Development of a short-form version of the Reading the Mind in the Eyes Test for assessing theory of mind in older adults

Construct validity evidence reporting practices for the Reading the Mind in the Eyes Test: A systematic scoping review

The Reading the Mind in the Eyes Test (RMET) is one of the most influential measures of social cognitive ability, and it has been used extensively in clinical populations. However, questions have been raised about the validity of RMET scores. We conducted a systematic scoping review of the validity evidence reported in studies that administered the RMET (n = 1461; of which 804 included at least one clinical sample) with a focus on six key dimensions: internal consistency, test-retest reliability, factor structure, convergent validity, discriminant validity, and known group validity. Strikingly, 63% of these studies failed to provide validity evidence from any of these six categories. Moreover, when evidence was reported, it frequently failed to meet widely accepted validity standards. Overall, our results suggest a troubling conclusion: the validity of RMET scores (and the research findings based on them) are largely unsubstantiated and uninterpretable. More broadly, this project demonstrates how unaddressed measurement issues can undermine a voluminous psychological literature.

No general pathological significance of aphantasia: An evaluation based on criteria for mental disorders

As awareness of the phenomenon of aphantasia (= lack of voluntary imagery) has increased in recent years, many psychotherapists ponder its clinical implications. The present study investigates whether aphantasia meets the criteria for mental disorders, i.e. statistical rarity, impairment in activities of daily living, violation of social norms and inappropriate behavior and personal distress. Prevalence of aphantasia was determined meta-analytically based on 3,543 participants. An international sample of 156 participants with aphantasia (58.3% male; M_age  = 35.23) and 131 controls (65.6% male; M_age  = 28.88) was assessed with the Reading the Mind in the Eyes Test, the Questionnaire for the Assessment of Everyday Memory Performance and the Aphantasia Distress Questionnaire, as well as measures of depression, anxiety and well-being. The prevalence of aphantasia was estimated at 3.5 to 4.8%. Participants with aphantasia scored significantly lower than controls on every day and autobiographical memory, but not on theory of mind. A subgroup of 34.7% of participants with aphantasia reported distress significantly associated with lower well-being and high levels of anxiety and depression. The level of distress increased with poorer performance in autobiographical memory and theory of mind. Although aphantasia meets the criterion of statistical rarity, the impact on activities of daily living and personal distress is too weak to justify a classification as a mental disorder. In a subgroup, however, distress can reach clinically relevant levels. In individual cases, it is therefore advisable to conduct a psychological assessment, for example by means of the Aphantasia Distress Questionnaire.

Reading language of the eyes

The need for assessment of social skills in clinical and neurotypical populations has led to the widespread, and still increasing use of the 'Reading the Mind in the Eyes Test' (RMET) developed more than two decades ago by Simon Baron-Cohen and colleagues for evaluation of social cognition in autism. By analyzing most recent clinical and brain imaging data, we illuminate a set of factors decisive for using the RMET. Converging evidence indicates: (i) In neurotypical individuals, RMET scores are tightly correlated with other social skills (empathy, emotional intelligence, and body language reading); (ii) The RMET assesses recognition of facial affect, but also heavily relies on receptive language skills, semantic knowledge, and memory; (iii) RMET performance is underwritten by the large-scale ensembles of neural networks well-outside the social brain; (iv) The RMET is limited in its capacity to differentiate between neuropsychiatric conditions as well as between stages and severity of a single disorder, though it reliably distinguishes individuals with altered social cognition or elevated pathological traits from neurotypical persons; (v) Merely gender (as a social construct) rather than neurobiological sex influences performance on the RMET; (vi) RMET scores do not substantially decline in healthy aging, and they are higher with higher education level, cognitive abilities, literacy, and mental well-being; (vii) Accuracy on the RMET, and engagement of the social brain, are greater when emotions are expressed and recognized by individuals with similar cultural/ethnic background. Further research is required to better inform usage of the RMET as a tool for swift and reliable examination of social cognition. In light of comparable visual input from the RMET images and faces covered by masks due to COVID-19 regulations, the analysis is of value for keeping efficient social interaction during the current pandemic, in particular, in professional settings related to social communication.

Reading Covered Faces

Covering faces with masks, due to mandatory pandemic safety regulations, we can no longer rely on the habitual daily-life information. This may be thought-provoking for healthy people, but particularly challenging for individuals with neuropsychiatric and neurodevelopmental conditions. Au fait research on reading covered faces reveals that: 1) wearing masks hampers facial affect recognition, though it leaves reliable inferring basic emotional expressions; 2) by buffering facial affect, masks lead to narrowing of emotional spectrum and dampen veridical evaluation of counterparts; 3) masks may affect perceived face attractiveness; 4) covered (either by masks or other veils) faces have a certain signal function introducing perceptual biases and prejudices; 5) reading covered faces is gender- and age-specific, being more challenging for males and more variable even in healthy aging; 6) the hampering effects of masks on social cognition occur over the globe; and 7) reading covered faces is likely to be supported by the large-scale assemblies of the neural circuits far beyond the social brain. Challenges and limitations of ongoing research and parallels to the Reading the Mind in the Eyes Test are assessed. Clarification of how masks affect face reading in the real world, where we deal with dynamic faces and have entrée to additional valuable social signals such as body language, as well as the specificity of neural networks underlying reading covered faces calls for further tailored research.

Reading the Mind in the Eyes: A Population-Based Study of Social Cognition in Older Adults

BACKGROUND

Social cognition indicates the cognitive processes involved in perceiving, interpreting, and processing social information. Although it is one of the six core DSM-5 cognitive domains for diagnosing neurocognitive disorders, it is not routinely assessed in older adults. The Reading the Mind in the Eyes Test assesses Theory of Mind, the social cognition mechanism which forms the root of empathy.

OBJECTIVES

To describe the distribution of, and factors associated with, scores on a 10-item version of Reading the Mind in the Eyes Test (RMET-10) in older adults.

DESIGN

Population-based cross-sectional study.

SETTING

Small-town communities in Pennsylvania.

PARTICIPANTS

Adults aged 66-105 years (N = 902, mean age = 76.6).

MEASUREMENTS

The assessment included RMET-10, demographics, cognitive screening, literacy, depression symptoms, anxiety symptoms, cognitive composites derived from a neuropsychological test battery, Social Norms Questionnaire, and Clinical Dementia Rating (CDR).

RESULTS

RMET-10 score was normally distributed in our overall study sample. Normative RMET-10 scores among those rated as CDR = 0 were calculated by age, sex, and education. RMET-10 score was significantly higher with younger age, higher education, white race, higher cognitive screening scores, literacy, social norms scores, higher scores in all five domains in cognitive composites, and lower CDR. RMET-10 score was also significantly higher with fewer depression and anxiety symptoms after adjusting for demographics.

CONCLUSIONS

The RMET is a potentially useful measure of social cognition for use in the research assessment of older adults. With appropriate calibration it should also have utility in the clinical setting.