Mind-blindness

Mind-blindness is a concept of a cognitive divergence where an individual is unable to attribute mental states to others. As a result of this kind of social and empathetic cognitive phenomenon, the individual is incapable of putting themselves 'into someone else's shoes' and cannot conceptualize, understand or predict knowledge, thoughts and beliefs, emotions, feelings and desires, behaviour, actions and intentions of another person. Such an ability to develop a mental awareness of what is in the other minds is known as the theory of mind (ToM), and the 'mind-blindness' theory asserts that children who delay in this development often are or will be autistic. In addition to autism, ToM and mind-blindness research has recently been extended to other fields such as schizophrenia, dementia, bipolar disorders, antisocial personality disorders as well as normal aging. Mind-blindness is a concept of a cognitive divergence where an individual is unable to attribute mental states to others. As a result of this kind of social and empathetic cognitive phenomenon, the individual is incapable of putting themselves 'into someone else's shoes' and cannot conceptualize, understand or predict knowledge, thoughts and beliefs, emotions, feelings and desires, behaviour, actions and intentions of another person. Such an ability to develop a mental awareness of what is in the other minds is known as the theory of mind (ToM), and the 'mind-blindness' theory asserts that children who delay in this development often are or will be autistic. In addition to autism, ToM and mind-blindness research has recently been extended to other fields such as schizophrenia, dementia, bipolar disorders, antisocial personality disorders as well as normal aging. Mind-blindness is a state where the ToM has not been developed, or has been lost in an individual. According to the theory, ToM is implicit in neurotypical individuals. This enables one to make automatic interpretations of events taking into consideration the mental states of people, their desires and beliefs. Simon Baron-Cohen described how an individual lacking a ToM would perceive the world in a confusing and frightening manner, leading to a withdrawal from society. An alternative approach to the social impairment observed in mind-blindness focuses on the emotion of subjects. Based on empirical evidence, Uta Frith concluded that the processing of complex cognitive emotions is impaired compared to simpler emotions. In addition, attachment does not seem to fail in the early childhood of autistics. This suggests that emotion is a component of social cognition that is separable from mentalizing. Lombardo and Cohen updated the theory and pinpointed some additional factors that play an important part in ToM of autistic people. They highlighted that the middle cingulate cortex which is outside the traditional mentalizing region was underactive in autistic patients, while the rest of ToM activation was normal. This region was important in deciding how much to invest in a person and hence required mentalization. Neural correlates of the ToM point towards three regions of the brains. The anterior paracingulate cortex (Brodmann), is considered at the key region of mentalizing. It is located anterior corpus callosum and the anterior cingulate cortex. This cortex is associated with the medial frontal cortex where activation is associated with the mentalization of states. The cells of the ACC develops at the age of 4 months suggesting that the manifestations of mind-blindness may occur around this time. In addition to the anterior paracingulate cortex is the superior temporal sulcus and the temporal poles that are involved with the ToM and its nature. However, these areas are not uniquely associated with mentalization. They aid in the activation of the regions that are associated with the ToM. The superior temporal sulcus is involved in the processing of behavioural information while the temporal poles are involved in the retrieval of personal experiences. These are considered important regions for the activation of the ToM regions and are associated with the mind-blindness. The temporal poles provide personal experiences for mentalization such as facial recognition, emotional memory and familiar voices. In patients suffering from semantic dementia, the temporal regions of these patients undergo atrophy and lead to certain deficits which can cause mind-blindness. The amygdala and the orbitofrontal cortex also are a part of the ToM. It is in involved in the interpretation of behaviour which plays an important role in social cognition and therefore contributes to the theory of the mind. It is suspected that the damage to the orbitofrontal cortex brings upon subtle impairments, but not a total loss of the ToM that would to mind-blindness. Some studies have shown that the orbitofrontal cortex is not directly associated with the theory of the mind or mind-blindness. However, a study by Stone and colleagues were able to show impaired ToM on mentalisation tasks. Since the frontal lobe is associated with executive function, researchers theorize that the frontal lobe plays an important role in ToM and its associated nature. It has also been suggested that the executive function and the theory of mind share the same regions. Despite the fact that ToM and mind-blindness can explain executive function deficits, it is argued that autism is not identified with the failure of the executive function. Lesion studies show that when lesions are imposed to the medial frontal lobe, performance on mentalization tasks is reduced, similar to typical mind-blindness cases. Patients that experienced frontal lobe injuries due to severe head trauma showed signs of mind blindness, as a result of a lost ToM. However, it is still debated whether the inactivation of the medial frontal lobe is involved in mind-blindness.