The Reading the Mind in the Eyes Test, Iowa Gambling Task and Interpersonal Reactivity Index: Normative Data in an Italian Population Sample

Abstract

Objective Social cognition and executive deficits are frequent in neurological and neuropsychiatric disorders. Yet, there is a paucity of standardized domain-specific psychometric tools for the assessment of complex decision-making, social cognition (i.e., Theory of Mind), and empathy. To this aim, this study intended at providing normative data in an Italian population sample for the Iowa Gambling Task, the Reading the Mind in the Eyes Test, and the Interpersonal Reactivity Index. Method The Iowa Gambling Task, the Reading the Mind in the Eyes Test, and the Interpersonal Reactivity Index were administered to 462 healthy Italian participants aged between 18 and 91 years, considering demographic factors. A confirmatory factor analysis was run to test for unidimensionality. Normative values were derived by means of the Equivalent Scores method. Results Education predicted all tests’ scores, age influenced scores at the Interpersonal Reactivity Index and the Reading the Mind in the Eyes Test, gender predicted empathic abilities only. The three tests did not underpin a unidimensional structure. Conclusions The present work provides demographically adjusted Italian normative data for a set of tests assessing real-life decision-making, emotion recognition and empathy, filling a gap within II-level, domain-specific, neuropsychological testing. For the first time, the Interpersonal Reactivity Index is proposed as an adjuvant neuropsychological tool, while the standardization of the Iowa Gambling Task offers a new scoring system for advantageous/disadvantageous choices.

Validity and diagnostics of the Reading the Mind in the Eyes Test (RMET) in non-demented amyotrophic lateral sclerosis (ALS) patients

“…Table 1 shows the background and clinical measures of participants. The prevalence of age- and education-adjusted, below-cutoff RMET scores ( Maddaluno et al, 2021 ) was 0% in HCs and 4.9% in patients.…”

“… ΔFS, progression rate; ALS, amyotrophic laterals sclerosis; ALSFRS-R, Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised; BDI, Beck Depression Inventory; CI, Causal Inference; DAS, Dimensional Apathy Scale; EA, Emotion Attribution; ECAS, Edinburgh Cognitive and Behavioral ALS Screen; F, female; FBI, Frontal Behavioral Inventory; IA, Intention Attribution; KSS, King’s staging system; M, male; NIV, non-invasive ventilation; PEG, percutaneous endoscopic gastrostomy; SET, Story-Based Empathy Task; STAI-Y1, State and Trait Anxiety Inventory–Form Y–State Anxiety; STAI-Y2, State and Trait Anxiety Inventory–Form Y–Trait Anxiety. a χ 2 -statistic (test of independence); b t -statistic; c F -statistic (covaried for age, education, and sex); d Maddaluno et al (2021) . …”

“…Both groups were administered the Italian version of the original RMET (maximum score achievable: 36) ( Maddaluno et al, 2021 ). The Italian RMET has been shown to be featured by adequate internal and test-retest reliability and construct validity, as well as being underpinned by a mono-factorial structure ( Serafin and Surian, 2004 ; Vellante et al, 2013 ; Preti et al, 2017 ).…”

“…Receiver-operating characteristics (ROC) analyses were run to derive intrinsic–i.e., sensitivity (Se) and specificity (Sp)–and post-test diagnostic properties–i.e., positive and negative predictive values (PPV and NPV) and likelihood ratios (LR+ and LR−)–at the optimal cutoff identified via Youden’s J statistic. Demographically adjusted RMET scores ( Maddaluno et al, 2021 ) were entered into the case-control ROC analysis (i.e., when addressing the occurrence of ALS as the positive state), since the two groups were matched for education but not for age–the latter having been identified as a significant confounder of the RMET according to the Italian norms herewith adopted ( Maddaluno et al, 2021 ). To further support the validity of such a ROC analysis, as well as in order to rule out a potential effect of sex, for which the two groups were unmatched, an F -test was preliminarily run on RMET raw scores by covarying for age, education, and sex and including a Sex * Group interaction term.…”

“…However, no study has to date explored the diagnostic properties of the original, 36-item RMET in ALS patients ( Taule et al, 2020 )–such analyses have only been performed on a shortened, and less widespread, form ( Burke et al, 2020 ). Moreover, as it is being debated whether socio-cognitive deficits merely arise from cognitive/behavioral dysexecutive features ( van der Hulst et al, 2015 ; Watermeyer et al, 2015 ; Burke et al, 2016a , 2017 ; Arioli et al, 2018 ) or are, at least to some extent, independent of them in this population ( Girardi et al, 2011 ; Trojsi et al, 2016 ; Palumbo et al, 2022 ; Panopoulou et al, 2022 ), little is known on the construct validity of tests supposedly targeting social cognition in patients with ALS, including the RMET ( Maddaluno et al, 2021 ).…”