Duverger H, Da Fonseca D, Bailly D, Deruelle C
Service de Pédopsychiatrie, Hôpital Sainte-Marguerite, 270, boulevard Sainte-Marguerite, 13009 Marseille.
Encephale. 2007 Sep;33(4 Pt 1):592-7. doi: 10.1016/s0013-7006(07)92058-8.
Theory of mind deficit can be used to explain social and communication impairments that define the autism spectrum disorder. Theory of mind is the ability to attribute mental states to self and others in order to understand and predict behavior. It involves the distinction between the real world and mental representations of the world. Several studies established that high functioning autistic individuals and individuals with Asperger syndrome (ASP) tend to be as proficient as controls in understanding first order false belief tasks. In contrast, they still lag behind their typical peers in understanding second order false belief tasks or more advanced tasks of theory of mind (e.g., Baron-Cohen, 1993). Most of these studies focus on the adult population and it seems particularly interesting to investigate whether children with ASP would present the same pattern of strengths and deficits as adults. In our research, children with ASP were tested in an advanced task of theory of mind based on a visual presentation of comic strips and in a more traditional assessment of false belief understanding: the Smarties test.
Two experimental groups participated in this study: a group of 16 high functioning children and adolescents with autism or with Asperger syndrome (ASP) and a group of 16 typically developing children matched on gender and age (CONT). The task was designed to assess the ability of children with ASP to infer the mental state of others. Stimuli were 26 different comic strips depicting a short story. Each comic strip was composed of three pictures and was shown on the upper half of the screen. Then three pictures numbered 1 to 3 showing possible outcomes of the scenario were superimposed on the bottom half of the screen. Only one of these three pictures represented a plausible conclusion to the scenario. This experiment contained two conditions: A Character intention (CI) condition and a Physical causality (PC) condition. The comic strips in the CI condition involved one character whose intentions had to be inferred by the subject in order to choose the correct picture. Comic strips in PC condition only required to understand physical causalities. Subjects were asked to watch the comic strip attentively and then they were required to make a choice between the three story endings by pressing the corresponding keyboard button. Both answers and response times were recorded. Additionally, all participants were enrolled in the classical false belief (Smarties) task.
Comic strips: An ANOVA [2 groups (CONT/ASP) x 2 conditions (CI/PC)] was performed on the number of correct responses. Neither the Group nor the Condition factor was significant (p>0.05). In contrast, the interaction Group x Condition reached significance level [F(1-30)=4.3, p<0.05)]. Further analysis revealed that performance of the ASP group was significantly higher in the CP (M=10.8, SD=2.5) than in the CI (M=9.8, SD=2) condition [t (1-14)=2.9, p<0.001)], whereas there was no condition difference in the control group (p>0.05). False belief: all ASP participants succeeded in the task.
Our data clearly demonstrated that children and adolescents with Asperger syndrome or high functioning autism exhibited an impairment in understanding the intention of others. In the comic strip task, children with ASP have more difficulties in the character's intention condition than in the physical causality condition. This impairment is not imputable to a deficit in taking into account the context (Weack Central Coherence theory) since they performed as well as controls in the physical causality condition which also required the processing of the whole scene. In contrast, all children with ASP succeeded at the false belief task. These contradictory findings suggest that, although testing theory of mind, the two tasks do not tap similar mechanisms. It is possible that the use of verbal material in the false belief task improved performance of the ASP children who are known to present particular strengths in this domain. Another possible explanation that needs further testing would be that the level of complexity differs between the two tasks.
心理理论缺陷可用于解释自闭症谱系障碍所特有的社交和沟通障碍。心理理论是一种将心理状态归因于自我和他人以理解和预测行为的能力。它涉及现实世界与对世界的心理表征之间的区分。多项研究表明，高功能自闭症个体和阿斯伯格综合征（ASP）患者在理解一阶错误信念任务方面与对照组一样熟练。相比之下，他们在理解二阶错误信念任务或更高级的心理理论任务（例如，Baron-Cohen，1993）方面仍落后于正常同龄人。这些研究大多集中在成年人身上，因此研究患有阿斯伯格综合征的儿童是否会表现出与成年人相同的优势和缺陷模式似乎特别有趣。在我们的研究中，患有阿斯伯格综合征的儿童接受了一项基于连环漫画视觉呈现的高级心理理论任务测试，以及一项更传统的错误信念理解评估：聪明豆测试。
两个实验组参与了本研究：一组是16名患有自闭症或阿斯伯格综合征（ASP）的高功能儿童和青少年，另一组是16名在性别和年龄上匹配的正常发育儿童（对照组）。该任务旨在评估患有阿斯伯格综合征的儿童推断他人心理状态的能力。刺激材料是26幅描绘简短故事的不同连环漫画。每幅连环漫画由三幅图片组成，并显示在屏幕的上半部分。然后，编号为1至3的三幅图片显示了该场景可能的结果，叠加在屏幕的下半部分。这三幅图片中只有一幅代表该场景的合理结论。本实验包含两个条件：角色意图（CI）条件和物理因果关系（PC）条件。CI条件下的连环漫画涉及一个角色，受试者必须推断其意图才能选择正确的图片。PC条件下的连环漫画只需要理解物理因果关系。要求受试者仔细观看连环漫画，然后通过按下相应的键盘按钮在三个故事结局中做出选择。记录答案和反应时间。此外，所有参与者都参加了经典的错误信念（聪明豆）任务。
连环漫画：对正确反应的数量进行了方差分析[2组（对照组/ASP组）×2条件（CI/PC）]。组因素和条件因素均无显著性差异（p>0.05）。相比之下，组×条件的交互作用达到了显著性水平[F(1 - 30)=4.3，p<0.05]。进一步分析表明，ASP组在CP条件下的表现（M = 10.8，SD = 2.5）显著高于CI条件下的表现（M = 9.8，SD = 2）[t(1 - 14)=2.9，p<0.001]，而对照组在两种条件下没有差异（p>0.05）。错误信念：所有ASP参与者都成功完成了任务。
我们的数据清楚地表明，患有阿斯伯格综合征或高功能自闭症的儿童和青少年在理解他人意图方面存在障碍。在连环漫画任务中，患有阿斯伯格综合征的儿童在角色意图条件下比在物理因果关系条件下有更多困难。这种障碍不能归因于考虑情境方面的缺陷（弱中央统合理论），因为他们在同样需要处理整个场景的物理因果关系条件下的表现与对照组一样好。相比之下，所有患有阿斯伯格综合征的儿童在错误信念任务中都取得了成功。这些相互矛盾的发现表明，尽管这两项任务都在测试心理理论，但它们挖掘的不是相似的机制。有可能在错误信念任务中使用语言材料提高了已知在该领域具有特殊优势的ASP儿童的表现。另一个需要进一步测试的可能解释是，这两项任务的复杂程度不同。
