Social Neuroscience: Empathy, Theory of Mind, and Metacognition

Fronto-temporal dementia (FTD) is a disease of insidious onset and gradual progression, clinically characterized by changes in personality, impaired social skills, poor decision making, and lack of insight. It shares many similarities with autism, including ecolalia, motor stereotypes, and deficits in executive functions. Thus, it offers a unique opportunity to study the neural, perceptual, and cognitive substrates of social behavior.[1] 

Empathy. I have shown that patients with fronto-temporal dementia are selectively impaired in the recognition of negative facial emotions. This research brings the methods of cognitive science to bear on questions of social cognition.[2] I am now collaborating with Sara Hodges, a social psychologist at the University of Oregon, to explore whether this deficit relates to patients’ inability to empathize in richer, more naturalistic situations.

Theory of Mind. Impaired social skills may be caused not only by perceptual deficits (e.g., inability to recognize facial emotions), but also by cognitive deficits. For this reason, I have been exploring FTD patients’ performance on the false-belief task, the litmus test for the ability to infer other people’s mental states (i.e., theory of mind).[3]  Preliminary results reveal similar performance to Alzheimer’s patients, whose social skills are spared. This finding argues against theory-of-mind impairment, as measured by the false-belief task, as the major contributor to social dysfunction of FTD patients.

Metacognition. Another hallmark of FTD is patients’ lack of insight into their disease and its effects on their behavior. Although healthy adults tend to overestimate their own abilities when predicting future task performance, this bias is reduced after performing the task, which offers the opportunity to experience error and failure. In contrast, patients with denial of deficit believe that their cognitive abilities are spared, despite daily evidence in the contrary. To explore whether denial of deficit stems in part from an inability to detect errors, I administered the Stroop and change blindness tasks to FTD patients who exhibit denial of deficit.[4]  Relative to healthy adults and patients with Alzheimer’s disease, FTD patients were overconfident in their abilities both before and after testing, and often failed to incorporate the feedback information.

This last study highlights theoretical similarities between metacognition and executive attention. Although these two fields –represented in the two strands of my own work- have often proceeded by relatively separate, independent channels, they are both greatly enriched when integrated into a common framework.[5] Pursuing such links is one the major goals of my research at this time. It includes studies of patient populations as well as studies with normally developing subjects.

[1] Fernandez-Duque, D. & Baird, J. A. (forthcoming). Is there a 'social brain'?: Lessons from eye-gaze following, joint attention, and autism. In  B.F.Malle & S. Hodges (Eds). Other Minds, Guildford Press