The document discusses theory of mind, including:
1) Defining theory of mind as the ability to infer mental states like beliefs, desires, intentions in oneself and others and understand they may differ.
2) The two main theories of how theory of mind develops are the theory-theory, which proposes it is based on learned folk psychology, and simulation theory, which suggests imagining oneself in another's perspective.
3) Theory of mind develops through childhood, starting with imitation and joint attention, then understanding knowledge, beliefs, and later false beliefs around ages 3-5. Neuroimaging research implicates temporal pole, medial prefrontal cortex, and posterior superior temporal sulcus in theory of mind.
The historical development of Abnormal Psychology or Psychopathology is worth studying. The progressive as well as conservative steps have contributed to a balanced view of abnormal behavior.
Neuropsychological rehabilitation focused on improving cognitive functions which further results in improving symptoms, functional ability which enhance overall quality of life.
Cognitive psychology is a relatively young branch of psychology, yet it has quickly grown to become one of the most popular subfields. Few Practical Application of Cognitive Psychology(Science),Thinking, decision-making/increasing decision making accuracy, problem-solving, learning /structuring educational curricula to enhance learning , attention,Memory/Improving memory, forgetting, and
language acquisition.
But what exactly is cognitive psychology?
What do cognitive psychologists do?
The historical development of Abnormal Psychology or Psychopathology is worth studying. The progressive as well as conservative steps have contributed to a balanced view of abnormal behavior.
Neuropsychological rehabilitation focused on improving cognitive functions which further results in improving symptoms, functional ability which enhance overall quality of life.
Cognitive psychology is a relatively young branch of psychology, yet it has quickly grown to become one of the most popular subfields. Few Practical Application of Cognitive Psychology(Science),Thinking, decision-making/increasing decision making accuracy, problem-solving, learning /structuring educational curricula to enhance learning , attention,Memory/Improving memory, forgetting, and
language acquisition.
But what exactly is cognitive psychology?
What do cognitive psychologists do?
The term "cognitive psychology" was first used in 1967 by American psychologist Ulric Neisser in his book Cognitive Psychology. According to Neisser, cognition involves "all processes by which the sensory input is transformed, reduced, elaborated, stored, recovered, and used.
It is concerned with these processes even when they operate in the absence of relevant stimulation, as in images and hallucinations. Given such a sweeping definition, it is apparent that cognition is involved in everything a human being might possibly do; that every psychological phenomenon is a cognitive phenomenon."
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Testing Instruments are used to test Intelligence Quotient or personality tests to evaluate past-acquired competencies or future success in education or employment. A close examination and study of human cognition based on biological and anthropological evidence such as plasticity of brain we may have to include more universal set of competencies than ordinarily been considered such as verbal, mathematical and logical competencies. This paper attempts to address issues relating to definition of intelligence, its components and application of study for educational testing and selection process.
US Army STARRS - The Army Study to Assess Risk and Resilience in ServicemembersAshutosh Ratnam
This is a seminar presentation I made on the US Army STARRS study to assess causality and make a predictive algorithm for suicides among veterans. It was made as part of my Psychiatry residency.
A seminar presentation I made as part of my residency. The drugs covered are Synthetic Cathinones, Synthetic Cannabinoids, Ecstacy/MDMA, GHB, Ketamine and Mephedrone.
A presentation on the newly introduced cross-cutting symptom measures in DSM5. I'd made this as part of my psychiatry residency, and the article describes why the need came about, the process of formulating and testing the new cross-cutting system and the repercussions this will have on psychiatric practice
This is a presentation I'd done during my Psychiatry residency. I evaluated the Preamble of the DSM5, evaluating how and why the new manual was conceived, the process of creation and review and the rationale behind these changes.
I also evaluated the reasons why DSM5 has come in for such attack, and did a critique of the very obvious shortcomings in the execution and implementation of the stated aims.
Here's a Journal Club Presentation I'd made on 'Repeated Δ9-THC Exposure in Adolescent Monkeys: Persistent Effects Selective for Spatial Working Memory'. It was taken from the April 14 issue of the American Journal of Psychiatry. It examined the long-term effects than THC exposure had on the working memory efficiency of adolescent monkeys, thereby providing some evidence to the near permanent effects cannabis use might have on the developing brain.
Journal Club: Telomere Length And Cortisol Reactivity In Children Of Depresse...Ashutosh Ratnam
Here's a Journal Club Presentation I made on the article 'Genetic Predisposition to Schizophrenia Associated with Increased Use of Cannabis' which appeared in the Sep 14 issue of Molecular Psychiatry. It examined and found a correlation between shortened telomere length in women and a risk for depression in their daughters.
Journal Club: Genetic Predisposition to Schizophrenia Associated with Increas...Ashutosh Ratnam
Here's a Journal Club Presentation I made on the article 'Genetic Predisposition to Schizophrenia Associated with Increased Use of Cannabis' which appeared in the Nov 14 issue of Molecular Psychiatry. It explored the possibility of whether people with high genetic risk scores for Schizophrenia somehow had a propensity for cannabis, establishing a biological basis for 'reverse causality'.
The Role of Mental Health Professionals in Adoption Ashutosh Ratnam
A seminar presentation I made on the role mental health professionals are expected and required to play in adoption. The presentation was made for an Indian setting, covering briefly the Hindu Adoption Act and the Guardianship Act, but the major of the presentation is on
why adoptees tend to have higher percentages of psychiatric problems, what adoption competent mental healthcare entails, and special emphasis on the process of disclosure to the child.
A seminar presentation I'd made for as part of my post-grad psych curriculum. Technically Jung and Alder being here is a problem for some, but it was what the faculty wanted added.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
3. INTRODUCTION
“As humans we assume that others want, think, believe and the like,
and thereby infer states that are not directly observable, using these
states anticipatorily, to predict the behaviour of others as well as our
own. These inferences, which amount to a theory of mind, are to our
knowledge, universal in human adults”
(Premack, D. G.; Woodruff, G. (1978). "Does the chimpanzee have a theory of mind?". Behavioural and
Brain Sciences 1 (4): 515–526.
e.g. Chimpanzee shown a video of human encountering
problems
Video stopped before solution reached
Chimp consistently chose picture depicting human solving
problem
Interpretation : attributed mental state to actor
3
4. When competing with others for
food chimps take into account
what the competitor can or cannot
see/hear and even what he
does/does not know
• Conceal own approach to food
• No understanding of false beliefs
• Performance did not improve
despite knowing competitor held a
false belief
Hare B, et al (2001) Do Chimpanzees know what
cospecifics know? Anim. Behav. 61, 139-51
4
5. INTRODUCTION
Definition :
The ability to
recognise that all people act on the basis of mental states or
propositional attitudes (beliefs, desires, etc)
attribute mental states or attitudes to oneself and to others
understand that others have beliefs, desires and intentions
different from one’s own
Premack, D. G.; Woodruff, G. (1978). "Does the chimpanzee have a theory of mind?". Behavioral and
Brain Sciences 1 (4): 515–526.
“Theory of mind is being able to infer the full range of mental
states (beliefs, desires, intentions, emotions etc) that cause
action. Having a theory of mind is to be able to reflect on the
contents of one’s own and other’s minds”
Baron-Cohen S, (2001) “Theory of Mind and Autism: a review”. J of Applied Research in
Mental Retardation
5
6. INTRODUCTION
Meta-representation – internal/mental representation of
ourselves and others as conscious beings who mentally
represent external reality
(Firth, 1992)
- Ability to represent someone else’s act of representing the world
(Josef Pener)
Mentalising – the process of deploying a ToM to infer states of
minds of others
(Langdon,R, Coltheart, M, 2001)
Intentional stance – intuitively understanding that the actions of
others are goal-directed and arise from particular beliefs or
desires
(Daniel Dennet, 1990)
Reflexive awareness – awareness of ourselves and others as
thinking beings
6
7. Theories of ToM
1. Theory-Theory
2. Simulation Theory
a) Direct Matching
b) Inverse Modelling
c) Response Modelling
7
8. Theory-Theory
‘Folk’ psychological ability resting upon knowledge of a theory
Theory = “large no. of conditional statements, with the
conjunction of
explanatory factors as antecedents
explanandum as consequence”
A person who suffers bodily damage will feel pain
A person who is denied food will feel hungry
Together, forms an integrated body of knowledge concerning
law-like relations between
external circumstances
internal states
overt behaviour
Churchland, P. M. (1991). Folk psychology and the explanation of human behavior. In: J. D. Greenwood (Ed.). The future of folk
psychology. Cambridge: Cambridge University Press. 51–69.
8
9. Theory-Theory
Use constantly, unaware of laws of which it is composed →
implicit/tacit
e.g. Person untrained in science knows just as well about food and hunger
Independent of
knowledge of one’s own mind
human psychology
Anyone who knows laws and propositions can form predictions
and explanations
9
10. Theory-Theory acquisition
1. Learned
a) By implicit “teaching” through others
b) Learning step-by-step by living with/having social interactions
with others
2. Innate
a) If young children ‘construct’ a theory how do all come to same
theory by age four?
b) If “learnt from” adults, can it take place w/o explicit ‘teaching’?
c) If learnt how can it be invariant across cultures/historical eras?
Carruthers, 1996
10
11. Simulation-Theory
Use “resources of our own mind to simulate others”
1. Creation of pretend states to match those of target
2. Processing of ‘pretend states’ by same mechanisms used to
understand own mental states
3. Assignment/projection of those states’ interpretations onto
target
Goldman, A. (2005). Imitation, mind reading, and simulation. In S. Hurley, & N. Chater, Perspectives on Imitation
II (pp. 80-81). Cambridge, MA: MIT Press.
11
12. Mirror Neurons
Neuron which fires both
when
animal acts
observes the an action
being performed by
another animal
Humans
Premotor Cortex
Primary Somatosensory
area
Inf Parietal Cortex
Supplementary Motor
Area
12
13. Mirror Neurons 13
Functions
Empathy
Ant Insula, Ant Cingulate Cortex, Inf Frontal
Cortex
Understanding actions & learning
new skills by imitation
Simulating observed actions
(ToM)
Interpreting intentions of other
people
Coupling of perception & action
14. Simulation-Theory
Direct Matching Hypothesis
Mirror Neurons mimic state of target in the observer
Smiling, Anger, etc
Mirroring elicits similar emotion/intention in observer
Implicitly/explicitly projected upon target
Inverse Modeling Hypothesis
Mirror Neurons simulate intended goal of action first
Observer then uses conceptual ability to infer intention of action
Response Modeling Hypothesis
Mirror Neurons prepare complementary action in response to
target
Dynamically couple action observation to action execution
14
15. Ontogenic aspects
6 months of age: Animate Vs inanimate
12 months: Joint attention
14-18 months: Senses direction of another’s gaze.
18-24 months: Pretense (Decoupling of reality)
3-4 years: False beliefs in others
6-7 years: Jokes, Metaphors, Irony
9-11 years: ‘faux pas’.
16. Development
1. Imitative Experiences with Other People
2. Understanding Attention in Others
3. Understanding Others’ Knowledge
4. Understanding Others’ Beliefs
a) True Beliefs
b) False Beliefs
5. Understanding Others’ Intentions
Firth, CD (1992) The cognitive neuropsychology of schizophrenia. Hove, UK: Psychology Press
16
17. Development 17
1. Imitative experiences with others
Precursor of perspective-taking and
empathy
Recognition of equivalence between
physical and mental states apparent in
others and those felt in self
Construction of first-person experience
Map the relation between mental experiences
and behaviour (facial gesture)
Infer about experiences of others
On seeing others behave like himself, infer
that others have similar mapped mental state
Meltzoff, A. N. (2002). Imitation as a mechanism of social cognition: Origins of empathy, theory of
mind, and the representation of action. In U. Goswami (Ed.), Handbook of childhood cognitive
development (pp. 6-25). Oxford: Blackwell Publishers.
18. Development
2. Understanding Attention
Skill formed at 7-9 months age
Understanding that
Seeing can be directed selectively as attention
Viewer assess a seen object as ‘of interest’
Seeing induces beliefs
Sharing → Following → Directing attention
(Carpenter, Nagell & Tomasello 1998)
Attention can be directed and shared by pointing
Taking into account other person’s mental state
(Baron-Cohen, S. (1991). Precursors to a theory of mind: Understanding attention in others. In A.
Whiten (Ed.), Natural theories of mind: Evolution, development and simulation of everyday
mindreading (pp. 233-251). Oxford: Basil Blackwell.)
18
19. Development
3. Understanding Others’ Knowledge
Povinelli & de Blois (1992)
3yrs vs 4yrs old children
‘Hider’ – hid toy in 1 of 4 containers behind screen
‘Knower’ – saw hider placing toy
‘Guesser’ – left before hider placed toy
‘Knower’ and ‘Guesser’ guided/advised children where toy was
4yr olds always chose correct cups, 3yr olds inconsistent
19
20. Development 20
O Neill (1996)
• Child would watch toy being hidden
in cup/box
• Parent would/would not be present
• When asking parent for help with
retrieval
• If not present – child significantly
more often named toy, named
location, gestured location
Dunham, Dunham, & O‘Keefe
(2000)
• if the parent‘s eyes are covered at
an irrelevant point in the hiding
process (before but not during the
hiding), young 2-year-olds treat the
parent as ignorant
21. Development
4. Understanding Others’ Intentions
Meltzoff (1995)
18 month old children
E attempted to pull an object away from another to which it is
attached, but failed
Infant able to infer what action person tried to perform
Call, Tomasello (1998)
2-3 year old child
Able to discriminate when E intentionally vs accidentally marked a
box as baited with stickers
21
22. Development
5. Understanding Others’ Beliefs
Begin to explain others’ behaviours based on beliefs at 3yrs
age
Wellman & Bartsch, 1988
Sam wants to find his puppy. The puppy might be hiding in the
garage or under the porch. But Sam thinks the puppy is under the
porch. Where will Sam look for the puppy: in the garage or under the
porch?
Three-year-olds pass this test.
3-year-olds do badly on tests of false beliefs.
22
23. Neural areas in ToM
Temporal
Pole
Dorsal
medial
PFC
Sup temporal
Sulcus
24. Neuroanatomy – Temporal Pole
aka Association cortex
Prefrontal Cortex (through Uncinate Process)
Basal forebrain
Visual / Auditory / Olfactory areas
Functions
Emotional attachment to peers/infants
Decoding/production of social signals
Narrative Coherence
Coding for personal memories
Representing social motives and appropriateness behaviour of
others (rTPJ)
Difficulty predicting how even familiar people behave in social/emotional
circumstances
Kaplan & Sadock, Comprehensive Text book of Psychiatry 9th edition
24
25. Posterior Sup Temporal Sulcus
Perception of biological motion
Motion cues express social information (intent)
Gaze shifts, communicative gestures
Heider-Simmel animations
Attribution of mental states even in absence of motion cues
(trustworthiness)
?? Three distinct regions
1. Biological motion
2. Mentalize whether or not motion
cues are present
Active vs passive movement
3. Mental states from motion cues
More active when mvt is
incongruous
Kaplan & Sadock, Comprehensive Text book of Psychiatry 9th edition
25
27. Medial Prefrontal Cortex
Pain / Tickling / Autobigraphical Memory / Aestheic Judgement
↓
Attending to mental state giving rise to experience
Create a representation of what one thinks/feels
Perspective taking
Perception of Communicative actions
Present and Foreseen Social Interactions
Lesion = Frontal variant of Fronto-temporal dementia
Striking personality changes, empathy impaired, ToM test
performance poor
Executive functions preserved
Kaplan & Sadock, Comprehensive Text book of Psychiatry 9th edition
27
28. Neuroanatomy – ToM
Rt Temporal Pole
Med PFC
Post Sup Temp Sulcus – biological motion, attributing cues
Distinguishing between False Belief and False-photograph test
Saxe, R; Kanwisher, N (2003). "People thinking about thinking peopleThe role of the temporo-
parietal junction in "theory of mind"". NeuroImage 19 (4): 1835–42
Saxe, Rebecca; Schulz, Laura E.; Jiang, Yuhong V. (2006). "Reading minds versus following
rules: Dissociating theory of mind and executive control in the brain". Social Neuroscience 1 (3–
4): 284–98.
28
Mentalising
29. FALSE PHOTOGRAPH
TEST
Zaitchik (1990):
compared out-of-date
beliefs to out-of-date
photographs (same structure,
cognitive demands)
3-year-olds fail this too
executive function
problems? (difficulty
inhibiting the perceptually
salient response? – not a
problem in tasks using
looking measures)
from Happé (1994)
30. Tests of Theory of Mind
1. False Belief Tasks
a) First Order
b) Second Order
c) Third Order
2. ToM Stories
3. Eye Interpretation Tasks
4. Hinting Tasks
5. Heider-Simmel (like) animations
6. Faux pas
30
31. False Belief Tasks
False belief = beliefs about the world which diverge from reality
Understand how knowledge is formed
People’s beliefs and mental states are based on their knowledge
Mental states can differ from reality
Behaviour can be predicted by mental states
1. First Order
a) Sally-Anne Test
b) Smarties Test
2. Second Order
3. Third Order
31
32. False Beliefs:
Sally-Anne (Maxi)
test
(Baron-Cohen, Leslie, & Frith,
1985; Wimmer & Perner, 1983)
control questions:
− Where is the marble really?
− Where did Sally put the marble
at the beginning of the story?
3-year-olds say box, where it is
(fail); 4+-year-olds say basket
from Frith (1989)
33. Development
3. Understanding Others’ Knowledge
Povinelli & de Blois (1992)
3yrs vs 4yrs old children
‘Hider’ – hid toy in 1 of 4 containers behind screen
‘Knower’ – saw hider placing toy
‘Guesser’ – left before hider placed toy
‘Knower’ and ‘Guesser’ guided/advised children where toy was
4yr olds always chose correct cups, 3yr olds inconsistent
33
34. False Beliefs:
Smarties test
(Perner, Leekam, & Wimmer,
1987)
control questions:
− Is that what’s really in here?
− What is really in here?
again, 3-year-olds fail (say
pencil); 4+-year-old pass (say
Smarties)
from Frith (1989)
?
?
35. False Belief Tasks 35
What does the person with the blue
shirt believe is in the bag?
(false belief)
Gift, present, flower, (bug is incorrect)
What‘s in the bag? (reality)
Wasp, bee, insect, or bug
What does the person in blue shirt
believe the person in red intends to
do?
(2nd order false belief)
Give him a gift or present
What does the person in red assume
the person with the blue shirt believes,
regarding his (the one in red)
intentions? (3rd order false belief)
Give him a gift or present
36. Theory of Mind Stories
Misunderstanding (Glove): A burglar who has just robbed a
shop is making his getaway. As he is running home, a
policeman on his beat sees him drop his glove. He doesn’t
know the man is a burglar, he just wants to tell him he dropped
his glove. But when the policeman shouts out to the burglar,
‘‘Hey you, Stop!’’, the burglar turns round, sees the policeman
and gives himself up. He puts his hands up and admits that he
did the break-in at the local shop.
1. Was the policeman surprised by what the burglar did?
2. Why did the burglar do this, when the policeman just wanted
to give him back his glove?
36
37. Theory of Mind Stories
Lie (Dentist): John hates going to the dentist because every
time he goes to the dentist he needs a filling, and that hurts a
lot. But John knows that when he has toothache, his mother
always takes him to the dentist. Now John has bad toothache
at the moment, but when his mother notices he is looking ill
and asks him ‘‘Do you have toothache, John?’’. John says
‘‘No, Mummy’’.
1. Is it true what John says to his mother?
2. Why does John say this?
37
38. Eye Interpretation Tasks 38
• Pure Theory of Mind Test
• No executive function
required
• Tests recognition of
complex mental states
• Artificial constraints not
present in real life
• Limited Choice of options
• Unlimited time to study
faces
• Validation study sample
size small
39. Hinting Tasks
Participant infers intentions behind veiled speech act
Normal adults perform close to ceiling
Example
Paul has to go to an interview and he’s running late. While he is
cleaning his shoes, he says to his wife, Jane:
“I want to wear my blue shirt but it’s very creased.”
Question: What does Paul really mean when he says this?
(If necessary add: Paul goes on to say: “Its in the ironing
basket.”
Question: What does Paul want Jane to do?)
39
40. Faux Pas Test
Faux pas = beach of etiquette
Recognition calls for a high level of ToM
Jill had just moved into a new apartment. Jill went shopping and
bought some new curtains for her bed room. When she had just
finished decorating the apartment, her best friend, Lisa, came
over. Jill gave her a tour of the apartment and asked, “How do
you like my bedroom?”
“Those curtains are horrible” Lisa said, “I hope you are going to
get some new ones!”
Questions
1. Did Lisa know the curtains were new?
2. Did some one say something she shouldn’t have said?
40
41. Spectrum of ToM abnormalities
Deficit in
TOM ability
Application
Deficit in TOM
Abnormal
attributions
Normal
TOM
Impaired
Sense of
Self-Agency
Autism NormalPassivity
phenomena
+ve Sx
Schiz
Asperger’s
-ve Sx Schiz
?PD
(Abu-Akel 1999)
42. ToM in Autism
S Baron Cohen, (1985)
Autistic children consistently fail False-Belief tasks e.g.Sally-Anne
(80%)
Down’s Syndrome children did not fail (86%)
Difficulties persisted even when child matched for verbal skill
Deficits persisted on picture story, hinting, when matched for
age/language
Inability to assign mental states to others
Neuroimaging studies
less activation in
mPFC (Happe (1996),
Frontal regions ( Ring, Baron-Cohen 1999),
mPFC, posterior STS, temporal poles (Castelli 2002)
STS hypo-activation (Pelphrey 2005).
m PFC and right STS (Wang 2007)
42
43. ToM in Autism
Social-affective Justification (Hobson)
ToM deficits are result of distortion in ability to understand &
reciprocate to emotions
Devoid of skills (social referencing ability) which later lets them
comprehend and react to other people’s feelings
(Hobson, R.P. (1995). Autism and the development of mind. Hillsdale, N.J.: Lawrence Erlbaum
Associates Ltd.)
Developmental Delay
Consistent with varying degrees of impairment (difficulties at
various stages of growth)
Early setbacks → Joint attention behaviour ability impaired
Hence unable to form full ToM
(Baron-Cohen, S. (1991). Precursors to a theory of mind: Understanding attention in others. In A. Whiten, Ed., Natural
theories of mind: Evolution, development, and simulation of everyday mindreading (233-251). Cambridge, MA: Basil
Blackwell.)
43
44. Ontogenic aspects
6 months of age: Animate Vs inanimate
12 months: Joint attention
14-18 months: Senses direction of another’s gaze.
18-24 months: Pretense (Decoupling of reality)
3-4 years: False beliefs in others
6-7 years: Jokes, Metaphors, Irony
9-11 years: ‘faux pas’.
45. ToM in Schizophrenia
Some symptoms of Schizophrenia are comparable to autism
Social dysfunction / withdrawal / impaired social cognition
? accountable by ToM deficit
ToM deficits accounting for Schizophrenia Symptoms
Firth (1992)
45
Inability to perceive own intentions
Inability to see behaviour as result of own
willed action
Disorder of Willed Action
(Passivity)
Impaired self monitoring
Impaired awareness of self-generation of
thoughts
Delusion of alien control
Impaired monitoring of others
(impaired awareness of others’
intentions/thoughts)
Persecutory delusions
Delusions of reference
Delusions of misidentification
46. ToM in Schizophrenia
Disorganized, paranoid schizophrenia, (>) negative show ToM
deficits.
Correlation of ToM deficit with
symptoms severity and remission
social functioning
pragmatic language use
ToM deficit is independent of
General intellectual ability
Memory
Executive function
(Leigh Harrington , Richard Siegert & John McClure (2005) Theory of mind in schizophrenia: A critical
review, Cognitive Neuropsychiatry, 10:4, 249-286,)
46
47. ToM in Schizophrenia State v/s Trait
5 studies found majority of ToM deficits disappear after acute episode
Severity correlates with severity of illness.
But in a few studies it was noted that,
Chronically ill patients also have ToM deficits
High schizotypal patients had ToM deficits (1 study)
Remitted patients > Family members of Schiz patients > controls: on ToM
tasks. (3 studies)
Imaging Findings
Russel et al (2000): eye-reading task on f MRI showed hypo-activity
left middle and inferior frontal regions
middle temporal regions
Brune (2001): picture-story task on PET hypo-activity
right prefrontal cortex
Hempel et al (2003) emotional recognition task
Medial PFC
(Leigh Harrington , Richard Siegert & John McClure (2005) Theory of mind in schizophrenia: A critical review,
Cognitive Neuropsychiatry, 10:4, 249-286,)
47
48. Other Conditions with ToM Deficits
Bipolar Disorder (Kerr et al 2003, Montag et al 2009)
Depression (Wolkenstein et al, 2011)
Huntington’s Disease (Brune et al, 2011)
Frontotemporal Dementia (Gregory et al, 2002)
Callosal Agenesis (Booth et al, 2011)
Congenital Deafness
Schizoid, Schizotypal
Pridmore S (2006) Download of Psychiatry, University of Tasmania Press
48
49. REFERENCES
Leigh Harrington , Richard Siegert & John McClure (2005)
Theory of mind in schizophrenia: A critical review, Cognitive
Neuropsychiatry, 10:4, 249-286,
Goldman A.I, (2012) Theory of Mind, Oxford Handbook of
Philosophy and Cognitive Science
Pridmore S (2006) Download of Psychiatry, University of
Tasmania Press
Call J, Tomasello M., (2008) Does the chimpanzee have a
theory of mind? 30 years later. Trends Cogn Sci.
May;12(5):187-92.
Flavell JH, (2004) Theory of Mind Development: Retrospect
and Prospect Merrill-Palmer Quarterly 50:3, 274-290
Kaplan & Sadock, Comprehensive Text book of Psychiatry 9th
edition
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