A research team led by Grazia Maria Giovanna Pastorino of Magna Graecia University of Catanzaro, working with colleagues at the University of Salerno and the University of Messina, recruited 123 children aged 6 to 11 years across two Italian public healthcare centers between 2021 and 2025. The sample comprised 42 children with Autism Spectrum Disorder Level 1, meaning autism without intellectual disability, 43 children with the combined presentation of Attention-Deficit/Hyperactivity Disorder, and 38 typically developing controls matched for age, sex, and socioeconomic status. Diagnoses were validated with gold-standard instruments: the ADOS-2 and ADI-R for autism, and Conners-3 parent and teacher rating scales for ADHD. Children with both conditions were deliberately excluded to isolate what the researchers call pure clinical phenotypes.

The central question was deceptively simple. Executive functions, the top-down regulatory processes of response inhibition, working memory, planning, cognitive flexibility, and attentional control, are known to support social cognition, the capacity to process and respond to socially relevant cues. Social cognition includes affect recognition, the perceptual decoding of emotional expressions, and theory of mind, the ability to attribute beliefs, intentions, and emotions to oneself and others. But it has remained unclear whether the social difficulties seen in autism and ADHD arise from shared executive failures or from disorder-specific neurocognitive wiring. Developmental models propose that executive functions provide the cognitive scaffolding on which theory of mind is built, yet the strength and shape of that scaffolding may differ dramatically across diagnostic profiles.

To find out, the team combined three standardized instruments. The WISC-IV measured cognitive functioning across verbal comprehension, perceptual reasoning, working memory, and processing speed. The BRIEF-2, completed by parents, captured everyday executive behavior at home, with higher T-scores indicating greater dysfunction. Selected NEPSY-II subtests probed performance directly, including Affect Recognition and Theory of Mind for social cognition, and Inhibition, Auditory Attention, Visual Attention, Response Set, and Design Fluency for executive functions. Testing sessions lasted roughly 90 to 120 minutes per child, and all analyses used non-parametric statistics with Bonferroni-corrected post-hoc comparisons, followed by multiple linear regression models within each clinical group.

The comparative results revealed a striking double dissociation. Both clinical groups showed widespread executive and social-cognitive impairments relative to typically developing peers, but their profiles diverged in opposite directions. Children with ADHD performed worst on response inhibition and basic attentional control, scoring significantly below the autism group on the NEPSY-II Inhibition, Visual Attention, and Auditory Attention subtests, and on the BRIEF-2 Inhibit scale, where the ADHD group’s deficit reached a large effect size. Children with autism Level 1, by contrast, showed the deepest impairments in social cognition itself, with Theory of Mind and Affect Recognition scores significantly lower than in ADHD, alongside greater difficulties in cognitive flexibility on the Response Set and Design Fluency tasks and more everyday inflexibility on the BRIEF-2 Shift scale.

Not everything separated the groups. Working memory emerged as a shared endophenotype: both clinical cohorts scored significantly lower than controls on the WISC-IV Working Memory Index, with no significant difference between them, while verbal comprehension, perceptual reasoning, and processing speed remained statistically homogeneous across all three groups. This pattern suggests that some cognitive vulnerabilities cut across traditional diagnostic boundaries, consistent with transdiagnostic models of neurodevelopmental psychopathology, even as other domains remain profile-specific.

The regression models delivered the study’s most consequential insight. In the ADHD group, theory of mind performance was strongly scaffolded by executive functions: a model combining Inhibition, Auditory Attention, and Design Fluency explained 72.2 percent of the variance in theory of mind scores. Affect recognition in ADHD was similarly driven by Inhibition and Visual Attention, accounting for 60.7 percent of variance, with theory of mind notably absent as a predictor. The interpretation is that children with ADHD do not lack social competence per se; rather, their social-cognitive performance collapses under executive load. To solve a theory of mind task, a child with ADHD must sustain attention on the narrative, inhibit premature responses, and flexibly generate solutions, and it is precisely these regulatory resources that are compromised.

In the autism group, the architecture looked fundamentally different. Theory of mind was predicted primarily by Affect Recognition and Response Set, explaining 55.1 percent of variance, with basic inhibitory and attentional resources exerting no direct predictive role. Affect recognition, in turn, was best predicted by theory of mind itself, explaining 32.7 percent of variance, suggesting an intimate interconnection between bottom-up perceptual decoding of faces and top-down mentalizing within the autistic socio-cognitive core. The authors read this as evidence that the social deficit in autism without intellectual disability is primary and pervasive, not merely a downstream consequence of generic executive failure, though it depends on higher-order flexibility and rule monitoring rather than on basic inhibition.

The clinical implications are substantial. If social difficulties in ADHD stem from executive-regulatory deficits while those in autism reflect primary mentalizing and shifting impairments, then rehabilitation cannot be one-size-fits-all. Interventions targeting inhibition and attentional control may unlock social-cognitive gains in ADHD, whereas autism-focused programs must address emotion decoding, perspective taking, and cognitive flexibility directly. The findings support transdiagnostic profiling that enriches categorical diagnoses with fine-grained cognitive mapping, potentially improving early screening during the 6-to-11 window, which the authors identify as a critical period of asynchronous maturation for both executive control and social reasoning.

The study has limitations the authors acknowledge candidly. The cross-sectional design cannot establish causal direction or track how these architectures remodel across adolescence. Excluding comorbid cases, while essential for isolating pure profiles, reduces ecological validity in a clinical world where autism and ADHD frequently co-occur. Parent-report measures on the BRIEF-2 may be shaped by informant perception and family context, and the sample, drawn from two southern Italian centers over five years, limits generalizability across cultures and to other phenotypic variants such as the predominantly inattentive presentation of ADHD. Future work, the team proposes, should add a comorbid ASD-plus-ADHD group to test whether co-occurrence produces additive, synergistic, or entirely novel endophenotypes, and should integrate eye-tracking and functional neuroimaging to quantify the visual strategies, diminished fixation on the eye region in autism, chaotic impulsive scanning in ADHD, that may underlie the distinct profiles revealed here.

Subject of Research: Neuroscience

Article Title: Neurocognitive endophenotypes in neurodevelopmental disorders: social cognition and executive functions in children with Autism Spectrum Disorder Level 1 and Attention-Deficit/Hyperactivity Disorder

Article References: Pastorino, G. M. G., Olivieri, M., Aquino, A., Mungo, N., Suriano, R., & Operto, F. F. (2026). Neurocognitive endophenotypes in neurodevelopmental disorders: social cognition and executive functions in children with Autism Spectrum Disorder Level 1 and Attention-Deficit/Hyperactivity Disorder. Frontiers in Child and Adolescent Psychiatry, 5, Article 1920753. https://doi.org/10.3389/frcha.2026.1920753

Image Credits: AI Generated

DOI: 10.3389/frcha.2026.1920753

Keywords: autism, ADHD, executive functions, social cognition, theory of mind, neurodevelopmental disorders, working memory, neuropsychology, Neurocognitive, endophenotypes, neurodevelopmental, disorders

The core idea is deceptively simple but consequential. A persistent organizational human-AI team is defined as a bounded collective in which distinguishable human and artificial contributors engage in interdependent activity across successive cycles, and in which prior collective activity can affect later artificial participation. That last condition, termed functional continuity, is what separates genuine hybrid teams from the far more common pattern of repeated, episodic use. A technically stateless base model can still belong to a persistent team if the deployed system can access and use externally maintained state, such as interaction history stored in an orchestration layer or shared knowledge infrastructure. Conversely, simply archiving records is not enough if that history never enters subsequent interaction. One-shot exchanges, sessions that functionally reset, and the static aggregation of separately produced human and AI outputs all fall outside the domain.

OHAI organizes inquiry around three analytically distinct objects: system configuration, collective functioning, and collective intelligence. System configuration is a structured, potentially time-indexed description of the pre-specifiable human, artificial, task, organizational, and temporal features of the hybrid system, including expertise, model capabilities, memory architecture, decision rights, roles, and information access. Collective functioning concerns what actually happens when configured contributors work together: how expertise is accessed, distributed, evaluated, combined, and updated, and how errors are detected and repaired. Collective intelligence, the framework’s primary theoretical target, is defined in line with landmark work by Anita Woolley and colleagues as a general group-level capacity manifested across diverse tasks, whose scope of generalization must be specified and empirically demonstrated rather than assumed.

The framework’s central inferential rule is its most provocative feature: a property implemented in an artificial component does not by itself establish a corresponding team-level phenomenon. An AI system that maintains an expertise map, for instance, does not automatically create a transactive memory system in the team. The team-level phenomenon must be demonstrated in the enacted organization and use of distributed contributions, that is, in evidence showing that questions are actually directed to appropriate contributors, that information is routed to where it can be used, and that source selection changes with experience. The rule cuts both ways: a team-level function need not depend on any particular AI architecture, since similar collective functions may be realized through different combinations of human practices, artificial features, task structures, and organizational arrangements.

To make collective functioning measurable, the authors propose three selective lenses drawn from human team research. Partner modeling, related to theory of mind, concerns the representations contributors hold of one another, whether psychological beliefs on the human side or computational user models, state tracking, and behavioral prediction on the artificial side. Transactive-memory-system-related coordination concerns how differentiated expertise is located and used across the collective, extending Wegner’s classic account of who knows what. Shared-mental-model-related representational alignment concerns whether human psychological representations and artificial computational task states are sufficiently compatible to support anticipation and coordination. In every case, the framework demands evidence at the team level and carefully distinguishes human psychological states from artificial computational operations, without assuming psychological symmetry between contributors.

Persistence is where the framework becomes genuinely dynamic. Once prior collective activity can shape later participation, the team cannot be represented as a sequence of independent encounters. Recursive updating names the temporal relation through which earlier outputs, expectations, routines, and interaction histories enter the conditions of subsequent activity, whether deliberately or not, symmetrically or not. Change can unfold at overlapping timescales, from within-episode adjustments to slow accretion of roles and procedures. This history sensitivity makes collective intelligence trajectories, the temporal patterns in repeated estimates of the same CI construct, legitimate empirical objects. But the authors insist that improvement, learning, or adaptation must never be presumed: accumulated history may just as easily stabilize errors, obsolete representations, or ineffective routines. Path dependence is an open empirical question, not a developmental promise.

Estimating a CI trajectory is methodologically demanding. Because performance in a single episode can reflect task difficulty, temporary coordination failures, or stochastic variation in AI outputs, claims about change in the general collective capacity require repeated estimation through comparable or defensibly linked multi-task task batteries, with sufficient task diversity to separate general capacity from episodic performance. Studies must also keep three questions distinct: whether the same collective continues, whether its claim-relevant configuration remains stable, and whether the measure remains comparable across periods. A team that swaps its AI model or restructures roles may still be a continuing collective, but attributing observed change to accumulated experience, to learning, or to the reconfiguration itself requires a comparison design appropriate to the specific claim.

The framework also launches a secondary comparative program on cross-substrate correspondence, asking whether selected human-team phenomena recur or perform comparable functions in hybrid teams. It distinguishes observable-pattern correspondence, functional correspondence, and a third form, relational-pattern correspondence, reserved as a limited future methodological possibility. Four test families organize the empirical work: interaction-pattern correspondence, informational synergy, failure-process correspondence, and correspondence in coordination structures. Notably, similar final errors do not establish the same underlying process, a caution drawn from the classic hidden-profile tradition, and informational synergy alone does not identify any particular coordination mechanism. Divergence from human-team references is treated as theoretically valuable in its own right, potentially revealing genuinely hybrid forms of organization.

To make the agenda cumulative, the authors describe four nonmandatory stages of research maturity. Stage one qualifies the configuration and measurement, documenting model versions, memory architectures, retrieval arrangements, roles, and authority structures. Stage two runs circumscribed local tests between selected configuration features, collective functioning, and performance or CI. Stage three addresses longitudinal team-level phenomena such as recursive updating and CI trajectories, with material configuration changes carefully documented. Stage four supports integrated multilevel studies linking configuration, functioning, intelligence, and downstream consequences. The authors stress that these stages organize research maturity, not team development, and that a well-qualified negative result should constrain or narrow a local claim rather than be expanded away post hoc.

Perhaps the most human dimension of the paper lies in its treatment of employee wellbeing. Persistent hybrid teams organize not only collective problem solving but also the relationships through which people experience their work: whom members consult, whose judgments carry weight, and how responsibilities and recognition are distributed. Citing evidence that transactive memory systems and shared mental models relate to job satisfaction, engagement, and identification in human teams, the authors call for research on how artificial participation reshapes these processes. They propose practical tools, including role-and-expertise maps, participative reviews, and longitudinal assessment profiles, to detect whether improved collective capability comes with concentrated verification burdens or narrowed recognition. The broader message is that organizations configure the conditions under which AI functions become part of collective life, and that governing that configuration, including the history it carries forward, is now an organizational responsibility, not merely a technical one.

Subject of Research: A theoretical framework for collective intelligence in persistent organizational human-AI teams

Article Title: When humans and agents form a collective: a framework for collective intelligence in persistent organizational human-AI teams

Article References: Rovetta, A., Bortolotti, A., & Di Berardino, C. (2026). When humans and agents form a collective: a framework for collective intelligence in persistent organizational human-AI teams. Frontiers in Organizational Psychology, 4, Article 1941058. https://doi.org/10.3389/forgp.2026.1941058

Image Credits: AI Generated

DOI: 10.3389/forgp.2026.1941058

Keywords: collective intelligence, human-AI teams, organizational psychology, transactive memory, team cognition, OHAI framework, employee wellbeing, recursive updating, cross-substrate correspondence, AI agents, team dynamics, theory of mind

Internal focalization is the literary device by which a narrative grants readers direct access to a character’s innermost thoughts and feelings. In the experimental story used by the research team, that access took the form of a repairman’s private regret over a careless act. Senior author Angus Fletcher, a professor of English at Ohio State’s Project Narrative, explained that being transported into a character’s mind elicits empathy toward that character and, in turn, forgiveness for the wrongdoing. Crucially, participants who were prompted to reflect on a past transgression of their own tended to extend their forgiveness of the fictional figure to the real-life event, suggesting the emotional shift generalizes beyond the page.

“If you just give people a story without the empathy technique, they’re not likely to forgive a character. But if you put the technique in, they not only forgive the character, but are then more likely to forgive other people in their actual life,” said Fletcher. The distinction matters because much of the previous research on literature and empathy has treated reading as a monolithic activity, comparing broad categories such as literary fiction versus nonfiction. By isolating a single, historically developed narrative technique, Fletcher and his co-author were able to test the mechanism itself rather than the genre label attached to it.

The study was completed with Mark Matthews, a recent Ohio State PhD graduate in social psychology. The collaboration brought together two disciplines that rarely share a laboratory bench: narrative theory, with its two-thousand-year history of claims about literature’s moral and emotional benefits, and experimental social psychology, with its insistence on controlled comparison and replication. That history of claims is long and venerable. Since antiquity, writers and philosophers have argued that literature helps people overcome anger, see situations from another person’s perspective, and function better socially, all of which are considered beneficial to mental health.

Modern science has tried to confirm those intuitions with mixed results. A widely cited 2013 study reported that reading passages of literary fiction, compared with nonfiction or popular fiction, enhanced readers’ ability to understand others’ beliefs and desires, a capacity psychologists call theory of mind. But subsequent efforts to replicate that finding, both by independent researchers and by the original team, did not pan out. Rather than abandon the question, Fletcher and Matthews reframed it. “We said, ‘What do we know about the history of how artists develop these techniques for creating empathy?’ We put the most powerful of those techniques into a story, and then tested whether that story without the technique creates empathy and if the story with the technique creates empathy,” Fletcher said. “By being more precise about it, we were able to identify these very specific mechanisms and connections.”

The experimental story itself was carefully constructed to provoke a genuine moral reaction. It follows a woman named Mary who, as a child, watched her puppy die after being hit by a car and swore off dog ownership for the rest of her life. At age 85, she finally adopts a puppy in an attempt to heal her lifelong grief, and she hires a repairman, warning him explicitly to keep the door shut so the dog cannot escape. He leaves the door open, and the puppy gets out, to Mary’s horror. Participants were then given different information about the act: in one version, the repairman disregarded Mary’s warning entirely, making the loss fully his fault; in another, he accidentally left the door open because he was distracted by personal problems at home.

The manipulation of internal focalization came next, and it was deliberately subtle. In the literary condition, the narrative reported the repairman’s private thought: “The repairman thought to himself, I wish I didn’t leave the door open.” In the nonliterary comparison condition, the same sentiment was spoken aloud: “The repairman said to Mary, ‘I wish I didn’t leave the door open.'” The propositional content of the two sentences is identical; what differs is whether the reader is given privileged access to the character’s inner world or merely observes an external utterance that could be insincere. That single difference in narrative perspective proved powerful enough to change how participants judged and forgave the character.

Across three studies involving a total of 1,563 people, Fletcher and Matthews found that forgiveness of a fictional character could be reliably promoted through internal focalization, and that facilitating forgiveness of the fictional transgression in turn brought about forgiveness of real-life transgressions. Because of how the study was designed, the fictional forgiveness had to occur first, establishing a causal sequence in which empathy for a character opens a pathway toward empathy for actual people. The researchers also deliberately omitted any detail about whether Mary forgave the repairman, so that participants never learned the outcome and the effect could not be attributed to the story simply modeling forgiving behavior for readers to imitate.

The researchers emphasize that the pathway to forgiveness runs through outrage, not around it. Before forgiveness becomes possible, readers must first feel a genuine sense of indignation at the repairman’s apparent callousness about keeping the dog safe. Matthews also draws a technical distinction between two forms of forgiveness that psychologists differentiate: decisional forgiveness, the behavioral choice to forgo resentment, and emotional forgiveness, the deeper restoration of warmth and closeness in a relationship. “Once we know the transgression is someone’s fault, what we discover is that if we can create a condition where you can see the internal remorse, the internal world of the person, people can feel the sincerity of it. They can open up and connect with the emotions that person is having,” Matthews said. “As a result, now we have the opportunity to forgive them more.” Notably, both types of forgiveness, decisional and emotional, were elicited by the literary technique, both toward the fictional character and toward real-life offenders.

The implications extend well beyond literary theory. Gallup research has found that more than one in five people worldwide routinely feel angry, a figure Fletcher cites as evidence that stories may serve as a kind of prescription for better emotional health. “What’s really great about literature is you don’t have to be at a crisis point to use it,” he said. “It’s something that you can just use a little bit to help get you through daily anger, daily depression, daily pessimism, daily anxiety. The right literature, once you learn how to use it, can help pop you out of that, can give you more joy, more optimism, more love, more empathy, all of these positive effects.” The effect, he added, is not restricted to the written word; people often report being more in tune with their emotions while watching a film or reading a novel than in ordinary life, which he sees as a clue to a much larger phenomenon. In his view, the study captures one instance of an emotional health crisis driven by spending too much time with technology and too little with what he calls ancient sources of human wisdom. The core hope, as Matthews put it, is that exposure to literature changes our perception of the world around us. “That’s the hope. That’s the goal,” he said. “And in our study, we wanted to approximate that.” The work was supported by Ohio State’s Department of English.

Subject of Research: How the literary technique of internal focalization promotes empathy and forgiveness of real-life transgressions

Article Title: How literature can inspire us to forgive

Article References: How literature can inspire us to forgive. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: internal focalization, forgiveness, empathy, literature, psychology, narrative technique, theory of mind, emotional health, Ohio State University, Frontiers in Psychology, decisional forgiveness, emotional forgiveness

The research team, led by corresponding author Jianfei Shi, set out to answer a question that has lingered in the literature on bipolar disorder for years. Impairments in theory of mind have been documented across mood states in bipolar disorder, and they appear to deepen during manic episodes. What has remained murky is the neurophysiological sequence behind those impairments, particularly the timing between two stages of mental-state reasoning: an earlier, posterior stage thought to handle perspective-related processing, and a later, frontal stage involved in selecting among perspectives and managing the conflicts that arise when another person’s viewpoint clashes with one’s own. Behavior alone cannot separate these stages; only a technique with fine temporal resolution can.

That technique is electroencephalography, or EEG, which records electrical activity at the scalp with millisecond precision. From the continuous EEG signal, researchers can extract event-related potentials, stereotyped waves of brain activity time-locked to specific events in a task. In this study, nineteen patients who met ICD-10 diagnostic criteria for a bipolar manic episode and twenty-four healthy controls completed a rapid theory of mind judgment task while their brain activity was recorded. The design was deliberately fast-paced, forcing participants to compute and apply mental-state inferences under time pressure, which is closer to the demands of real social life than the leisurely judgments used in many earlier studies.

The behavioral results confirmed what clinicians observe at the bedside. Compared with healthy controls, the patients with bipolar disorder showed reduced accuracy and prolonged reaction times across all conditions of the task. In other words, they were both slower and less accurate when asked to reason about another person’s perspective, a double deficit that suggests the difficulty is not simply a matter of hesitation or caution but of genuinely impaired computation. Notably, the patients’ manic symptoms were subthreshold at the time of assessment according to established cutoffs on the Young Mania Rating Scale, meaning the participants were not in an acute, severe episode, yet the social-cognitive differences were still measurable.

The electrophysiological findings are where the study makes its most distinctive contribution. The researchers focused on two components. The first, dubbed TP450, spans roughly 325 to 525 milliseconds after a stimulus and is associated with posterior perspective-related processing, drawing on regions toward the back and side of the brain, including areas near the temporoparietal junction that have long been implicated in reasoning about other minds. The second, the late frontal slow wave, or LFSW, spans roughly 600 to 800 milliseconds and is treated as a marker of later frontal processing during perspective selection and conflict management, engaging the prefrontal systems that govern control and decision-making.

When the two groups were compared, a clear dissociation emerged. The patients showed significantly attenuated TP450 amplitudes at right parietal electrode sites, specifically at the P4 position, consistent with altered processing in the posterior network that assembles perspective-related information in the first place. They also exhibited reduced LFSW amplitudes at left frontal sites, at electrode F3, consistent with altered recruitment of the later frontal machinery that selects among perspectives and resolves conflicts between them. The deficit, in other words, was not confined to a single stage. Both the early assembly of social information and the later executive application of that information appeared to be blunted in the patient group.

This two-stage picture matters because it helps distinguish between two broad hypotheses about social-cognitive impairment in bipolar disorder. One possibility is that patients fail at the representational level: they cannot build an adequate model of another person’s mental state. The other is that the model is built adequately but then applied poorly, especially when the patient’s own perspective competes with the other person’s. The concurrent reduction of both the TP450 and the LFSW in this sample suggests that the application phase of theory of mind, not merely the representational phase, is compromised, and that the temporal handoff between posterior and frontal systems may be a key point of failure. The authors frame this as preliminary evidence for differences in posterior perspective-related processing and subsequent frontal processing during theory of mind application.

The methodological care behind these conclusions is worth appreciating. The study was approved by the Ethics Committee of Hangzhou Seventh People’s Hospital and conducted in accordance with the Declaration of Helsinki, with written informed consent obtained from all participants or their legal guardians. It was registered in the National Medical Research Registration and Filing Information System of China. Standard EEG preprocessing practices, including independent component analysis, were applied to clean the data, and neuropsychological measures such as the digit span test and verbal fluency test were used to characterize the participants’ broader cognitive profiles. The work was partly supported by the Construction Fund of Key Medical Disciplines of Hangzhou.

At the same time, the researchers are candid about the limits of what they can claim. The patient sample comprised only nineteen individuals, a small clinical cohort by any standard, and the manic symptoms were subthreshold rather than severe at the time of testing. The authors explicitly state that the findings require replication in larger, independent samples before they can be generalized to the broader population of people with bipolar disorder. Small ERP studies are vulnerable to sampling variability, and effect sizes at individual electrode sites can shift between cohorts. The results should therefore be read as a well-controlled first signal rather than a settled answer, a signal that nonetheless points in a theoretically coherent direction.

If the findings do replicate, the implications could extend well beyond the laboratory. Theory of mind deficits are strongly linked to real-world functioning in bipolar disorder, influencing relationship stability, occupational performance, and the ability to recognize when one’s own judgment is drifting. A temporal marker such as the TP450 or the LFSW could eventually serve as an objective index of social-cognitive state, potentially helping clinicians track recovery across mood episodes or evaluate whether an intervention is restoring not just mood but the neural machinery of social understanding. The study also adds bipolar disorder to the growing list of conditions, from autism to schizophrenia, in which the fine-grained choreography of perspective taking can now be watched in real time, one electrical oscillation at a time.

Subject of Research: Neural mechanisms of theory of mind application deficits in bipolar mania measured with event-related potentials

Article Title: Neural mechanisms underlying theory of mind application deficits in bipolar mania: an event-related potential study

Article References: Zhou, J., Zhou, X., Zhang, K., Wang, C., Li, X., & Shi, J. (2026). Neural mechanisms underlying theory of mind application deficits in bipolar mania: an event-related potential study. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08652-3

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08652-3

Keywords: bipolar disorder, mania, theory of mind, event-related potentials, EEG, TP450, late frontal slow wave, perspective taking, social cognition, temporoparietal junction, prefrontal cortex, BMC Psychiatry

The research, led by Lily Chen and Eva Kimonis of the University of New South Wales together with colleagues at Macquarie University, is the first to disentangle the unique contributions of ASD symptoms and CU traits to different components of empathy in clinic-referred children as young as one to eight years old. The distinction matters enormously for treatment. Children with conduct problems, which include the symptoms of oppositional defiant disorder and conduct disorder, are among the most common referrals to psychological services, and an estimated 20 to 50 percent of them also show CU traits, a pattern marked by lacking guilt, remorse, and concern for others. Meanwhile, between 22 and 51 percent of young people with ASD also display elevated CU traits, creating a diagnostic tangle that has long frustrated clinicians trying to decide which intervention a child actually needs.

The theoretical backbone of the study is a hierarchical model of empathy proposed by Nuske and colleagues, which treats empathic responding as the final product of an assembly line. First, a child must attend to another person’s emotional cues. Next, the child must recognise which emotion those cues express and understand the underlying emotional state, a capacity related to theory of mind. Only then can the child produce a behavioural empathic response, such as comforting or helping. According to the model, empathy can fail at any link in this chain, and crucially, different disorders may break different links. Prior meta-analyses suggested that CU traits blunt affective resonance, the emotional arousal that motivates prosocial action, whereas ASD primarily disrupts cognitive empathy, including emotion recognition and perspective taking. But almost no previous study had tested both conditions simultaneously in the same young clinical sample.

The researchers recruited 317 children referred to a university-based or community-based clinic in metropolitan Sydney for assessment and treatment of conduct problems, plus 91 typically developing children from the same communities. Parents completed well-validated questionnaires: the Eyberg Child Behaviour Inventory for conduct problems, the Social Communication Questionnaire for ASD symptoms, and the preschool version of the Inventory of Callous-Unemotional Traits. Children themselves then completed a battery of laboratory tasks. A preschool dot-probe task measured how quickly children orient their attention toward images of distress. A dynamic emotion recognition task presented 40 one-second video clips of adults expressing anger, fear, happiness, sadness, or pain, and asked children to identify the emotion. Understanding of emotional states was probed with an ingenious task built around four emotional scenes from the animated film The Lion King, in which children were asked how Simba felt and why. Prosocial responding was captured through parent-report measures of empathic behaviour.

The statistical strategy was deliberately layered. Hierarchical regressions tested whether ASD symptoms or CU traits were uniquely associated with each empathy component, over and above the severity of conduct problems and the influence of components lower in the hierarchy. The results drew a strikingly clean dividing line. ASD symptoms, but not CU traits, were uniquely associated with poorer emotion recognition, a small-to-moderate effect. When the researchers examined specific emotions, higher ASD symptoms predicted deficits in recognising anger, fear, and pain, though not happiness or sadness in this sample. In contrast, CU traits, but not ASD symptoms, were uniquely and negatively associated with empathic responding, and this association was small to moderate in size. Neither condition showed a unique association with attention to distress cues or with understanding of emotional states once the lower components of the hierarchy were accounted for.

The person-centred analyses told the same story from a different angle. Children were classified into clinical groups: conduct problems alone, conduct problems plus CU traits, conduct problems plus ASD, and conduct problems with both. The two groups containing ASD, CP+ASD and CP+CU+ASD, showed significantly poorer emotion recognition than the CP+CU group, whose accuracy did not differ from typically developing children. The pattern reversed for empathic responding. Here the CP+CU+ASD group showed the lowest prosocial behaviour of all, significantly below the CP+CU group, which in turn fell significantly below the CP-only group. Children with conduct problems alone did not differ from typically developing children. In other words, ASD erodes the cognitive front end of the empathy chain, while CU traits erode the affective back end, and when both are present the damage compounds.

One of the most consequential implications of the findings is that emotion recognition deficits long attributed to psychopathy and CU traits may actually have been driven by undetected, co-occurring ASD symptoms. Earlier meta-analyses had reported that children with CU or psychopathic traits struggle to recognise anger, fear, and sadness. But those analyses never controlled for ASD. The current results, consistent with a 2021 study of seven-year-old community children, suggest that once ASD symptoms are accounted for, the link between CU traits and emotion recognition largely evaporates. This reframing matters because it redirects clinical attention: a child with conduct problems and poor emotion reading may need support with social perception, not the interventions designed for shallow affect.

Equally intriguing is what the study found about children with ASD whose empathic responding remains intact. Despite measurable emotion recognition deficits, these children engaged in prosocial behaviour at levels comparable to typically developing peers. Emerging research suggests that some autistic individuals experience differences rather than deficits in emotional processing, including hypersensitivity to others’ emotions that can heighten emotional resonance in some situations, even when recognising facial expressions is harder. This challenges the popular but inaccurate stereotype that autism is defined by an absence of empathy, and it aligns with systematic reviews showing that autistic children comfort, help, and share to the same degree as their neurotypical peers.

The study is not without limitations, which the authors acknowledge candidly. Some laboratory tasks, particularly the dot-probe measure of attention and the Lion King task of emotional understanding, may have been too demanding for children as young as one to four years old, since the attention task is validated only from age three and the understanding task from age five. Low accuracy rates and high variance on these measures may explain why no unique associations emerged for those components, contradicting some earlier work with older children and adolescents. Laboratory data were also not available for every participant, leaving some analyses underpowered, and the sample contained no children with ASD without comorbid conduct problems, so the findings cannot yet be generalised to that population. The authors suggest that mobile eye tracking, which requires no active response from the child, could provide a more developmentally appropriate window onto attentional processes in future research.

The clinical payoff is concrete. For children with conduct problems and co-occurring ASD, the hierarchical model implies that adding an emotion recognition module to treatment could produce flow-on benefits to emotional understanding and empathic behaviour. For children with CU traits, whose recognition and understanding appear relatively preserved, the evidence points toward directly training empathic responding itself. One promising example is the Coaching and Rewarding Emotional Skills module adapted for Parent-Child Interaction Therapy for children with CU traits, which uses parent modelling and an intensive reward-based token economy to reinforce prosocial behaviour and has been shown to significantly improve child empathy. Given that CU traits predict earlier-onset, more severe, and more treatment-resistant antisocial behaviour, identifying which children need which kind of support, and doing so before school age, could change developmental trajectories that are otherwise difficult to redirect. The authors call for replication in larger samples and in populations beyond clinic-referred children, but the central message is already clear: empathy fails in different places for different children, and treatment should target the exact link that is broken.

Subject of Research: Differential associations of childhood callous-unemotional traits and autism spectrum disorder symptoms with components of empathy in children with conduct problems

Article Title: The Empathy Hierarchy: Unique Associations of Childhood Callous Unemotional Traits and Autism Spectrum Disorder Symptoms

Article References: The Empathy Hierarchy: Unique Associations of Childhood Callous Unemotional Traits and Autism Spectrum Disorder Symptoms. (n.d.). https://doi.org/10.1007/s10578-026-02104-5

Image Credits: AI Generated

DOI: 10.1007/s10578-026-02104-5

Keywords: autism spectrum disorder, callous-unemotional traits, empathy, emotion recognition, conduct problems, prosocial behaviour, theory of mind, child psychopathology, hierarchical model of empathy, clinical assessment, developmental psychology, Parent-Child Interaction Therapy

The review, led by ChaoZheng Huang and AiBao Zhou of Northwest Normal University in Lanzhou, together with YuHui Yang of Hunan Police Academy and Pei Xie of Sichuan Normal University, proposes a three-factor neurobehavioral framework that reframes empathy difficulties in schizophrenia as failures of self–other distinction regulation. Rather than asking whether empathic capacity is reduced, the authors ask where in the chain of empathic processing the sense of who is feeling what becomes unstable. The framework is a narrative synthesis rather than a single experiment, but it draws together behavioral findings, neuroimaging evidence, and theoretical models into a coherent architecture that makes testable predictions for future research.

The first factor in the model is spontaneous empathic access. This concerns whether cognitive and affective cues from another person—facial expressions, tone of voice, posture, words—actually enter the observer’s processing system when task demands are low. Empathy cannot begin unless social signals are registered, and this registration often happens automatically, before any deliberate effort. In schizophrenia, the authors argue, bottom-up access to social cues may be compromised by attentional abnormalities, sensory processing disturbances, or motivational deficits. A patient who never fully registers a companion’s subtle expression of worry cannot be expected to respond to it, regardless of how intact the rest of the empathic machinery might be. This stage explains some cases of apparent emotional coldness that are, at root, failures of signal capture rather than failures of feeling.

The second factor, inferential empathy, refers to the representation of another person’s beliefs, intentions, perspectives, and emotional states as mental content that belongs to someone else. This is the territory traditionally covered by theory of mind and mentalizing research, and it maps onto a well-characterized set of brain circuits, including the mentalizing network of the medial prefrontal cortex, temporoparietal junction, and posterior cingulate cortex, together with frontotemporal social-inference systems. Decades of work have documented theory-of-mind impairments in schizophrenia, and the framework does not dispute them. Instead, it situates them: inferential empathy is one stage among several, and impairments here cannot by themselves account for the full profile of empathic disturbance seen across patients.

The third and most novel factor is attributional empathy. Once emotions, thoughts, or perspectives have been activated in the observer’s mind, they must be assigned to their correct owner. Is this sadness mine, or does it belong to the person sitting across from me? Is this interpretation of the situation my own judgment, or am I borrowing someone else’s? In healthy cognition, this assignment happens largely outside awareness, supported by neural systems for self–other distinction and source attribution. The review proposes that in schizophrenia this labeling process becomes unstable. Emotions generated by another person’s distress may be experienced as one’s own, producing the elevated personal distress and emotional over-involvement frequently reported by patients. Conversely, one’s own internally generated thoughts and feelings may be attributed to external sources—a misattribution that resonates strikingly with core symptoms of the disorder, such as thought insertion and delusions of influence.

At the neural level, the framework distributes these three processes across interacting large-scale networks. Spontaneous empathic access is linked to the salience network, which detects behaviorally relevant signals, and to affective-sharing and mirror networks that allow another person’s state to resonate in the observer’s own affective circuitry. Inferential empathy recruits the mentalizing and frontotemporal social-inference circuits described above. Attributional empathy depends on self–other distinction and source-attribution systems, including regions such as the temporoparietal junction and prefrontal areas that have been implicated in distinguishing self-generated from externally generated mental content. Crucially, the authors emphasize that these networks do not operate in isolation; empathic success depends on their dynamic coordination, and empathic failure can arise from discoordination as readily as from damage to any single node.

A further layer of the model concerns interpersonal synchrony, the real-time coordination of self- and other-related signals during social interaction. Conversations involve continuous mutual adjustment of gaze, timing, rhythm, and affect. The review suggests that synchrony acts as a modulator across all three stages of empathic processing, helping to keep self- and other-related signals properly segregated and aligned as interaction unfolds. If synchrony mechanisms are disrupted in schizophrenia—as some evidence on sensorimotor coordination and social timing suggests—the stability of self–other distinction may degrade precisely in the live, fast-moving situations where empathy matters most. This may help explain why social difficulties in the disorder often appear more severe in dynamic interaction than in structured laboratory tasks.

The framework’s explanatory power lies in what it clarifies about existing accounts. Theory-of-mind models capture inferential failures but say little about emotional over-involvement. Empathic-disequilibrium models, which describe imbalances between cognitive and affective empathy, describe the pattern but do not fully explain its mechanism. By locating both under-response and over-response in the regulation of self–other distinction, the new framework unifies them: a person can show poor empathic accuracy because other-related representations are never clearly formed or are contaminated by self-related content, and simultaneously show heightened personal distress because other-related emotions are misattributed to the self. The apparent contradiction dissolves once empathy is understood as a multi-stage process whose stages can fail in different combinations in different patients.

This heterogeneity is perhaps the framework’s most clinically important implication. If empathy deficits in schizophrenia reflect less stable self–other distinction regulation across multiple stages, then patients may differ systematically in which stage is most affected. One patient’s primary problem might be spontaneous access to social cues, pointing toward interventions that enhance attention to and encoding of social signals. Another’s might be inferential representation, consistent with existing social-cognitive training programs targeting theory of mind. A third’s might be attributional, calling for approaches that strengthen the sense of mental ownership—helping patients learn to tag activated emotions and thoughts as self-generated or other-generated. The framework thus provides a mechanistic basis for profiling individual patients and matching them to targeted treatments, a step beyond one-size-fits-all social skills training.

Because the review is a theoretical synthesis, its claims now face the test of data. The authors frame their model explicitly in terms of testable predictions for behavioral studies, neuroimaging experiments, and intervention trials. Behavioral work could measure access, inference, and attribution as separable components within the same participants, testing whether they dissociate across patients. Neuroimaging studies could examine whether instability in self–other distinction networks predicts the specific pattern of empathic disturbance a patient shows. Intervention research could evaluate whether training that targets attributional processes reduces personal distress and emotional over-involvement in ways that theory-of-mind training alone does not. If those predictions hold, the humble question of where I end and you begin may turn out to be one of the most consequential frontiers in understanding the social brain—and in helping people with schizophrenia reclaim their place within it.

Subject of Research: Self–other distinction regulation and empathy processing in schizophrenia

Article Title: When “I” and “You” blur: self–other distinction failure and empathy dysregulation in schizophrenia

Article References: Huang, C., Yang, Y., Xie, P., & Zhou, A. (2026). When “I” and “You” blur: self–other distinction failure and empathy dysregulation in schizophrenia. Translational Psychiatry. https://doi.org/10.1038/s41398-026-04514-4

Image Credits: AI Generated

DOI: 10.1038/s41398-026-04514-4

Keywords: schizophrenia, empathy, self–other distinction, theory of mind, mentalizing, social neuroscience, personal distress, interpersonal synchrony, source attribution, Translational Psychiatry, social cognition, neurobehavioral framework

The stakes of this question are high. Decades of developmental research show that romantic relationships are a central task of adolescence and young adulthood, and that their quality carries lasting consequences. High-quality early relationships have been linked to greater self-esteem, lower alienation, better self-image, and stronger commitment in later partnerships, while poor-quality relationships are associated with more depressive symptoms, substance use, and difficulties in academic and social adjustment. Crucially, researchers argue that it is not involvement itself but the balance of positive and negative interactions that shapes well-being. That makes the psychological machinery underlying constructive interaction—understanding a partner’s feelings, managing one’s own emotional arousal, and accurately reading a partner’s intentions—a prime target for scientific scrutiny, particularly at the developmental moment when both relationships and these abilities are still maturing.

The review followed PRISMA 2020 guidelines, searching PsycINFO, Scopus, and Web of Science for peer-reviewed quantitative studies of unmarried, non-cohabiting young people. From 701 retrieved records, 26 studies met all inclusion criteria, with sample sizes ranging from 22 to 1,527 participants. Methodological quality, assessed with the AXIS appraisal tool, was moderate to high on average, though weaknesses clustered around sampling: only six studies justified their sample size, and most relied on non-representative convenience samples. Because the studies were too heterogeneous in design and measures for meta-analysis, the authors synthesized findings through structured vote counting based on the direction of effects, tabulating each reported association as positive, negative, or null and mixed.

Emotion regulation emerged as the most heavily studied domain, contributing 23 effect estimates across 14 studies, and the pattern was strikingly strategy-specific. Cognitive reappraisal—reinterpreting emotional events to change their impact—was consistently beneficial: of nine estimates for adaptive regulation and reappraisal combined, none were negative. Experimental work showed that minimizing reappraisal reduced relationship satisfaction and conflict-resolution self-efficacy relative to control conditions. Expressive suppression, by contrast, in which outward emotional expression is inhibited, showed the mirror image: five of eight estimates were negative and none positive. Suppression lowered satisfaction and increased loneliness, particularly for women suppressing negative emotions, reduced conversation quality and felt connectedness for the suppressor, and hindered post-breakup growth. This is developmentally troubling because suppression is precisely the strategy adolescents increasingly rely on as they learn to control emotional expression, meaning the tool young people adopt most readily during their first relationships is the one carrying the steepest relational cost.

Notably, global measures of regulatory difficulty produced the most inconsistent results, and the inconsistency itself is informative. Two studies found no direct link between regulatory difficulties and satisfaction, yet one dyadic study revealed a significant indirect pathway: difficulties predicted greater withdrawal during conflict, which in turn eroded satisfaction for both partners. The authors interpret such null direct effects not as evidence that regulation is irrelevant, but as a sign that its influence is often transmitted through behavioral mechanisms—like pulling away from a difficult conversation—that simple direct-effect models fail to capture. Gender and age qualified the picture further: boys’ withdrawal damaged both partners’ satisfaction more than girls’, the relational cost of dysregulation was greater for younger individuals and attenuated with age, and a person-centered analysis found that a proactive profile of active communication and reappraisal reported the highest satisfaction, while an inhibiting profile marked by suppression and avoidance reported the lowest.

Empathy told a similarly dual story. Across seven studies, the relational value of empathy depended on whether it took an other-focused or self-focused form. Empathic concern—compassion directed outward toward a partner’s difficulties—was consistently associated with higher satisfaction and more constructive conflict resolution. Personal distress, which turns the emotional response inward into one’s own fear and stress, showed the opposite association, particularly among women. One especially intriguing finding concerned the source of the benefit: partner-perceived empathic concern predicted satisfaction whereas the actor’s own empathic concern did not, suggesting that feeling understood by one’s partner may matter more than one’s own dispositional tendency to care. Daily-diary evidence reinforced this, with day-to-day fluctuations in state empathy tracking daily satisfaction over a two-week period. Empathy also operated through mediation and moderation: it carried the effect of negative arousability on satisfaction, mediated links between mindfulness and daily satisfaction, and in one study empathy, humility, and forgiveness together explained 43.4 percent of the variance in satisfaction.

The review’s most surprising finding was almost the complete absence of research on theory of mind—the ability to attribute beliefs, intentions, feelings, and desires to oneself and others—in the romantic lives of young people. Only two studies qualified, though both pointed in promising directions. One found that lower mentalization in adolescent girls was associated with greater emotion-regulation difficulties, with a bidirectional link in which poor mentalization hindered regulation while dysregulation impaired mentalizing under stress. The other, a neuroimaging study, showed that young adults who considered their partner’s beliefs were more likely to support their partner’s well-being that day and the next—an effect specific to romantic partners and moderated by neural selectivity during mentalizing. Because so few studies addressed theory of mind directly, the authors added perspective-taking, a closely related ability, which showed consistent positive associations across five studies with no negative direct effects, partly through more positive problem-solving and constructive conflict resolution.

Woven together, the findings suggest these abilities may function as an interlocking system rather than independent traits. The authors ground this in Decety and Jackson’s functional model of empathy, in which affective responding, mental-state representation, and emotion regulation operate as interacting components, and in the vulnerability–stress–adaptation model of relationships, in which stable individual characteristics shape relationship quality through adaptive processes like communication and conflict resolution. From this view, weak socio-cognitive abilities act as enduring vulnerabilities while strong ones act as resources. The review also identified an intriguing asymmetry between actor and partner effects: for empathy and perspective-taking, partner effects tended to outweigh actor effects—feeling understood mattered more than being understanding—whereas for suppression, the costs fell first and most strongly on the suppressor, with partner effects largely absent. The authors caution that this asymmetry rests on few dyadic studies and should be treated as a hypothesis for future research rather than an established finding.

The limitations are candidly acknowledged. The broad 14-to-35 age range introduces developmental heterogeneity, the evidence base is skewed toward Europe and the United States—particularly relevant for suppression, whose costs may be weaker in cultures where emotional restraint carries different social meaning—and most studies were cross-sectional, restricting causal inference. Strikingly, no included study examined these abilities in digitally mediated romantic contexts, despite the fact that young people’s relationships increasingly unfold on platforms that introduce unique stressors such as heightened jealousy and relational uncertainty. Early neuroscience hints at what screen-mediated interaction may do: remote communication increases activation in theory-of-mind regions like the temporal-parietal junction as the brain works harder to fill in missing social cues, while decreasing amygdala activation, suggesting reduced emotional engagement. Whether these shifts alter how young people learn to read and care for romantic partners remains entirely unknown. For now, the review stands as the first to place empathy, emotion regulation, and theory of mind side by side in early romance, and its message is clear: helping young people reappraise rather than suppress, feel concern rather than distress, and genuinely understand their partners may be among the most practical investments science can offer the next generation of relationships.

Subject of Research: The role of empathy, emotion regulation, and theory of mind in adolescent and young adult romantic relationships

Article Title: The role of socio-cognitive abilities in adolescent and young adult romantic relationships: a systematic review

Article References: Polak, N., Confalonieri, E., & Milani, L. (2026). The role of socio-cognitive abilities in adolescent and young adult romantic relationships: a systematic review. Current Psychology, 45(19), Article 1565. https://doi.org/10.1007/s12144-026-10100-0

Image Credits: AI Generated

DOI: 10.1007/s12144-026-10100-0

Keywords: empathy, emotion regulation, theory of mind, perspective-taking, romantic relationships, adolescence, young adults, relationship satisfaction, cognitive reappraisal, expressive suppression, systematic review, social cognition

The study, published in the journal Trends in Psychology, was led by Laura Canani and Letícia S. Czepielewski of the Cognition and Psychopathology Laboratory at the Federal University of Rio Grande do Sul, working with Sarah Corrêa de Sales and Raffael Massuda of the Psychosis Research Program at the Federal University of Paraná. Their goal was not to question the test’s basic utility but to fill in a technical gap that has long been acknowledged by specialists: although the Reading the Mind in the Eyes Test is routinely described as a measure of decoding complex mental states, the instrument itself does not classify the emotional valences of the mental states it presents. In other words, the test tells you whether someone can pick the right label for a pair of eyes, but it says nothing systematic about whether that label describes something pleasant, unpleasant, or emotionally neutral.

That gap matters more than it might first appear. Emotional valence, the degree to which a mental state is experienced as positive or negative, is one of the organizing dimensions of affective science, and it shapes how people attend to, remember, and interpret social information. Clinicians and researchers have long suspected that patients with depression, for example, may show biased processing of negative emotional material, and that such biases could interact with performance on mental-state decoding tasks. Without knowing the valence of each item in the test, however, researchers cannot cleanly separate the ability to decode a mental state from the tendency to be drawn to, or repelled by, emotionally charged material. A person who performs poorly on the test might genuinely struggle to read minds, or might simply avoid guessing negative states, and the standard scoring system cannot distinguish between these possibilities.

The Brazilian team followed a methodological template laid out by Catherine Hudson and colleagues in a 2020 study published in Psychological Assessment, which was the first to systematically classify the valence of the test’s items using an English-speaking sample. Canani and her colleagues recruited 186 Brazilian adults and collected data through an online cross-sectional quantitative survey. Participants were asked to evaluate the emotional character of the words and picture-word pairs that make up the revised version of the test, which contains 36 items pairing photographs of the eye region with four candidate mental-state labels, and 45 items consisting of the mental-state words alone. The researchers used the Brazilian version of the test, which had previously been adapted and validated for Portuguese speakers, ensuring that language barriers would not contaminate the valence judgments.

The results were striking. Among the 36 picture-word pairs, participants classified 7 items as neutral, 12 as positive, and 17 as negative. Among the 45 words-only items, the distribution tilted even more heavily toward the unpleasant end of the spectrum: 13 words were judged positive, only 1 was judged neutral, and 31 were judged negative. This heavy skew toward negative valence in the vocabulary of the test is itself revealing. The mental-state words that Baron-Cohen and his team selected to capture the subtleties of human inner life, words like skeptical, uneasy, or defensive, are simply not emotionally balanced, and Brazilian raters perceived that imbalance clearly.

More consequential still was the comparison with the earlier English-language study. When the Brazilian classification was set against the valence assignments produced by Hudson and colleagues, important differences emerged, suggesting that the same mental-state vocabulary does not carry the same emotional weight for speakers of different languages embedded in different cultural worlds. The authors interpret this divergence through the lens of cultural models of emotion, a framework in which the meanings, norms, and display rules that surround emotional experience are shaped by the societies in which people live. Classic work in cultural psychology, including the influential theory of independent and interdependent self-construals proposed by Hazel Markus and Shinobu Kitayama, has long argued that cognition, emotion, and motivation are inseparable from cultural context. The new findings extend that argument into the fine-grained territory of psychometric measurement, showing that even the perceived emotional tone of a single word can shift across cultural boundaries.

The implications ripple outward across an enormous research literature. The Reading the Mind in the Eyes Test has been used to document social cognitive dysfunction as a clinical marker across some 30 psychiatric and neurological conditions, from borderline personality disorder to post-traumatic stress disorder, from first-episode psychosis to eating disorders. Large-scale cross-cultural studies, including a 2022 analysis of sex and age differences in theory of mind across 57 countries, have relied on the English version of the test to draw sweeping conclusions about how mentalizing varies around the globe. If the emotional valence of the test’s items is culturally contingent, then some portion of the cross-cultural variance in test scores could reflect differences in how emotional words are evaluated rather than genuine differences in the capacity to infer mental states. A Brazilian participant and a British participant might both correctly identify the mental state behind a pair of eyes, yet weight its pleasantness differently, and downstream analyses that pool valence information across samples could be quietly confounded.

The study also speaks to a broader movement in psychiatry toward frameworks such as the Research Domain Criteria, which treat social cognition as a core domain of functioning and call for measures that can cleanly parse its subcomponents. Within that vision, knowing the valence structure of a widely used task is not a pedantic detail but a prerequisite for building theoretically coherent models of how emotion recognition breaks down in psychopathology. The Brazilian authors note that impairments in social cognition have been documented across a wide range of conditions and lead to serious difficulties in social functioning, which makes it all the more important that the instruments used to detect those impairments behave consistently and transparently. A test whose items carry culturally variable emotional charges cannot fully serve that purpose without supplementary information about what each item means emotionally to the population being assessed.

Technically, the study demonstrates a practical and relatively inexpensive pathway for researchers elsewhere: recruit a reasonably sized community sample, present the test’s items for valence judgment, and compare the resulting classification against existing benchmarks. The Brazilian team’s use of an online cross-sectional design, combined with the previously validated Portuguese adaptation of the test, shows that valence mapping can be carried out without laboratory equipment or clinical populations, making it feasible for research groups in many countries. The authors analyzed their data using standard quantitative methods implemented in the R statistical environment, and the work was conducted in accordance with Brazilian research ethics regulations, including the national data protection law governing the handling of personal information.

What emerges from this study is a picture of a famous psychological instrument that is both more and less universal than its reputation suggests. The test’s photographs of eyes may tap into something deeply human about the way we search faces for meaning, but the emotional labels attached to those photographs are filtered through language, culture, and lived experience. As the authors conclude, culture models appear to play an important role in how emotional valence is classified, and researchers who use the Reading the Mind in the Eyes Test outside the English-speaking world would be wise to establish the valence profile of the items for their own populations. In the science of reading minds, it turns out, the first thing we need to read more carefully is our own instruments.

Subject of Research: Cultural differences in the emotional valence of Reading the Mind in the Eyes Test items among Brazilian adults

Article Title: Emotional Valences in the Reading the Mind in the Eyes Test: A Brazilian Study

Article References: Canani, L., Corrêa de Sales, S., Massuda, R., & Czepielewski, L. S. (2025). Emotional Valences in the Reading the Mind in the Eyes Test: A Brazilian Study. Trends in Psychology. https://doi.org/10.1007/s43076-025-00503-6

Image Credits: AI Generated

DOI: 10.1007/s43076-025-00503-6

Keywords: social cognition, theory of mind, Reading the Mind in the Eyes Test, emotional valence, emotion recognition, cultural psychology, psychometrics, psychological assessment, Brazil, mental state decoding, empathy, psychopathology

Theory of Mind, often abbreviated as ToM, is the cognitive machinery that allows humans to attribute mental states to others and to predict behavior on that basis. First described in the landmark 1978 question of whether chimpanzees possess a theory of mind, the capacity depends on a distributed network of cortical regions, particularly the prefrontal, insular and cingulate areas. Those same regions are among the most consistently altered in people with substance use disorder, whether through reduced cortical volume, disrupted connectivity or changes in neurochemistry. This anatomical overlap is one reason researchers have long suspected that psychoactive substances could compromise the ability to understand other people.

Previous syntheses had already documented ToM problems among people with alcohol use disorder, with effect sizes ranging from moderate to very large. Meta-analyses of facial emotion recognition, a related social-cognitive skill, also pointed to deficits among alcohol and substance users. But evidence on substances other than alcohol remained scattered. The only earlier systematic review covering the broader landscape, published in 2016, found relatively weak evidence for ToM impairments linked to methamphetamine and no impairments among recreational cocaine users. The new study, led by José Vitor de Lima Neto and Flavia de Lima Osório of the University of São Paulo, set out to resolve that uncertainty with a formally registered, PRISMA-guided search of eight databases including Embase, Scopus, PsycINFO, Web of Science, PubMed, PsycNet, LILACS and SciELO.

The review included original quantitative studies comparing Theory of Mind performance between adult psychoactive substance users and controls. After screening, 37 studies met the criteria, and 30 of them—covering 35 distinct samples—provided data suitable for meta-analysis. Most of the research originated in Europe, with 70 percent of studies conducted there, and the field’s first study dates only to 2006, making this a young but rapidly growing literature. Alcohol was the predominant substance studied, accounting for roughly half of the samples, followed by stimulants, opioids, cannabis and a single study involving the hallucinogen MDMA. Participants were mostly men, with a mean age of about 37 years, and were largely recruited from inpatient detoxification clinics.

The pooled result was striking. Across the meta-analyzed samples, substance users showed significantly poorer Theory of Mind performance than controls, with a standardized mean difference of −0.80, a large effect by conventional statistical standards. The 95 percent confidence interval ran from −1.13 to −0.47, well clear of zero. Heterogeneity was high, at roughly 93 percent, reflecting the diversity of instruments, populations and study designs, but sensitivity analyses removing statistical outliers left the overall estimate essentially unchanged. Publication bias tests, including Begg’s rank correlation test and funnel plot inspection, found no evidence that negative findings were being suppressed.

Subgroup analyses revealed something perhaps even more consequential: the impairment did not appear to depend on which substance was used. Samples of alcohol users produced an effect size of −0.92, opioid users −1.12 and stimulant users −1.29. A formal between-group test found no statistically significant differences among these classes, with overlapping confidence intervals pointing to a common magnitude of deficit. The authors also tested whether the choice of assessment tool mattered, given ongoing debate about the Reading the Mind in the Eyes Test, the most frequently used instrument in this literature. A mixed-effects meta-regression comparing studies that used the Eyes Test with those using other measures found no significant moderating effect, suggesting the deficits are not an artifact of one particular task.

Two theoretical explanations dominate the interpretation of these findings, and they are not mutually exclusive. The first is neurotoxicity: chronic exposure to alcohol, opioids or stimulants damages or dysregulates precisely the prefrontal, insular and cingulate circuits that Theory of Mind depends upon, and decades of neuroimaging work document structural and functional changes in these regions among people with substance use disorder. The second is vulnerability: weak social cognition may predate substance use, increasing susceptibility to social stress, isolation and exclusion, and leading individuals to use substances as a way of coping with relational difficulties or of conforming to perceived social norms. Supporting the vulnerability hypothesis, a 2022 meta-analysis found an inverse relationship between alcohol-related problems and ToM performance even in non-clinical samples, where use never reached diagnostic thresholds.

The new review itself is cross-sectional in its evidence base, with 36 of the 37 included studies using cross-sectional designs, so causality cannot be established. The authors are explicit that their pooled estimate should be read as evidence of association rather than cause. They also note that the two mechanisms likely interact in a self-reinforcing loop: a primary ToM weakness predisposes someone to use substances, chronic use then intensifies the deficit through neurotoxic effects, and the deepened impairment in turn hinders therapeutic adherence and relapse control. Interestingly, one study in the review found that long-term MDMA users actually performed better on Theory of Mind tasks than non-users, a finding consistent with evidence that the pursuit of empathetic social experience motivates MDMA use—though it rests on a single study.

Important gaps remain. Evidence on cannabis, hallucinogens and nicotine is too sparse for meta-analysis; two cannabis studies found no significant differences, though the tasks used assessed affective rather than cognitive ToM, a subdomain that may be selectively vulnerable given cannabis-linked frontal reductions. Methodological quality across the field was only moderate, most samples came from high-income countries, inpatient recruitment may have inflated severity, and polysubstance use and psychiatric comorbidities were rarely controlled. Nevertheless, the authors argue the practical message is clear: sociocognitive skills deserve formal assessment in both prevention programs and addiction treatment, because deficits in reading minds can raise vulnerability to initiating use, undermine therapy and complicate recovery long after detoxification ends.

Subject of Research: Theory of Mind deficits among psychoactive substance users

Article Title: Theory of Mind in Psychoactive Substance Users: A Systematic Literature Review and Meta-analysis

Article References: Neto, J. V. D. L., & Osório, F. D. L. (2026). Theory of Mind in Psychoactive Substance Users: A Systematic Literature Review and Meta-analysis. International Journal of Mental Health and Addiction. https://doi.org/10.1007/s11469-026-01717-0

Image Credits: AI Generated

DOI: 10.1007/s11469-026-01717-0

Keywords: Theory of Mind, psychoactive substances, substance use disorder, social cognition, meta-analysis, alcohol, opioids, stimulants, addiction, prefrontal cortex, mental state attribution, systematic review