Cognitive processes predicting advanced theory of mind in the broader autism phenotype

Abstract

Little is known about executive functions (EFs) associated with advanced theory of mind (ToM) abilities. We aimed to determine if advanced ToM abilities were reduced in individuals with subclinical traits of autism spectrum disorder (ASD), known as the “Broader Autism Phenotype” (BAP), and identify the EFs that predicted unimpaired performance on an advanced ToM task, the faux pas test. We assessed 29 participants (13 males) with the BAP who were relatives of children with ASD. Thirteen participants showed reduced ability to understand a faux pas. A discriminant function analysis correctly classified 79% of cases as impaired or unimpaired, with high sensitivity (80%) and specificity (77%), which was best predicted by language‐mediated EFs, including verbal generativity, working memory, cognitive inhibition, and flexibility. Autism Res 2020, 13: 921‐934. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Little is known about the complex cognitive processes that enable accurate interpretation of another person's thoughts and emotions, known as “theory of mind.” In relatives of individuals with autism, who had mild traits of autism themselves, approximately half had difficulty interpreting situations involving a social faux pas. Cognitive inhibition and flexibility, working memory, and verbal generativity were related to, and appeared to be protective for, unimpaired understanding of a faux pas.

Evaluative contexts facilitate implicit mentalizing: relation to the broader autism phenotype and mental health

“…The broader autism phenotype (BAP) was proposed to indicate a collection of sub-clinical expressions of autistic traits 46 – 50 . The BAP is qualitatively similar to autism, but neither leads to the full autism phenotype nor results in significant difficulties in socio-cognitive functioning 46 , 47 . Studies have observed that BAP is especially prevalent in the relatives of autistic people, for example, 20–40% of first-degree relatives but 2–9% of the general population 47 , indicating that autism is highly heritable 51 – 53 .…”

“…The BAP is qualitatively similar to autism, but neither leads to the full autism phenotype nor results in significant difficulties in socio-cognitive functioning 46 , 47 . Studies have observed that BAP is especially prevalent in the relatives of autistic people, for example, 20–40% of first-degree relatives but 2–9% of the general population 47 , indicating that autism is highly heritable 51 – 53 . Parents of autistic children (BAP) are about three times more likely to have autistic traits than parents of non-autistic children (non-BAP), especially in the communication and social skills domains 54 – 56 .…”

“…BAP populations have been found to have similar social cognition challenges as autistic people 42 , 47 , 59 . Relatives of autistic people have moderate difficulties in mentalizing compared to non-autistic and autistic people 42 , 47 , and people with higher self-reported autistic traits show more difficulties in mentalizing 60 .…”

“…BAP populations have been found to have similar social cognition challenges as autistic people 42 , 47 , 59 . Relatives of autistic people have moderate difficulties in mentalizing compared to non-autistic and autistic people 42 , 47 , and people with higher self-reported autistic traits show more difficulties in mentalizing 60 . Moreover, Livingston et al 61 found that BAP co-twins have mentalizing difficulties but can compensate for them at a behavioural level, which may potentially cause missed or late diagnosis 62 .…”

Attribution of intentions in autism spectrum disorder: A study of event‐related potentials

“…The psychological and cognitive processes that support ToM remain a matter of debate (Brewer et al, 2017; Rosenthal et al, 2019). Facial and vocal emotion processing, mental state reasoning, and various executive functions such as attention switching, working memory and cognitive flexibility, among others, are all believed to contribute to ToM processing (Brewer et al, 2017; Green et al, 2020), and probably reflect a multilevel structure that involves both cognitive and affective processes and the interactions between them (Schurz et al, 2021). This translates into multiple instruments having been developed to measure ToM, or specific aspects of ToM, including false belief, mental state attribution, and various formats of attribution of intentions (AI) (Brewer et al, 2017; Livingston et al, 2019).…”