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: 5.13). 09/2011; 48(10):1329-41. DOI: 10.1016/j.cortex.2011.08.003
Source: PubMed
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.

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    • "At the end of each clip, participants answer four yes/no questions regarding the speaker's true beliefs, intentions, and emotional state. TASIT-III requires complex processing to decode speakers' thoughts and intentions and thus measures high-level social cognition and theory of mind (Shany-Ur et al. 2012). Scores range from 0 to 64 questions correct. "
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    • "While the measure has consistently demonstrated sensitivity in the detection of higher order social cognition impairments in Australian-based clinical samples (consisting mainly of Caucasian and monolingual individuals) (e.g., Honan et al., 2015; Kumfor et al., 2014), it also has demonstrated sensitivity to detect impairments in various clinical conditions in other English-speaking countries including the USA, UK, and Canada. The various clinical groups examined in these non-Australian populations have included stroke (Cooper et al., 2013), multiple sclerosis (Genova, Cagna, Chiaravalloti, DeLuca, & Lengenfelder, 2015), schizophrenia and schizotypy (Deptula & Bedwell, 2015; Green et al., 2012; Kern et al., 2009; Mathews & Barch, 2010; Woolley et al., 2014), bv-FTD (Kipps et al., 2009; Shany-Ur et al., 2012), supranuclear palsy (Shany-Ur et al., 2012), older adults (Phillips et al., 2015), microdeletion syndrome (22q11DS) (Jalbrzikowski et al., 2014), undergraduate female students with an eating disorder (Ridout, Thom, & Wallis, 2010), individuals who have undergone hemispherectomy due to epilepsy (Fournier et al., 2008), and Parkinson's disease (Pell et al., 2014 ). TASIT has also been used in bilingual-speaking populations including healthy adolescents with a range of language backgrounds (McDonald et al., 2015). "
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    Full-text · Article · Feb 2016 · The Clinical Neuropsychologist
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    • "Emotion deficits in FTLD are diverse and multidimensional: deficits may affect the cognitive processing of emotional cues in the verbal, visual, auditory or chemosensory modalities and extend across emotion categories (Snowden et al., 2001; Keane et al., 2002; Rosen et al., 2002; Werner et al., 2007; Bedoin et al., 2009; Omar et al., 2011a,b; Kumfor et al., 2011; Rohrer et al., 2012; Hsieh et al., 2012a; Kumfor and Piguet, 2012) and the processing of both elementary emotions and more complex prosocial sentiments (Moll et al., 2011 ). Impaired processing of emotional signals is often mirrored by abnormal emotional behaviours exhibited by patients themselves and correlates both with impaired understanding of others' mental states (Snowden et al., 2001; Kipps et al., 2009; Shany-Ur et al., 2012) and with altered autonomic reactivity (Werner et al., 2007; Eckart et al., 2012; Balconi et al., 2015) , consistent with the targeting of distributed neural networks that process emotion by the proteinopathies that underpin FTLD (Omar et al., 2011a,b; Virani et al., 2013; Woolley et al., 2015). Limited evidence suggests that particular emotion categories or emotion modalities may be differentially affected in FTLD (Snowden et al., 2001; Kumfor et al., 2013; Lindquist et al., 2014; Oliver et al., 2015 ). "
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