and
language processing, and facial affect processing, yet superior ‘‘systemising’’
abilities such as attention to detail, preference for constructional and vehicle
toys, and islets of ability in factual and rule-based systems or academic
subjects. Lastly, a recent study has suggested that females with anorexia
nervosa (AN) have persevered ToM abilities, despite suggested similarities
between AN and autism-spectrum disorders (Fisman, Steele, Short, Byrne,
& Lavalee, 1996; Tchanturia et al., 2005). Clearly, further empirical data on
normative sex differences (as well as other individual differences) in ToM is
essential to furthering our understanding of impairments in social cognition
in these clinical disorders.
The aim of the present investigation was to utilise a well-established
ToM task (Happe´’s cartoon task; Happe´ et al., 1999) in a sample of
healthy adult males and females matched for age and years of education.
The cartoon task comprises twelve cartoons, taken from newspapers; half
of which require the understanding of a character’s mental state in order to
get the joke and the other half requiring the understanding of physical
states. It has been used previously to assess ToM in brain-damaged
individuals (Happe´ et al., 1999), and with patients with schizophrenia;
Russell, 2002).
This represents the first study of its kind. The dearth of prior literature
precludes directional hypothesising. However, on the basis of the extant
literature for a female advantage in other domains of social cognition and
the theoretical proposal that females should be adept at inference of
mental states specifically (Baron-Cohen, 2002), it was predicted that
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females would perform better than males on the mental states (MS)
component of the task. No sex differences were expected on the physical
states (PS) component of the task, as these do not involve inferences about
mental states.
METHOD
Participants
These were 40 females and 40 males matched for age and years of education
(males mean age 34.3, SD
/10.58, range /1861; education level mean
13.8 years, SD
/2.9, range 8 21; females mean age 30.35, SD/9.39, range
1966; education level mean 14.32 years, SD
/2.36, range 920). Partici-
pants were screened by a clinical psychologist (KT) and an experienced
research psychologist (TR) to ensure no prior history of psychiatric or
neurological morbidity, or learning disabilities.
Measures
Happe´’s theory of mind cartoon task was used (Happe´ et al., 1999). Half the
cartoons (6 stimuli) required the understanding of a physical state in order to
‘‘get’’ the joke (PS cartoons) and half required the understanding of a mental
state (MS cartoons) in order to appreciate the joke. The cartoons were
scored using guidelines provided by Happe´, with a score of 3 given for a full
explanation; 2 for a partial explanation; 1 if the subject mentioned relevant
details of the picture or gave a description only; and 0 if the subject
mentioned only irrelevant aspects of the picture. A maximum score of 18 was
obtainable in each condition (MS and PS). The cartoons were presented to
each subject in a different order to minimise ordering and fatigue effects on
performance.
Procedure
Participants were seen individually in a session lasting approximately
30 minutes. Each participant was remunerated for his or her time. The
Ethical (Research) Committee of the Institute of Psychiatry and Maudsley
Hospital, London, approved all procedures.
Statistical analysis
To determine whether the data were normally distributed, box-plots were
computed for each variable. Group differences in age and years in education
were analysed by the one-way analyses of variance (ANOVA) using the
Statistical Package for the Social Sciences (SPSS) Version 10.0. Group
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differences in ToM performance were examined using General Linear Model
(GLM) repeated measures ANOVA with Sex as the between-subjects factor
and Cartoon Condition (MS or PS) as the within-subject repeated factor.
Effect size was calculated as [mean 1
/mean 2]/[(SD 1/SD 2)/2], where
0.2 is a small effect, 0.5 a medium effect and 0.8 a large effect by standard
criteria (Cohen, 1988). Alpha level was set at .05. Interrater reliability for
scores on the cartoon task was assessed by two raters for 31 subjects
(Kappa
/.81).
RESULTS
Participant characteristics
There were no significant between-group difference in years of education,
F(1, 78)
/0.78, p/.37, nor age, F(1, 78)/3.11, p/.08.
ToM Performance
Males had a mean score of 15.75 (SD/2.45, range 718) on the MS
cartoons while females had a mean of 13.37 (SD
/3.97, range 5 18). On the
PS cartoons, the male mean was 15.95 (SD
/1.79, range 9 18) while the
female mean was 13.77 (SD
/2.92, range 618).
There was a main effect of sex, F(1, 78)
/16.18, p/.001. Irrespective of
cartoon type, male subjects were more accurate than female subjects on this
task (male mean
/15.85, SD/1.80; female mean/13.57, SD /3.08). There
was no main effect of cartoon type, Wilks’ Lambda
/.988, F(1, 78)/0.91,
p
/.34, nor any interaction between sex and cartoon type, Wilks’ Lambda/
.99, F(1, 78) /0.10, p /.75.
Effect sizes were calculated using the average score of MS and PS
cartoons and resulted in an effect size (Cohen’s d) of 0.80. Calculating these
separately for the MS and the PS cartoons revealed effect sizes of 0.53 and
0.86 respectively.
DISCUSSION
The aim of the present study was to explore the notion that adult females
would show better performance than adult males on a ToM task requiring
mental state inferences in contrast to physical state inferences (for which no
sex differences were predicted). Such tasks are a hallmark feature of
psychological investigations at the interface of cognitive, affective and social
processes. The results clearly show no support for this hypothesis. Rather, we
found, for the first time, strong evidence that the opposite is true*that men
performed better on our ToM task across both conditions compared to
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women. These findings are inconsistent with the suggestion that females
(both girls and adults) should perform better on tasks designed to tap into
the ability to make accurate inferences about the mental states of others
(Baron-Cohen, 2002; Baron-Cohen et al., 1997, 1999, 2003; Dunn et al.,
1991; Happe´, 1995).
The effect size for the difference was in the medium to large range
(Cohen, 1988). Given the size of the effect it is unlikely that this finding is
spurious and makes this sex difference similar to the male advantage on the
mental rotation test (Voyer et al., 1995). Moreover, the sample comprised
healthy adults screened for any evidence of psychiatric or neurological
morbidity, learning disabilities and matched on age and years of education.
Thus, the finding appears somewhat robust. Other task details, such as the
requirement to ‘‘get the joke’’, are unlikely to explain the findings as there
are no clear sex differences in the appreciation of humour. The observation
that males in the present study showed better inference of mental and
physical states compared to women suggests a generalised male advantage
for understanding the rules underlying inferential processes regardless of
whether they involve animate (which includes systems that ‘‘mentalise’’, i.e.,
other humans) or inanimate objects. We propose that the male advantage
observed here reflects a task-specific ‘‘systemising’’ strategy employed by
men, ‘‘systemising’’ being a construct on which men are known to score
particularly highly when evaluated psychometrically (Baron-Cohen et al.,
2003). The ‘‘cartoon’’ task and, in fact, many standardised ToM measures
require the understanding and prediction of law-governed behaviour. The
cartoon task comprises an inductive process from which one formulates a
rule about how the system, or in this case the inferential components of the
task, works. This is comparable to many standardised decision-making
tasks. In support of this explanation Reavis and Overman (2001) reported a
robust male advantage on the Iowa Card Sorting task, a reward-related
decision-making task. Performance on this task has previously been shown
to depend on the integrity of the orbital prefrontal cortex, a region also
implicated in ToM processing (Reavis & Overman, 2001). Thus, a common
neural substrate underlying systemic decision-making and ToM may explain
the male advantage. In monkeys, the orbital prefrontal region matures faster
in males than in females and, consequently, infant male monkeys outper-
form infant females on another decision-making task, the object reversal
task (see Reavis & Overman, 2001, for a review).
The present findings also add to an increasing body of experimental work
in another domain of social or ‘‘affective’’ cognition*facial emotion
recognition* where mixed results regarding sex differences have been found
(Campbell et al., 2002; Thayer & Johnsen, 2000; cf. Erwin et al., 1992). This
brings into question the extent to which sex differences in social cognition
can be generalised across measures used to test them. As with sex differences
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in facial emotion recognition, there are more consistent findings for a stable
difference favouring female infants, children and adolescents (for facial
emotion recognition see McClure, 2000; for ToM see Baron-Cohen et al.,
1999; Dunn et al., 1991; Happe´, 1995; Hughes & Dunn, 1998). Thus it is
possible that early sex differences do not extend into adulthood. This would
make social cognitive ability similar to many aspects of verbal ability (aside
from verbal fluency) in which girls mature faster than boys but the female
advantage has dissipated by adulthood (Kimura, 1999; Lynn, 1994).
Lastly, the male advantage demonstrated in the present study may be a
reflection of the type of task used. While this test has been used by a number
of studies to probe ToM, it is not clear how performance on this task relates
to actual social functioning, which may include a more affective component.
While it has yet to be empirically investigated, it may be the case that there
are both ‘‘hot’’ and ‘‘cold’’ routes to solve ToM problems with the cartoon
task probing a ‘‘cold’’ route. To test the prediction that females might be
better on more affective ToM tasks (for example on Baron-Cohen’s Reading
the Mind in the Eyes test) different types of ToM tasks should be used in the
same sample of participants.
In conclusion, we have shown, for the first time, a male advantage on one
well-established test of ToM, Happe´’s cartoon task, and have suggested that
this is due to a task-specific systemising strategy used by men. These data
suggest sexual dimorphism in social abilities that involve both cognitive and
affective components to their execution. These findings should alert
investigators to the potential pitfalls of using tasks with several unspecified
cognitive subcomponents and be wary of models of sex differences based on
little more than stereotypical gender schemas. Future studies will have to
employ a range of ToM tasks that incorporate the major dimensions of both
‘‘systemising’’ and ‘‘empathising’’ in order to explicate fully normative sex
differences.
Manuscript received 9 July 2003
Revised manuscript received 13 October 2005
Manuscript accepted 9 November 2006
First published online 13 June 2007
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