Theory of Mind after Severe Acquired Brain Injury: Clues for Interpretation

Abstract

Background. Recently, increased interest has been shown in Theory of Mind (ToM) abilities of individuals with severe acquired brain injury (sABI). ToM impairment following sABI can be associated with altered executive functioning and/or with difficulty in decoding and elaborating emotions. Two main theoretical models have been proposed to explain the mechanisms underlying ToM in the general population: Theory Theory and Simulation Theory. This review presents and discusses the literature on ToM abilities in individuals with sABI by examining whether they sustain the applicability of the Theory Theory and/or Simulation Theory to account for ToM deficits in this clinical population. We found 32 papers that are directly aimed at investigating ToM in sABI. Results did not show the univocal predominance of one model with respect to the other in explaining ToM deficits in sABI. We hypothesised that ToM processes could be explained by coinvolvement of the two models, i.e., according to personal experience, cognitive features, or the emotional resources of the persons with sABI.

The unidimensionality of the five Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs) may be improved: preliminary evidence from classical psychometrics

“…Neurobehavioral disability has also been described in nontraumatic acquired brain injuries (nt-ABI). Indeed, several behavioral changes have been described among these latter patients (16), including disorders of social perceptiveness, self-control and/or emotional regulation, decreased ability to learn from social experience, difficulties with impulse control, development of sociopathic or borderline traits, loss of self-sense, childish behavior, disinhibited behavior, and poor social judgment (17). Thus, non-cognitive behavioral impairments may be considered a landmark of ABI regardless of its etiology.…”

Visual strategies underpinning social cognition in traumatic brain injury

“…The Simulation Theory also has support from studies reporting associations between low self-awareness, emotional disturbances and low ToM scores (Bivona et al, 2014;de Sousa, McDonald, Rushby, Dimoska & James, 2010). Bivona et al, (2018) concluded that the two models are more than likely not mutually exclusive in explaining ToM and mentalizing impairments post-TBI and more research is needed in the area to fully understand these univocal findings.…”

“…In a recent review by Bivona et al, (2018), the authors outlined the two main theoretical models explaining ToM. 'Theory Theory' suggests that humans infer other people's intentions and beliefs by deploying general principles, such as cultural rules and laws, with the involvement of executive functions, abstract reasoning and working memory (Carruthers & Smith, 1996).…”