Biomedicine Institute of Seville (IBiS), Spain.
Neuropsychologia. 2010 Apr;48(5):1181-91. doi: 10.1016/j.neuropsychologia.2010.02.009. Epub 2010 Feb 12.
Impaired theory of mind (ToM) reasoning is considered an underlying cause of social cognition deficits in patients with acquired brain injury (ABI). However, the literature does not agree on the severity of ToM impairment in this clinical population, nor does it coincide on the proper tools for its assessment. In this paper, we use a meta-analytic approach to review 26 studies which compare the performance of ABI patients and healthy controls in four widely-used ToM tasks: first-order belief task, second order belief task, understanding indirect speech (IS) and social faux pas. Overall, patients show moderate to severe ToM impairment. The latter appears in faux pas (effect size=0.70) and understanding IS tasks (ES=0.87), while moderate impairment can be seen in second-order (ES=0.60) and first-order belief tasks (ES=0.52). The severity of ToM impairment was influenced by ratio of patients with frontal lobe lesion, ratio of patients with right hemisphere injury, type of belief task, and heterogeneity of the sample's etiology. Our results provide important quantitative evidence on the severity of ToM deficits in the ABI population, while identifying variables that influence these deficits. Implications for basic and clinical neuropsychology are discussed.
受损的心理理论（Theory of Mind，ToM）推理被认为是后天脑损伤（Acquired Brain Injury，ABI）患者社会认知缺陷的一个潜在原因。然而，文献对于该临床人群的 ToM 损伤严重程度并未达成一致意见，也没有就其评估的适当工具达成一致意见。在本文中，我们使用元分析方法回顾了 26 项研究，这些研究比较了 ABI 患者和健康对照组在四项广泛使用的 ToM 任务中的表现：一阶信念任务、二阶信念任务、理解间接言语（Indirect Speech，IS）和社交失礼。总体而言，患者表现出从中等到严重的 ToM 损伤。后者出现在失礼（效应量=0.70）和理解 IS 任务（ES=0.87）中，而在二阶（ES=0.60）和一阶信念任务（ES=0.52）中则可以看到中度损伤。ToM 损伤的严重程度受到额叶损伤患者比例、右侧损伤患者比例、信念任务类型以及样本病因异质性的影响。我们的结果提供了关于 ABI 人群 ToM 缺陷严重程度的重要定量证据，同时确定了影响这些缺陷的变量。讨论了对基础和临床神经心理学的影响。
