Do executive function and theory of mind predict pragmatic abilities following traumatic brain injury? An analysis of sincere, deceitful and ironic communicative acts

Abstract

Quality of life and social integration are strongly influenced by the ability to communicate and previous research has shown that pragmatic ability can be specifically impaired in individuals with traumatic brain injury (TBI). In addition, TBI usually results in damage to the frontotemporal lobes with a consequent impairment of cognitive functions, i.e., attention, memory, executive function (EF) and theory of mind (ToM). The role of the underlying cognitive deficits in determining the communicative-pragmatic difficulties of an individual with TBI is not yet completely clear. This study examined the relationship between the ability to understand and produce various kinds of communicative acts, (i.e., sincere, deceitful and ironic) and the above-mentioned cognitive and ToM abilities following TBI. Thirty-five individuals with TBI and thirty-five healthy controls were given tasks assessing their ability to comprehend and produce sincere, deceitful and ironic communicative acts belonging to the linguistic and extralinguistic scales of the Assessment Battery for Communication (ABaCo), together with a series of EF and ToM tasks. The results showed that, when compared to healthy individuals, participants with TBI performed poorly overall in the comprehension and production of all the pragmatic phenomena investigated, (i.e., sincere, deceitful and ironic communicative acts), and they also exhibited impaired performance at the level of all the cognitive functions examined. Individuals with TBI also showed a decreasing trend in performance in dealing with sincere, deceitful and ironic communicative acts, on both the comprehension and production subscales of the linguistic and extralinguistic scales. Furthermore, a hierarchical regression analysis revealed that - in patients with TBI but not in the controls - EF had a significant effect on the comprehension of linguistic and extralinguistic irony only, while the percentage of explained variance increased with the inclusion of theory of mind. Indeed, ToM had a significant role in determining patients' performance in the extralinguistic production of sincere and deceitful communicative acts, linguistic and extralinguistic comprehension of deceit and the linguistic production of irony. However, with regard to the performance of patients with TBI in the various pragmatic tasks investigated, (i.e., sincere, deceitful and ironic communicative acts), EF was able to explain the pattern of patients' scores in the linguistic and extralinguistic comprehension but not in production ability. Furthermore, ToM seemed not to be able to explain the decreasing trend in the performance of patients in managing the various kinds of communicative acts investigated.

The Ability of Patients With Schizophrenia to Comprehend and Produce Sincere, Deceitful, and Ironic Communicative Intentions: The Role of Theory of Mind and Executive Functions

“…More specifically, in line with Colle et al (2013), our results revealed a decreasing trend in patient performance in managing the different pragmatic tasks investigated, including sincere, deceitful, and ironic communicative acts in both comprehension and production on both the linguistic and extralinguistic scales of the ABaCo (Angeleri et al, 2012). Other studies in the literature have found the same trend of difficulty across different populations, such as patients with left (Gabbatore et al, 2014) and right (Parola et al, 2016) brain damage and traumatic brain injury (Angeleri et al, 2008; Bosco et al, 2018a) and children with typical (Bosco and Bucciarelli, 2008; Bosco et al, 2013) and atypical development, i.e., autism spectrum disorder (Angeleri et al, 2016), and these authors explained the changing difficulty based on the increasing role of the inferential abilities required in the different tasks.…”

“…The participants either deals with videorecorded communicative interactions set in everyday contexts or interact with the examiner in short exchanges/conversations. Even if we are unable to provide direct experimental evidence supporting the external validity of the instruments, a recent studies (Bosco et al, 2018a; Parola et al, 2019a) support the convergent validity of a battery with a different instruments measuring functional communication, i.e., the Communication Activities of Daily Living (Holland et al, 1999) and narratives tasks (Marini et al, 2017).…”

“…In the case of non-standard communications, such as deceitful and ironic communicative acts, more complex inferential processes are involved. Specifically, as previously proposed, “when a speaker utters a deceitful communicative act, her/his intention contrasts with her/his private knowledge, but it does not contrast with the knowledge s/he shares with the partner” (Bosco et al, 2018a). In a deceitful communicative act, the interlocutor “must handle the difference between what is said and what the speaker privately knows” (Bosco et al, 2018a).…”

“…Specifically, as previously proposed, “when a speaker utters a deceitful communicative act, her/his intention contrasts with her/his private knowledge, but it does not contrast with the knowledge s/he shares with the partner” (Bosco et al, 2018a). In a deceitful communicative act, the interlocutor “must handle the difference between what is said and what the speaker privately knows” (Bosco et al, 2018a). In the case of irony, the most difficult case to deal with, among those we analyzed, as in the previous case, the interlocutor’s communicative intention is in conflict with her/his private knowledge; however, in this case, it is also in contrast with the piece of knowledge s/he shares with the partner (for a more detailed description see Bara, 2010).…”

Irony, deception and theory of mind in people with intellectual disabilities and dual diagnoses

“…Partial absence of correlations between comprehending deception and irony can also be observed as a part of differences between these skills and their partially different neurological basis. For example, in a neuroimaging study, Bosco et al 70 found that the left middle temporal gyrus activated in comprehending ironic statements, while it did not activate in comprehending lies.…”