BARON-COHEN, JOLIFFE, MORTIMORE AND ROBERTSON …



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BARON-COHEN, JOLIFFE, MORTIMORE AND ROBERTSON (1997): ANOTHER ADVANCED TEST OF THEORY OF MIND: EVIDENCE FROM VERY HIGH FUNCTIONING ADULTS WITH AUTISM OR ASPERGER SYNDROME.

INTRODUCTION

This study investigates the core problem experienced by people with autism, a disorder involving social and communication difficulties. Theory of mind develops in most humans (as part of their general cognitive development) at about the age of 4. Theory of mind is the ability to understand and predict what other people think and feel. It is therefore the ability to infer in other people a range of mental states such as beliefs, desires, intentions, imaginations and emotions.

This study attempts to measure the short fall of advanced theory of mind skills in adults with autism/Asperger syndrome, through the use of a well-known test, the ‘Eyes Task’ Baron-Cohen et al claim that the results of this study show the core deficit in autism is failure to develop a TOM rather than low intellectual ability. It certainly appears that autistics, even if they have some basic understanding of other people’s thoughts, feelings etc, it tends not to be at the level one would expect from observed abilities in other areas e.g. intellectual ability. This suggestion obviously has implications for understanding and helping people with autism. Adults with autistic spectrum disorders have problems with social relationships. Research using TOM tasks has found children diagnosed with autism are not able to reason what another person is thinking (see results of the study using the Sally-Anne Test). However the Sally-Anne Test is obviously not appropriate for adults, so another test had to be devised – the Eyes Task.

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ABSTRACT

The ‘Eyes Task’ was used to see if high functioning adults with autism/AS have a theory of mind.

Three groups of participants were tested:

• Group 1 – participants with autism/As, normal intelligence, 13 males and 3 females.

• Group 2 – 50 normal adults, age matched.

• Group 3 – participants with Tourette syndrome (TS), age matched, 8 males and 2 females.

Groups 2 and 3 served as controls.

Participants were given the following tasks (tasks C & D were control tasks given to Group 1; Group 2 only did task A):

• Task A – Eyes Task, 25 forced choice questions about emotion expressed in a person’s eyes. Tested basic and more complex emotions.

• Task B – Strange Stories Task used to validate the results from Eyes Task.

• Task C – Gender Recognition of eyes, a control task involving face perception but not mindreading.

• Task D – Basic Emotion Recognition Task, a control task, participants had to identify basic emotions in whole faces to demonstrate they could recognise emotional states in a simple test.

Results showed:

Eyes task – The mean score for individuals with autism/AS was 16.3 (out of 25) whereas it was 20.3 and 20.4 respectively for Groups 2 and 3. Within the normal group males did less well than females.

Strange Stories task – Group 1 had more difficulty with this task, supporting the validity of the Eyes task as a test for autism.

Control tasks – there was no difference between Groups 1 and 3.

These results provide evidence of mindreading deficits even in high functioning individuals with autism/AS.

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|THE STUDY |

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|THE AIM: was to find out why adults with autism have problems with social relationships and to develop an advanced test for theory of mind in adults with |

|autism. |

|In order to show an impaired theory of mind was a specific deficit associated with the autistic spectrum of disorders, this group was compared with a |

|clinical control group of adults with Tourette syndrome, chosen because of the number of similarities these participants had with the participants with |

|autism and Asperger syndrome: |

|They all had intelligence in the normal range. |

|They had all suffered from a developmental disorder since childhood. |

|These disorders all cause disruptions to normal schooling and peer relations. |

|These disorders are all believed to affect the same area of the brain. |

|They are all suggested to be genetic in origin. |

|These disorders all affect males more than females. |

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|A third group of participants was made up of normal adults. Each group was tested on their theory of mind skills using the ‘Eyes Task’ and their |

|performance compared. |

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|A secondary aim of this study was to investigate whether females would be better than males on this test of theory of mind. |

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|THE HYPOTHESIS: Adults with Asperger syndrome/autism can’t interpret states of mind from ‘reading eyes’. |

|The independent variable (IV) was the three different groups of participants (autistics/AS; Tourettes; normal). |

|The dependent variable (DV) was performance on an advanced test of theory of mind (eyes task). |

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|THE METHOD: This was a natural/quasi experiment having a matched participant design. Since participants were allocated to the three conditions depending |

|on whether they were autistic/AS, normal, or had Tourette syndrome, the IV occurred naturally, was not manipulated and so the method used was a |

|quasi-experiment. |

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|THE PARTICIPANTS: Three groups of participants were tested: |

|1. 16 participants (13 males, 3 females) with high functioning autism (4) or Asperger syndrome (12). All were of normal intelligence (mean IQ = 105.31), |

|therefore unconfounded by mental handicap. They were recruited from a variety of sources, as well as an advert in the national Autistic Society magazine, |

|‘Communication’. |

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|2. 50 normal age-matched adults, 25 males, 25 females, all drawn from the general population of Cambridge. None had any history of any psychiatric |

|condition (as established by self-report). They were selected randomly from the subject panel held in the university department. They were all assumed to |

|have intelligence in the normal range i.e. an IQ above 85. |

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|3. 10 adult patients (8 males, 2 females, mirroring the sex ratio of Group 1)) with Tourette syndrome, also age-matched with Group 1. They were all |

|attending a referral centre in London (mean IQ = 103.5). The reason for using people with TS was because of the similarities between autism, AS and TS. |

|e.g. they are all developmental disorders, experienced since childhood, which disrupt normal schooling and normal peer relations. They all have a |

|significant genetic basis (i.e. are likely to be inherited) and all have been associated with abnormalities in the frontal region of the brain. |

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|All participants in Group 1 and 3 were able to pass the first and second-order false belief (TOM) tasks. This meant that any failure on the Eyes task |

|could be attributed to problems with mindreading problems beyond that of a six year old. |

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|It was expected that only participants in Group 1 would be significantly impaired on the Eyes Task. |

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|THE LOCATION AND THE TASKS: The Eyes Task, the Strange Stories and two control tasks were presented in random order to all participants; this to avoid |

|order effects. The participants were tested individually in a quiet room in their own home, in the researchers’ clinic or in the laboratory at Cambridge |

|University. |

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|THE PROCEDURE: |

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|1. The Eyes Task: the test comprises photographs of the eye region of 25 different faces (male and female).the photos were taken from magazines and were |

|standardised: same size (15 x 10 cm), all black and white and all of the same region (from midway along the nose to just above the eyebrow). |

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|Each picture was shown for 3 seconds and participants were given a forced choice question – they had to select between two mental states terms printed |

|under each picture. These mental state terms were either ‘basic’ mental states (such as sad or afraid) or more ‘complex’ (such as reflective, arrogant, |

|scheming etc). The two terms for each photo were one mental state and its ‘foil’ i.e. a term with the opposite meaning – e.g. concerned and unconcerned, |

|or friendly and hostile. The experimenter asks the participant, ‘Which word best describes what this person is thinking or feeling?’ The maximum score = |

|25. |

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|The full list was: |

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|Photo Number |

|Target Term |

|Foil |

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|1 |

|Concerned |

|Unconcerned |

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|2 |

|Noticing you |

|Ignoring you |

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|3 |

|Attraction |

|Repulsion |

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|4 |

|Relaxed |

|Worried |

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|5 |

|Serious message |

|Playful message |

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|6 |

|Interested |

|Disinterested |

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|7 |

|Friendly |

|Hostile |

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|8 |

|Sad reflection |

|Happy reflection |

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|9 |

|Sad though |

|Happy thought |

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|10 |

|Certain |

|Uncertain |

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|11 |

|Far away focus |

|Near focus |

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|12 |

|Reflective |

|Unreflective |

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|13 |

|Reflective |

|Unreflective |

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|14 |

|Cautious about something over there |

|Relaxed about something over there |

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|15 |

|Noticing someone else |

|Noticing you |

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|16 |

|Calm |

|Anxious |

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|17 |

|Dominant |

|Submissive |

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|18 |

|Fantasising |

|Noticing |

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|19 |

|Observing |

|Daydreaming |

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|20 |

|Desire for you |

|Desire for someone else |

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|21 |

|Ignoring you |

|Noticing you |

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|22 |

|Nervous about you |

|Interested in you |

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|23 |

|Flirtatious |

|Disinterested |

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|24 |

|Sympathetic |

|Unsympathetic |

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|25 |

|Decisive |

|Indecisive |

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|For details of the Eyes Test see the following website: |

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|To try an eyes test go to the following website: |

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|2. Strange Stories TasK: participants in groups 1 and 3 were also tested on Happé’s Strange Stories Task in order to demonstrate the validity of the Eyes |

|Task as a test of TOM. If it is a valid test then performance on the Eyes Task should correlate with performance on the strange stories task (this is an |

|example of concurrent validity). |

|Find examples of Happé Strange Stories at the following website: |

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|3. Control Tasks: In order to check whether difficulties with the Eyes Task might be due to other factors participants in Group 1 were given two control |

|tasks: |

|* Gender recognition of Eyes Task: identifying the gender of the eyes used for the Eyes Task. Such a judgement does not involve mindreading but does |

|involve face perception, perceptual discrimination and/or social perception. Therefore this controls for any difficulties in those areas. The maximum |

|score on this test was also 25. |

|* Basic Emotion Recognition Task (Emotion Task): participants were asked to judge photos of whole faces which displayed the six basic emotions identified |

|by Ekman (1992) (happy, sad, angry, afraid, disgust and surprise). This was done to check if difficulties on the Eyes Task were due to difficulties with |

|basic emotional recognition. This task is not the same as the Eyes Task for two reasons – it involves whole faces and it tests only the basic six emotions|

|rather than a fuller range of mental states. Such differences mean that it is easier to recognise emotional states on this basic task than on the Eyes |

|Task. |

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|THE RESULTS |

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|Results from the Eyes Task showed participants with Tourette syndrome did not differ from normal participants on this task, but both control groups |

|performed significantly better than the group with autism or AS. |

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|On the Happé’s ‘strange stories’ no participants with Tourette syndrome made any errors but the participants with autism or AS made errors and were |

|significantly impaired on this task compared to controls. |

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|On the gender and emotion-control tasks, there were no real differences between the groups. |

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|Mean performance on the Eyes Task and gender recognition task |

|EYE TASK |

|AUTISTIC/AS |

|NORMAL |

|TOURETTE |

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|MEAN |

|16.3 |

|20.3 |

|20.4 |

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|RANGE |

|10 |

|9 |

|9 |

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|GENDER RECOGNITION TASK |

|24.1 |

|23.3 |

|23.7 |

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|Do females have a more advanced theory of mind? |

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|In the normal group, as predicted, female participants performed significantly better than males on the Eyes Task: |

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|GENDER |

|EYES TASK |

|(MEAN) |

|EYES TASK |

|(RANGE) |

|GENDER CONTROL |

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|MALES (25) |

|18.8 |

|6 |

|24.0 |

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|FEMALES (25) |

|21.8 |

|5 |

|23.8 |

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|Mean performance by males and females in the normal group |

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|The results therefore show: |

|Adults with autism/AS were impaired on a TOM despite having normal intelligence. |

|Within the normal population females do better on this test of TOM than males. |

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|The autism/AS impairment is: |

|Not due to low intelligence because performance on the Eyes Task was not correlated with IQ. |

|Not the result of just any developmental neuropsychiatric disability since participants with TS were unimpaired on the test (Neuropsychiatric refers to |

|mental disorder which has a neurological or ‘brain’ component). |

|Not due to having difficulty interpreting context. Some psychologists have suggested that individuals with autism have difficulty dealing with some tasks |

|because they cannot separate themselves from reality and answer questions out of context. In the case of the Eyes Task there was no context – it consisted|

|of items that were relatively ‘pure’ TOM. |

|Additionally the results showed: |

|No support for a link between TOM and frontal brain processes. Previous research had suggested that the frontal part of the brain might be involved in TOM|

|but the fact that TS participants had no greater difficulty than normal participants on the TOM task suggests otherwise. |

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|CONCLUSION |

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|Baron-Cohen confirmed that adults with autism/AS, despite being of normal or above average IQ, performed poorly on the Eyes Task, an advanced test of |

|theory of mind. They therefore concluded from this that the core deficit involved in autism is the lack of an advanced theory of mind. They justify this |

|conclusion because: |

|Poor performance by this group could not have been due to low intelligence because participants were in the normal or above normal range of IQ – some of |

|the participants even had university degrees. This strongly suggests that social cognition is independent of general intelligence. |

|Poor performance could not have been due to developmental neuropsychiatric disability because participants with TS were unimpaired on this task. |

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|The researchers claim that the Eyes task was a valid measure of theory of mind because: |

|The target words are mental state terms. |

|The target words are not just emotional states but include terms describing cognitive mental states, suggesting that this task is not just an emotion |

|perception task. |

|The pattern of results from the Eyes task mirrored the performance on Happé’s ‘strange stories’, another test of advanced theory of mind. |

|The poor performance on the Eyes task was not mirrored on the two control tasks, suggesting that the poor performance by participants with autism/AS was |

|not due to the stimuli being eyes, or to basic emotion recognition. |

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|From the second finding that females performed significantly better on the Eyes Task than males, the researchers concluded that within the normal |

|population, females have more advanced theory of mind skills than males. Baron-Cohen suggests this may reflect sex differences in the rate of development |

|of theory of mind in childhood and therefore be due to genetic factors, or this advantage may be due to the ways girls are socialised differently to boys,|

|encouraging them to pay more attention to what people are thinking. Either way previous research has not found a gender difference on mindreading tests |

|but this may be because previous tests showed a ceiling effect. Therefore the Eyes Task offers a new method of investigating this difference. |

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|DISCUSSION |

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|When evaluating this study one needs to consider the following key issues: |

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|Can this study be seen from another psychological approach or perspective? |

|Was it ecologically valid? |

|Were any ethical issues raised? |

|Are there any methodological limitations? |

|What does the study tell us about the nature/nurture debate? |

|What type of data was gathered? Are there any strengths/weaknesses of this type of data? |

|How reliable are the findings? |

|How valid are the findings? |

|Can the study be considered reductionist? |

|Can the findings of this study be of any use? |

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1. Identify two features of the sample used in this study. [2]

2. How were participants matched in this study? [2]

3. (a) Identify the two control groups used in this study. [2]

(b) Explain why one of these control groups was used. [2]

4. Explain what is meant by the term ‘theory of mind’. [2]

5. (a) Describe one of the control tasks used in this study. [2]

(b) Outline the findings from this study. [2]

6. Describe the Eyes Task as used in this study. [4]

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|EYE TASK |AUTISTIC/AS |NORMAL |TOURETTE |

|MEAN |16.3 |20.3 |20.4 |

|RANGE |10 |9 |9 |

|GENDER RECOGNITION TASK |24.1 |23.3 |23.7 |

Mean performance on the Eyes Task and gender recognition task

(a) Use the above table to draw a graph of the three groups of participants’ mean performance on the Eyes task and gender recognition task. [2]

(b) Draw one conclusion from your graph. [2]

8.

|GENDER |EYES TASK |EYES TASK |GENDER CONTROL |

| |(MEAN) |(RANGE) | |

|MALES (25) |18.8 |6 |24.0 |

|FEMALES (25) |21.8 |5 |23.8 |

Mean performance by males and females in the normal group

Draw one conclusion from the above table which gives the mean performance by

normal males and females on the Eyes Task. [2]

9. (a) Explain what is meant by the term ‘ecological validity’. [2]

(b) Explain in what way this study may be described as lacking in ecological

validity. [2]

10. Suggest one practical application of this study. [2]

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