Mindblindness - This is a summary I put together to help me revise for the part 2 psych exams. PDF

Preview

Summary

This is a summary I put together to help me revise for the part 2 psych exams....

Description

Is autism predominantly a disorder of mindblindness? 1) Introduction - ASCs (autistic spectrum conditions) refers to a range of neurodevelopmental conditions of which there are two main domains of symptoms according to DSM V the first of which is deficits in socialising, learning and communication and the second being restricted repetitive behaviours. - These symptoms may occur in day to day life but it’s when it interferes with daily functioning that it becomes a cause for medical concern. - Mindblindness refers to a deficit in cognitive empathy - with social, communicative and imaginative deficits. - In this essay, I will briefly discuss what is meant by ‘mindblindness’ in terms of a lack of mindreading behaviour and then argue that it is predominantly a disorder of mind blindness by reviewing empirical evidence in the literature which suggests that there are the deficits mentioned above using a developmental cascade. I will then review counter arguments in the form of other theories that account for autism which some may use to argue that autism is not predominantly a disorder of mindblindness. 2) Mind reading and mindblindness: preschool - Autistic children are thought to be deficient in their theory of mind i.e. ability to attribute mental states to others. One precursor to this impairment is through joint attentional gestures - specifically pointing. - Normal children produce the pointing gesture by 9-14 months for two different functions: a) Protoimperative pointing (points to use another person to obtain an object, not trying to influence mental state) b) Protodeclarative pointing (points to comment on the world to another person - there is an intention to influence the other person’s mental state). - Baron-Cohen (1985) showed that autistic children may be unimpaired in tests of comprehension/production of protoimperative pointing but comprehension of protodeclarative pointing seems severely imapired. This confirms earlier prediction i.e. that this may be a developmental precursor to the deficit in ToM. - Other deficits in joint-attention in autism include a relative lack of showing objects to others and of gaze monitoring — directing one’s gaze where someone else is looking (Sigman et al, 1986). - Later work by Baron-Cohen in 1987 found that another early sign in autistic children is severe impairment in their ability to produce pretend play (compared to non-autistic disabled and neurotypical controls) discussed in terms of a symbol deficit theory (Ricks & Wing, 1975). When a symbol is defined as being a ‘second order representation’ the theory can link both the social and pretend impairments in autism. - This is corroborated by finding that children at a later stage, approx 3 years old, lack understanding of the principle that ‘seeing leads to knowing’ i.e. the role of visual access in knowledge formation. Baron-Cohen and Goodheart (1994) found a pass rate of only 33% for those with ASCs compared to a 75% pass rate for other intellectually disabled counterparts suggesting that this is specific to ASC. 3) Mind reading and mindblindness: childhood - Further mind reading deficits can be seen as individuals with ASCs progress through

-

-

-

-

childhood. One key finding is the high failure rate at false belief tasks and second-order false belief tasks, commonly occurring at age 4. Before discussing false belief tasks, it is important to consider the lack of understanding of ‘seeing leads to knowing’ which can be seen through deception tasks conducted on slightly older infants (e.g. 4 years +) such as that in Baron-Cohen’s (1992) Penny Hiding Game. Autistic individuals reported an impaired capacity for deception and a strong correlation with performance on both a false belief (“theory of mind”) task. They enjoyed the game as a game of object occlusion (keeping things out of sight) but failed to perceive it as a game of information occlusion (keepign things out of mind) unlike neurotypical controls. A famous false belief task is that conducted by Baron Cohen et al (1985) called the Sally Anne task where children are asked reality, memory, critical belief and control questions. 80% of autistic children failed the belief question and failed to point to where the marble was whilst those with Downs’ Syndrome performed similar to healthy controls. Similar to the first-order false belief tasks, second-order false belief tasks are used to assess the continuation of children’s ToM development after the age of 4 — requires higher level of cognitive function hence only develops around age 6 years old. Girli & Tekin (2010): used Perner & Wimmer’s second order false belief task of ice cream truck - 63.6% of neurotypical children passed yet only 7.1% of autistic children passed.

4) Mind reading and mind blindness: adolescence and adulthood - The idea that autism is predominantly a disorder of mind blindness is further reinforced by seeing deficits in mind reading abilities during adolescence and early adulthood through a range of other experimental paradigms. - The concept of mind reading can be broadened to now include empathy which tends to develop in adolescents as they go through puberty and mature emotionally. This can be subdivided into cognitive empathy (i.e. identifying another person’s mental state) and affective empathy (responding to another person’s mental state with an appropriate emotion). - Empathy can be objectively measured through the development of the Empathy Quotient (Auyeung et al, 2009) where neurotypical females had higher scores than neurotypical males, compared to autistic individuals who had a considerably lower score as empathy is deficient in autism. Sex differences are reduced in autism. This lends support to the Empathising-Systemising theory of autism, of which Extreme Male Brain Theory is an extension which refutes the idea that autism is predominately a disorder of mindblindness. - Neurotypical adolescents develop their mind reading skills further by being able to read the mind in the eyes and voice - this was investigated in autistic individuals and found to be inadequate, again reinforcing the idea that autism is predominantly a disorder of mind blindness. This is based on the principle that basic emotions can be deduced from the whole face mainly, and then the eyes/mouth as well as complex emotions which can be extracted from the whole face/eyes and then the mouth. - Baron Cohen et al (2001) published the ‘reading the mind in the eyes’ test as a measure of adult ‘mentalising’, and was inversely correlated with the AQ (Autistic

-

-

Spectrum Quotient). This study found that adults with Aspergers syndrome (AS)/High Functioning Autism (HFA) are significantly impaired on such tests. Some argue that the original version of this test was limited in providing evidence for our theory as the original version of the test due to narrow range of scores in the test which can reveal individual differences — a wider range is needed to reveal individual differences with greater power. However this was overcome in BC et al (2001) by increasing the number of items in the test and number of response options in each trial. Rutherford et al (2002) sought to investigate ToM deficits in adults with HFA and AS as traditional ToM tasks were not sensitive enough for adults. They wanted to extend the Reading the Mind in the Eyes test into the auditory domain and as predicted, found that individuals with AS/HFA have difficulty extracting mental state information from vocalizations.

5) Hormones - There have been associations found between certain hormones and empathy levels. Research in the literature has found a deficiency in these hormone levels in autistic individuals thus treatment to restore these hormone levels which reduces mind blindness symptoms thereby alleviating the effects of autism. This provides additional support for the idea that autism is predominantly a disorder of mind blindness. - Rodrigues et al (2009): It is thought that oxytocin has broad effects on social/emotional processing — it can influence empathy and stress responsivity. - Intranasal oxytocin treatment reduces amygdala activation and cortisol increases to emotional stimuli for those with ASCs. Those who are homozygous for the G allele (compared to those with one/two A alleles) are better at inferring mental states of others, showing higher empathy and reducing stress. - Vasopressin is another hormone which also has an important role in modulating social behaviour - Reading of the Mind in the Eyes Test and intranasal administration of vasopressin shows that it leads to a sig. decrease in emotion recognition — it was restricted to the recognition of negative emotions whilst leaving recognition of positive emotions unaffected. AVP in this study has a selective role in male emotional perception and empathy. - CSF samples of children with autism show lower levels of vasopressin hence intranasal vasopressin is being researched for the treatment of social ability in children with autism - Hence oxytocin and vasopressin - both of which can be shown to alter socio-emotional responses and mindreading - the treatment of which alleviates these symptoms in autistic individuals lends support to the notion that autism is predominantly a disorder of mindblindness. 6) Brain imaging studies - Some neuroimaging studies suggest that there is specificity in the underlying neural systems involved in multiple component processes that contribute to phenotypic variability in ASC. - Lombardo et al (2011) reports that autistic men showed reduced vmPC representation and right TPJ mentalizing responses compared to TD men. This study consisted of 29 males with ASC scanned with fMRI whilst making reflective mentalizing/physica

-

-

judgements about themselves or another person. Hence it was suggested that one of the neural systems responsible for mind blindness in ASC and its relation to social impairments is the right TPJ However it is not always apparent that the task used can elicit engagement of all regions within the standard mentalizing circuit i.e. mPFC, PCC, rTPJ and LTPJ. These results suggest that a possible neural system linked to delayed mentalizing development in ASC is the delayed development of right TPJ for specialising in representing mental state information. The fact that these certain brain regions, responsible for mentalising - a component crucial for mind reading - are affected in autistic individuals suggests that its consequence (i.e. mind blindness) is the cause of autism.

7) Conclusion...