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Mind-blindness

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Not to be confused with aphantasia, the inability to produce mental images.

Mind-blindness, mindblindness or mind blindness is a theory initially proposed in 1990 that claims that all autistic people have a lack or developmental delay of theory of mind (ToM), meaning they are unable to attribute mental states to others.[1][2][3] According to the theory, a lack of ToM is considered equivalent to a lack of both cognitive and affective empathy.[4] In the context of the theory, mind-blindness implies being unable to predict behavior and attribute mental states including beliefs, desires, emotions, or intentions of other people.[5] The mind-blindness theory asserts that children who delay in this development will often develop autism.[4][6]

One of the main proponents of mind-blindness was Simon Baron-Cohen, who later pioneered empathising–systemising theory.[6] Over the years, the mind-blindness hypothesis has faced criticism from the scientific community[7] due to inconclusive empirical evidence, mixed findings with different ToM tasks, repetitive failed replications of some (but not all) classic ToM studies,[8][9][10][11] and consistent evidence (including some studies by Baron-Cohen) of substantial heterogeneity of autistic people in ToM and empathy measures.[12][13][14][15][16]

Theory of mind

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Main article: Theory of mind

Mind-blindness is defined as a state where the ToM has not been developed in an individual.[1] According to the theory, neurotypical people can make automatic interpretations of events taking into consideration the mental states of people, their desires, and beliefs. Individuals lacking ToM would therefore perceive the world in a confusing and frightening manner, leading to a social withdrawal.[1] The theory was based on the assumption that biology is linked to autistic behavior, so it was expected that a delayed development or lack of ToM would lead to additional psychiatric complications. Research into a model with more than two categories was also considered.[1]

Mind-blindness, a lack of ToM, was later theorised to be equivalent to a lack of empathy,[4] although research published a year later suggests there is considerable overlap but not complete equivalence.[17] It was empirically demonstrated that processing of complex cognitive emotions is more difficult than processing simpler emotions. In addition, evidence existed at the time that autism was not correlated with the failure of social bonding and attachment in childhood. This was interpreted to suggest that emotion is a component of social cognition that is separable from mentalizing.[3]

Biological basis

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Superior temporal sulcus

Since the frontal lobe is associated with executive function, it was predicted that the frontal lobe plays an important role in ToM; that executive function and ToM share the same functional regions in the brain.[18] Damage to the frontal lobe is known to affect ToM,[19][20] partially confirming this hypothesis. From a 2000 study, it was found that a neural network that comprised the medial prefrontal cortex, the anterior cingulate cortex, the circumscribed region of the anterior paracingulate cortex and the superior temporal sulcus, is crucial for the normal functioning of ToM and self monitoring.[5][21] Although there is a possibility that ToM and mind-blindness could explain executive function deficits, it was argued that autism is not identified with the failure of executive function alone.[22] It has also been shown that the right temporo-parietal junction behaves differently in those with autism,[23] and the middle cingulate cortex is less active in autistic people during mentalization.[24]

History and relationship to autism

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Mind-blindness of autistic people relative to non-autistic people

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In an attempt to empirically explain the tendency of autistic people to avoid eye contact, a hypothesis was proposed in 1995 that autistic children fail to "read" the eyes of others.[2] This hypothesis was tested with participant performance on false-belief tasks and detecting gaze shifts.[25] In the moral blindness hypothesis study, some evidence existed to support this hypothesis. At the time there was insufficient evidence to support a generalization to explain facial processing difficulties and affective sensitivity, common characteristics of autism, with this hypothesis. In 2001, it was suggested that the mind-blindness hypothesis may explain more severe symptoms of autism, including social withdrawal and social skill deficiencies.[3] With good robustness, it was found that a lower performance on mentalization tasks correlates with autism, suggesting mentalization theory as an effective explanatory model of autism, especially for social skill deficiencies. However, the generally unclear physiological basis of mentalization at the time limited a broader understating of the correlation.[3]

In the 1996 book Theories of Mind,[26]: 258  Peter Carruthers argues in support of the mind-blindness hypothesis in spite of inconclusive evidence for its generalisation. Recognising the hypothesis has lost popularity, Carruthers argues this is mainly due to the disregard of its proponents to consider the perspectives of autistic people.[26]: 259  The latter view is shared by David Smukler in his 2005 analysis of the history of the ToM in autism research.[11]

The assumption that autism is a homogenous condition underpinned by a ToM deficit, genetics, neurological abnormalities, or a 'failure of understanding' as implied by the mind-blindness hypothesis was questioned shortly after its publication.[10] This contrasts with autism as heterogeneous.[11] There is now a large pool of strong evidence supporting the heterogeneity of autism,[27][28][29] and general scientific consensus accepts this as contrary to the original mind-blindness hypothesis, although there has existed some disagreement that heterogeneity is incompatible with alternative mind-blindness definitions.[11]

An author of the original mind-blindness hypothesis, Simon Baron-Cohen, later published foundational research in empathising–systemising theory, which asserts there exists neurological sex differences in autism,[30] and that such differences are not due exclusively to socialization.[31]

Mind-blindness of non-autistic people relative to autistic people

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The double empathy problem, first proposed in 2012 by Damian Milton, is a theory in opposition of the mind-blindness hypothesis. It proposes that social and communication difficulties present in autistic people are due to a reciprocal lack of understanding and mutual differences in communication style between autistic and non-autistic people, as opposed to an asymmetric theory such as the mind-blindness hypothesis.[32] There is a growing body of evidence supporting the double empathy problem.[32][33] A possible explanation supported empirically is that the reciprocal lack of understanding is because "we interpret others’ actions according to models built through experience with our own actions".[34]

See also

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Citations

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  1. ^ a b c d Baron-Cohen, Simon (1990). "Autism: a specific cognitive disorder of 'mind-blindness". International Review of Psychiatry. 2 (1): 81–90. doi:10.3109/09540269009028274.
  2. ^ a b Baron-Cohen, Simon; Campbell, Ruth; Karmiloff-Smith, Annette; Grant, Julia; Walker, Jane (November 1995). "Are children with autism blind to the mentalistic significance of the eyes?". British Journal of Developmental Psychology. 13 (4): 379–398. doi:10.1111/j.2044-835x.1995.tb00687.x. ISSN 0261-510X. S2CID 34341464.
  3. ^ a b c d Frith, Uta (20 December 2001). "Mind Blindness and the Brain in Autism". Neuron. 32 (6): 969–979. doi:10.1016/S0896-6273(01)00552-9. PMID 11754830.
  4. ^ a b c Jurecic, Ann (Spring 2006). "Mindblindness: Autism, Writing, and the Problem of Empathy". Literature and Medicine. 25 (1): 1–23. doi:10.1353/lm.2006.0021. PMID 17040082. S2CID 2822141.
  5. ^ a b Gallagher, Helen L.; Frith, Christopher D. (1 February 2003). "Functional imaging of 'theory of mind'" (PDF). Trends in Cognitive Sciences. 7 (2): 77–83. doi:10.1016/S1364-6613(02)00025-6. PMID 12584026. S2CID 14873867.
  6. ^ a b Baron-Cohen, Simon (25 March 2009). "Autism: The Empathizing-Systemizing (E-S) Theory". Annals of the New York Academy of Sciences. 1156, The Year in Cognitive Neuroscience (1): 68–80. Bibcode:2009NYASA1156...68B. doi:10.1111/j.1749-6632.2009.04467.x. PMID 19338503. S2CID 1440395.
  7. ^ Dinishak, Janette; Akhtar, Nameera (June 2013). "A Critical Examination of Mindblindness as a Metaphor for Autism". Child Development Perspectives. 7 (2): 110–114. doi:10.1111/cdep.12026.
  8. ^ Boucher, Jill (2012). "Putting theory of mind in its place: psychological explanations of the socio-emotional-communicative impairments in autistic spectrum disorder". Autism. 16 (3): 226–246. doi:10.1177/1362361311430403. ISSN 1362-3613. PMID 22297199. S2CID 30738704.
  9. ^ Gernsbacher, Morton; Yergeau, Melanie (2019). "Empirical Failures of the Claim That Autistic People Lack a Theory of Mind". Archives of Scientific Psychology. 7 (1): 102–118. doi:10.1037/arc0000067. PMC 6959478. PMID 31938672.
  10. ^ a b Shanker, S. (1 October 2004). "The Roots of Mindblindness". Theory & Psychology. 14 (5): 685–703. doi:10.1177/0959354304046179. S2CID 143801835.
  11. ^ a b c d Smukler, David (February 2005). "Unauthorized Minds: How 'Theory of Mind' Theory Misrepresents Autism". Mental Retardation. 43 (1): 11–24. doi:10.1352/0047-6765(2005)43<11:UMHTOM>2.0.CO;2. PMID 15628930.
  12. ^ Baksh, R. Asaad; Abrahams, Sharon; Bertlich, Maya; Cameron, Rebecca; Jany, Sharon; Dorrian, Terin; Baron-Cohen, Simon; Allison, Carrie; Smith, Paula; MacPherson, Sarah E.; Auyeung, Bonnie (2021-10-03). "Social cognition in adults with autism spectrum disorders: Validation of the Edinburgh Social Cognition Test (ESCoT)". The Clinical Neuropsychologist. 35 (7): 1275–1293. doi:10.1080/13854046.2020.1737236. hdl:20.500.11820/ea02ab9c-73be-4e85-916a-7612aa640013. ISSN 1385-4046. PMID 32189564. S2CID 151487088.
  13. ^ Greenberg, David M.; Warrier, Varun; Allison, Carrie; Baron-Cohen, Simon (2018-11-27). "Testing the Empathizing–Systemizing theory of sex differences and the Extreme Male Brain theory of autism in half a million people". Proceedings of the National Academy of Sciences. 115 (48): 12152–12157. Bibcode:2018PNAS..11512152G. doi:10.1073/pnas.1811032115. ISSN 0027-8424. PMC 6275492. PMID 30420503.
  14. ^ Lombardo, Michael V.; Lai, Meng-Chuan; Auyeung, Bonnie; Holt, Rosemary J.; Allison, Carrie; Smith, Paula; Chakrabarti, Bhismadev; Ruigrok, Amber N. V.; Suckling, John; Bullmore, Edward T.; MRC AIMS Consortium; Bailey, Anthony J.; Baron-Cohen, Simon; Bolton, Patrick F.; Bullmore, Edward T. (2016-10-18). "Unsupervised data-driven stratification of mentalizing heterogeneity in autism". Scientific Reports. 6 (1): 35333. Bibcode:2016NatSR...635333.. doi:10.1038/srep35333. ISSN 2045-2322. PMC 5067562. PMID 27752054.
  15. ^ Hajdúk, Michal; Pinkham, Amy E.; Penn, David L.; Harvey, Philip D.; Sasson, Noah J. (April 2022). "Heterogeneity of social cognitive performance in autism and schizophrenia". Autism Research. 15 (8): 1522–1534. doi:10.1002/aur.2730. ISSN 1939-3792. PMID 35460541. S2CID 248345497.
  16. ^ Bird, G.; Cook, R. (2013-07-23). "Mixed emotions: the contribution of alexithymia to the emotional symptoms of autism". Translational Psychiatry. 3 (7): e285. doi:10.1038/tp.2013.61. ISSN 2158-3188. PMC 3731793. PMID 23880881.
  17. ^ Rogers, Kimberley; Dziobek, Isabel; Hassenstab, Jason; Wolf, Oliver T.; Convit, Antonio (2006-08-12). "Who Cares? Revisiting Empathy in Asperger Syndrome". Journal of Autism and Developmental Disorders. 37 (4): 709–715. doi:10.1007/s10803-006-0197-8. ISSN 0162-3257. PMID 16906462. S2CID 13999363.
  18. ^ Josef Perner & Birgit Lang (1 September 1999). "Development of theory of mind and executive control". Trends in Cognitive Sciences. 3 (9): 337–344. doi:10.1016/s1364-6613(99)01362-5. PMID 10461196. S2CID 11112882.
  19. ^ Bird, Chris M.; Castelli, Fulvia; Malik, Omar; Frith, Uta; Husain, Masud (2004-04-01). "The impact of extensive medial frontal lobe damage on 'Theory of Mind' and cognition". Brain. 127 (4): 914–928. doi:10.1093/brain/awh108. ISSN 0006-8950. PMID 14998913.
  20. ^ Stone, Valerie E.; Baron-Cohen, Simon; Knight, Robert T. (September 1998). "Frontal Lobe Contributions to Theory of Mind". Journal of Cognitive Neuroscience. 10 (5): 640–656. doi:10.1162/089892998562942. ISSN 0898-929X. PMID 9802997. S2CID 207724498.
  21. ^ Vogeley, K.; Bussfeld, P.; Newen, A.; Herrmann, S.; Happé, F.; Falkai, P.; Maier, W.; Shah, N.J.; Fink, G.R.; Zilles, K. (July 2001). "Mind Reading: Neural Mechanisms of Theory of Mind and Self-Perspective". NeuroImage. 14 (1): 170–181. doi:10.1006/nimg.2001.0789. ISSN 1053-8119. PMID 11525326. S2CID 7053366.
  22. ^ Carruthers, Peter (1996). "Chapter 16. Autism as Mind-Blindness: an elaboration and partial defence (pp. 257 ff.)". In Carruthers, Peter; Smith, Peter K. (eds.). Theories of Theories of Mind. Cambridge University Press. ISBN 978-0-521-55916-4.
  23. ^ Lombardo, Michael V.; Chakrabarti, Bhismadev; Bullmore, Edward T.; Baron-Cohen, Simon (June 2011). "Specialization of right temporo-parietal junction for mentalizing and its relation to social impairments in autism". NeuroImage. 56 (3): 1832–1838. doi:10.1016/j.neuroimage.2011.02.067. ISSN 1053-8119. PMID 21356316. S2CID 14782731.
  24. ^ Chiu, Pearl H.; Kayali, M. Amin; Kishida, Kenneth T.; Tomlin, Damon; Klinger, Laura G.; Klinger, Mark R.; Montague, P. Read (February 2008). "Self Responses along Cingulate Cortex Reveal Quantitative Neural Phenotype for High-Functioning Autism". Neuron. 57 (3): 463–473. doi:10.1016/j.neuron.2007.12.020. ISSN 0896-6273. PMC 4512741. PMID 18255038.
  25. ^ Mosconi, Matthew W.; Mack, Peter B.; McCarthy, Gregory; Pelphrey, Kevin A. (August 2005). "Taking an "intentional stance" on eye-gaze shifts: A functional neuroimaging study of social perception in children". NeuroImage. 27 (1): 247–252. doi:10.1016/j.neuroimage.2005.03.027. PMID 16023041. S2CID 25792636.
  26. ^ a b Carruthers, Peter; Smith, Peter K., eds. (1996-02-23). Theories of Theories of Mind. doi:10.1017/cbo9780511597985. ISBN 9780521551106.
  27. ^ Toal, F.; Daly, E. M.; Page, L.; Deeley, Q.; Hallahan, B.; Bloemen, O.; Cutter, W. J.; Brammer, M. J.; Curran, S.; Robertson, D.; Murphy, C.; Murphy, K. C.; Murphy, D. G. M. (July 2010). "Clinical and anatomical heterogeneity in autistic spectrum disorder: a structural MRI study". Psychological Medicine. 40 (7): 1171–1181. doi:10.1017/S0033291709991541. ISSN 0033-2917. PMID 19891805. S2CID 10216391.
  28. ^ Lenroot, Rhoshel K.; Yeung, Pui Ka (2013-10-30). "Heterogeneity within Autism Spectrum Disorders: What have We Learned from Neuroimaging Studies?". Frontiers in Human Neuroscience. 7: 733. doi:10.3389/fnhum.2013.00733. ISSN 1662-5161. PMC 3812662. PMID 24198778.
  29. ^ Chapman, Robert (2020-08-17). "The reality of autism: On the metaphysics of disorder and diversity". Philosophical Psychology. 33 (6): 799–819. doi:10.1080/09515089.2020.1751103. hdl:1983/309dc16c-cfe9-4356-81b8-6d95510b5eb0. ISSN 0951-5089. S2CID 203059811.
  30. ^ Baron-Cohen, S.; Knickmeyer, Rebecca S.; Belmonte, Mathew S. (4 November 2005). "Sex Differences in the Brain: Implications for Explaining Autism" (PDF). Science. 310 (5749): 819–823. Bibcode:2005Sci...310..819B. doi:10.1126/science.1115455. PMID 16272115. S2CID 44330420.
  31. ^ Chapter 16 The evolution of empathizing and systemizing: assortative mating of two strong systemizers and the cause of autism. R. I. M. Dunbar, Louise Barrett. Oxford: Oxford University Press. 2007. ISBN 978-0-19-856830-8. OCLC 75713253. {{cite book}}: |work= ignored (help)CS1 maint: others (link)
  32. ^ a b Milton, Damian E.M. (October 2012). "On the ontological status of autism: the 'double empathy problem'". Disability & Society. 27 (6): 883–887. doi:10.1080/09687599.2012.710008. ISSN 0968-7599. S2CID 54047060.
  33. ^ "Double empathy, explained". Spectrum. Simons Foundation. 2021-07-22. Retrieved 2022-02-13.
  34. ^ "Supplemental Material for Interaction Takes Two: Typical Adults Exhibit Mind-Blindness Towards Those With Autism Spectrum Disorder". Journal of Abnormal Psychology. 2016. doi:10.1037/abn0000199.supp. ISSN 0021-843X.

Further reading

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