Other minds in the brain: a functional imaging study of "theory of mind" in story comprehension

Comparing third-party responsibility with intention attribution: An fMRI investigation of moral judgment

Neuroimaging studies demonstrate that moral responsibility judgments activate the social cognition network, presumably reflecting mentalising processes. Conceptually, establishing an agent's intention is a sub-process of responsibility judgment. However, the relationship between both processes on a neural level is poorly understood. To date, neural correlates of responsibility and intention judgments have not been compared directly. The present fMRI study compares neural activation elicited by third-party judgments of responsibility and intention in response to animated pictorial stimuli showing harm events. Our results show that the social cognition network, in particular Angular Gyrus (AG) and right Temporo-Parietal Junction (RTPJ), showed stronger activation during responsibility vs. intention evaluation. No greater activations for the reverse contrast were observed. Our imaging results are consistent with conceptualisations of intention attribution as a sub-process of responsibility judgment. However, they question whether the activation of the social cognition network, particularly AG/RTPJ, during responsibility judgment is limited to intention evaluation.

Decision-Making with Predictions of Others' Likely and Unlikely Choices in the Human Brain

For better decisions in social interactions, humans often must understand the thinking of others and predict their actions. Since such predictions are uncertain, multiple predictions may be necessary for better decision-making. However, the neural processes and computations underlying such social decision-making remain unclear. We investigated this issue by developing a behavioral paradigm and performing functional magnetic resonance imaging and computational modeling. In our task, female and male participants were required to predict others' choices in order to make their own value-based decisions, as the outcome depended on others' choices. Results showed, to make choices, the participants mostly relied on a value difference (primary) generated from the case where others would make a likely choice, but sometimes they additionally used another value difference (secondary) from the opposite case where others make an unlikely choice. We found that the activations in the posterior cingulate cortex (PCC) correlated with the primary difference while the activations in the right dorsolateral prefrontal cortex (rdlPFC) correlated with the secondary difference. Analysis of neural coupling and temporal dynamics suggested a three-step processing network, beginning with the left amygdala signals for predictions of others' choices. Modulated by these signals, the PCC and rdlPFC reflect the respective value differences for self-decisions. Finally, the medial prefrontal cortex integrated these decision signals for a final decision. Our findings elucidate the neural process of constructing value-based decisions by predicting others and illuminate their key variables with social modulations, providing insight into the differential functional roles of these brain regions in this process.

A further study of the psychometric qualities of the Strange Stories-Revised across the three stages of aging

INTRODUCTION

Happé's Strange Stories task was developed in 1994 to assess theory of mind, the ability to infer mental states in oneself and others. Since then, it has undergone revisions, translations, and adaptations. A modified version of the task, the Strange Stories-Revised (SS-R), previously showed satisfactory qualities in a study aiming at identifying psychometrically acceptable social cognitive measures.

OBJECTIVE

The current study expands upon the psychometric evaluation study by examining the qualities of a short version of the SS-R in a sample of healthy adult subjects.

METHODS

One hundred and eighteen healthy adults completed the task along with neurocognitive measures. Mean scores of the long and short versions were compared. Associations between ToM as measured by performance on this abbreviated version of the SS-R, and potential confounders were explored. Internal consistency, dimensionality of the short version, and performance comparisons across three stages of aging (18-34; 35-59; 60-85 years old) were investigated, and standard measurement error was calculated to improve precision and data interpretation.

RESULTS

Reliability coefficients were comparable in the short and long versions. Principal component analysis showed that a one-factor structure best fits the data. Significant differences were observed in ToM performance across the three age groups, indicating a decline with time that was also captured by the long version, starting during midlife and increasing in significance with age.

CONCLUSION

The short version of the SS-R is a promising measure that can be profitably used in time-limited settings to assess theory of mind.

Long-term music instruction is partially associated with the development of socioemotional skills

This study aims to investigate the development of pitch-matching, rhythmic entrainment, and socioemotional skills in children who received formal music instruction and other non-music based after school programs. Eighty-three children, averaging 6.81 years old at baseline, were enrolled in either a music, sports, or no after-school program and followed over four years. The music program involved formal and systematic instruction in music theory, instrumental technique, and performance. Most control participants had no music education; however, in some instances, participants received minimal music education at school or at church. Musical development was measured using a pitch-matching and drumming-based rhythmic entrainment task. Sharing behavior was measured using a variation of the dictator game, and empathy was assessed using three different assessments: the Index of Empathy for Children and Adolescence (trait empathy), the Reading the Mind in the Eyes Test (theory of mind), and a Fiction Emotion-Matching task (state empathy). Results revealed no time-related associations in pitch-matching ability; however, formal music instruction improved pitch-matching relative to controls. On the contrary, improvements in rhythmic entrainment were best explained by age-related changes rather than music instruction. This study also found limited support for a positive association between formal music instruction and socioemotional skills. That is, individuals with formal music instruction exhibited improved emotion-matching relative to those with sports training. In terms of general socioemotional development, children's trait-level affective empathy did not improve over time, while sharing, theory of mind, and state empathy did. Additionally, pitch-matching and rhythmic entrainment did not reliably predict any socioemotional measures, with associations being trivial to small. While formal music instruction benefitted pitch-matching ability and emotion-matching to an audiovisual stimulus, it was not a significant predictor of rhythmic entrainment or broader socioemotional development. These findings suggest that the transfer of music training may be most evident in near or similar domains.

Long-term effects of vagus nerve stimulation therapy on cognitive functioning in patients with drug-resistant epilepsy

BACKGROUND

Despite the increasing use of vagus nerve stimulation (VNS) for drug-resistant epilepsy, its impact on cognitive functioning remains insufficiently investigated.

OBJECTIVE

We aimed to comprehensively assess changes in cognition after long-term VNS therapy in a prospective sample of adults with epilepsy.

METHODS

Between December 2019 and March 2023, patients scheduled for VNS implantation were invited for neuropsychological assessment, including tests of executive functions, working and short-term memory (recall of a verbal logical story and the Rey-Osterrieth complex figure (ROCF)), and social cognition. Participants were re-evaluated after a year of VNS therapy and the pre- and postoperative scores were compared by means of the Student's t or Wilcoxon's signed rank tests for paired samples. Patients available only after a longer follow-up (more than 24 months) were also re-examined and included in a secondary analysis.

RESULTS

The study included 28 PWE (16, 57.1% female, average age 33.7 ± 10.0 years). Twenty-two PWE followed-up at 14.5 ± 4.8 months had worse categorical verbal fluency than preoperatively (t = 2.613, p = 0.016). After including patients with long follow-up (n = 28, 21.6 ± 11.4 months), the group scored better on the delayed recall of the ROCF (17.09 ± 8.84 to 20.65 ± 8.32 points, t(22) =  - 2.618, p = 0.016) and the Happé strange stories test (5.0 ± 2.6 to 6.1 ± 2.1 points, t(14) =  - 3.281, p = 0.005). No significant changes were observed in other cognitive domains (p > 0.05).

CONCLUSION

We suggest improvements in a task of social cognition and short-term visual memory after longer use of VNS therapy. Such findings should be confirmed in larger trials after controlling for changes in ictal or interictal activity.

Assessing Frontal Lobe Function on Verbal Fluency and Emotion Recall in Autism Spectrum Disorder by fNIRS

This study applied the functional near-infrared spectroscopy (fNIRS) to investigate frontal activity in autism when performing verbal fluency test and emotion recall task. We recruited 32 autistic adults without intellectual disability and 30 typically-developing controls (TDC). Prefrontal hemodynamic changes were evaluated by fNIRS when the participants performed the verbal fluency test and emotion recall task. fNIRS signals in the prefrontal cortex were compared between autism and TDC. Compared to TDC, autistic adults showed comparable performance on the verbal fluency test but exhibited lower frontal activity on the vegetable category. In the verbal fluency test, left frontal activity in TDC significantly increased in the vegetable category (vs. fruit category). In the emotion recall task, left frontal activity increased significantly in TDC when recalling emotional (vs. neutral) events. This increase of left frontal activity on the more difficult works was not found in autism. Similarly, brain activities were related to test performance only in TDC but not in autism. In addition, more severe social deficits were associated with lower frontal activity when recalling emotional events, independent of autism diagnosis. Findings suggested reduced frontal activity in autism, as compared to TDC, when performing verbal fluency tests. The reduction of left frontal activation in verbal fluency test and emotion recall tasks might reflect on the social deficits of the individual. The fNIRS may potentially be applied in assessing frontal lobe function in autism and social deficits in general population. Trial registration number: NCT04010409.

The role of cognitive estimation in understanding the mental states of others

Previous studies have emphasized the critical role of the prefrontal cortex in cognitive estimation and theory of mind, however, none of them has questioned the possible role of cognitive estimation processes in understanding the mental states of others. In this study, we compared 30 patients with focal prefrontal cortex damage and 30 control subjects matched by gender, age, and education level on their performances on a cognitive estimation task and two tasks assessing theory of mind: the "Faux-Pas" task and the Reading the Mind in the Eyes task. The results showed that patients were significantly impaired compared with control subjects on both abilities of cognitive estimation and theory of mind. Moreover, regression analyses showed that performance on theory of mind was predicted by the scores on cognitive estimation. Finally, using voxel-based lesion analysis, we identified a partially common bilaterally distributed prefrontal network involved in both these domains centred within the ventral and dorsomedial areas with extension to the dorsolateral prefrontal cortex.

Grey-matter correlates of empathy in 4-Repeat Tauopathies

Loss of empathy is an early and central symptom of frontotemporal lobar degeneration spectrum diseases. We aimed to investigate the topographical distribution of morphometric brain changes associated with empathy in Progressive Supranuclear Palsy (PSP) and Corticobasal Syndrome (CBS) patients. Twenty-seven participants with CBS and 31 with PSP were evaluated using Interpersonal Reactivity Index scales in correlation with gray matter atrophy using a voxel-based morphometry approach. Lower levels of empathy were associated with an increased atrophy in fronto-temporal cortical structures. At subcortical level, empathy scores were positively correlated with gray matter volume in the amygdala, hippocampus and the cerebellum. These findings allow to extend the traditional cortico-centric view of cognitive empathy to the cerebellar regions in patients with neurodegenerative disorders and suggest that the cerebellum may play a more prominent role in social cognition than previously appreciated.

The Relationship between Narrative Skills and Executive Functions across Childhood: A Systematic Review and Meta-Analysis

Executive functions (EFs) and narrative competence (NC) are two important predictors of many outcomes in human development. To date, however, it is unclear whether these skills develop synergistically-supporting or opposing each other-or whether they are independent of each other. The purpose of this meta-analysis is to understand if these skills are related to over development and if the magnitude of their association changes over time; differs in typical and atypical development; and changes with EF (inhibition, working memory, flexibility, planning) and NC (oral, written; micro and macrostructural level). For this purpose, 30 studies containing 285 effect sizes were selected and combined. The results show that EFs and NC are weakly associated with each other (r = 0.236, p < 0.001) and that this association decreases with age (b(267) = -0.0144, p = 0.001). They are more associated in preschool and early elementary school grades, becoming more independent after seven years old. Between 3 and 7 years of age, the association seems stronger in atypically developing children and for macrostructural NC. Additionally, before 7 years old, the various EF domains seem to associate indistinctly with NC, and only later specific links between EFs and NC would be observed.

Gaze patterns and brain activations in humans and marmosets in the Frith-Happé theory-of-mind animation task

Theory of Mind (ToM) refers to the cognitive ability to attribute mental states to other individuals. This ability extends even to the attribution of mental states to animations featuring simple geometric shapes, such as the Frith-Happé animations in which two triangles move either purposelessly (Random condition), exhibit purely physical movement (Goal-directed condition), or move as if one triangle is reacting to the other triangle's mental states (ToM condition). While this capacity in humans has been thoroughly established, research on nonhuman primates has yielded inconsistent results. This study explored how marmosets (Callithrix jacchus), a highly social primate species, process Frith-Happé animations by examining gaze patterns and brain activations of marmosets and humans as they observed these animations. We revealed that both marmosets and humans exhibited longer fixations on one of the triangles in ToM animations, compared to other conditions. However, we did not observe the same pattern of longer overall fixation duration on the ToM animations in marmosets as identified in humans. Furthermore, our findings reveal that both species activated extensive and comparable brain networks when viewing ToM versus Random animations, suggesting that marmosets differentiate between these scenarios similarly to humans. While marmosets did not mimic human overall fixation patterns, their gaze behavior and neural activations indicate a distinction between ToM and non-ToM scenarios. This study expands our understanding of nonhuman primate cognitive abilities, shedding light on potential similarities and differences in ToM processing between marmosets and humans.

Specialized Networks for Social Cognition in the Primate Brain

Primates have evolved diverse cognitive capabilities to navigate their complex social world. To understand how the brain implements critical social cognitive abilities, we describe functional specialization in the domains of face processing, social interaction understanding, and mental state attribution. Systems for face processing are specialized from the level of single cells to populations of neurons within brain regions to hierarchically organized networks that extract and represent abstract social information. Such functional specialization is not confined to the sensorimotor periphery but appears to be a pervasive theme of primate brain organization all the way to the apex regions of cortical hierarchies. Circuits processing social information are juxtaposed with parallel systems involved in processing nonsocial information, suggesting common computations applied to different domains. The emerging picture of the neural basis of social cognition is a set of distinct but interacting subnetworks involved in component processes such as face perception and social reasoning, traversing large parts of the primate brain.

Coffee consumption decreases the connectivity of the posterior Default Mode Network (DMN) at rest

Habitual coffee consumers justify their life choices by arguing that they become more alert and increase motor and cognitive performance and efficiency; however, these subjective impressions still do not have a neurobiological correlation. Using functional connectivity approaches to study resting-state fMRI data in a group of habitual coffee drinkers, we herein show that coffee consumption decreased connectivity of the posterior default mode network (DMN) and between the somatosensory/motor networks and the prefrontal cortex, while the connectivity in nodes of the higher visual and the right executive control network (RECN) is increased after drinking coffee; data also show that caffeine intake only replicated the impact of coffee on the posterior DMN, thus disentangling the neurochemical effects of caffeine from the experience of having a coffee.

Teachers recruit mentalizing regions to represent learners' beliefs

Teaching enables humans to impart vast stores of culturally specific knowledge and skills. However, little is known about the neural computations that guide teachers' decisions about what information to communicate. Participants (N = 28) played the role of teachers while being scanned using fMRI; their task was to select examples that would teach learners how to answer abstract multiple-choice questions. Participants' examples were best described by a model that selects evidence that maximizes the learner's belief in the correct answer. Consistent with this idea, participants' predictions about how well learners would do closely tracked the performance of an independent sample of learners (N = 140) who were tested on the examples they had provided. In addition, regions that play specialized roles in processing social information, namely the bilateral temporoparietal junction and middle and dorsal medial prefrontal cortex, tracked learners' posterior belief in the correct answer. Our results shed light on the computational and neural architectures that support our extraordinary abilities as teachers.

No evidence of theory of mind reasoning in the human language network

Language comprehension and the ability to infer others' thoughts (theory of mind [ToM]) are interrelated during development and language use. However, neural evidence that bears on the relationship between language and ToM mechanisms is mixed. Although robust dissociations have been reported in brain disorders, brain activations for contrasts that target language and ToM bear similarities, and some have reported overlap. We take another look at the language-ToM relationship by evaluating the response of the language network, as measured with fMRI, to verbal and nonverbal ToM across 151 participants. Individual-participant analyses reveal that all core language regions respond more strongly when participants read vignettes about false beliefs compared to the control vignettes. However, we show that these differences are largely due to linguistic confounds, and no such effects appear in a nonverbal ToM task. These results argue against cognitive and neural overlap between language processing and ToM. In exploratory analyses, we find responses to social processing in the "periphery" of the language network-right-hemisphere homotopes of core language areas and areas in bilateral angular gyri-but these responses are not selectively ToM-related and may reflect general visual semantic processing.

How social information impacts action in rodents and humans: the role of the prefrontal cortex and its connections

Day-to-day choices often involve social information and can be influenced by prior social experience. When making a decision in a social context, a subject might need to: 1) recognize the other individual or individuals, 2) infer their intentions and emotions, and 3) weigh the values of all outcomes, social and non-social, prior to selecting an action. These elements of social information processing all rely, to some extent, on the medial prefrontal cortex (mPFC). Patients with neuropsychiatric disorders often have disruptions in prefrontal cortical function, likely contributing to deficits in social reasoning and decision making. To better understand these deficits, researchers have turned to rodents, which have revealed prefrontal cortical mechanisms for contending with the complex information processing demands inherent to making decisions in social contexts. Here, we first review literature regarding social decision making, and the information processing underlying it, in humans and patient populations. We then turn to research in rodents, discussing current procedures for studying social decision making, and underlying neural correlates.

Implicit Perception of Differences between NLP-Produced and Human-Produced Language in the Mentalizing Network

Natural language processing (NLP) is central to the communication with machines and among ourselves, and NLP research field has long sought to produce human-quality language. Identification of informative criteria for measuring NLP-produced language quality will support development of ever-better NLP tools. The authors hypothesize that mentalizing network neural activity may be used to distinguish NLP-produced language from human-produced language, even for cases where human judges cannot subjectively distinguish the language source. Using the social chatbots Google Meena in English and Microsoft XiaoIce in Chinese to generate NLP-produced language, behavioral tests which reveal that variance of personality perceived from chatbot chats is larger than for human chats are conducted, suggesting that chatbot language usage patterns are not stable. Using an identity rating task with functional magnetic resonance imaging, neuroimaging analyses which reveal distinct patterns of brain activity in the mentalizing network including the DMPFC and rTPJ in response to chatbot versus human chats that cannot be distinguished subjectively are conducted. This study illustrates a promising empirical basis for measuring the quality of NLP-produced language: adding a judge's implicit perception as an additional criterion.

Narcolepsy and emotions: Is there a place for a theory of mind approach?

Narcolepsy type 1 is a central disorder of hypersomnolence characterized by excessive daytime sleepiness, rapid eye movement sleep-related manifestations, and cataplexy. In the current literature there is general agreement regarding neural correlates of Narcolepsy type 1 that appear to be related to anatomical and functional abnormalities in the hypothalamic region. In the last two decades, researchers shed light on the neurological bases of cataplexy by focusing on the neurobiological correlates of emotions. Although the results of these studies differ, they all point to an impairment in the amygdala and hypothalamus functions that are known to be involved in emotional processing, suggesting an impairment in this domain in narcoleptic patients. Indeed, despite heterogeneous results, several studies showed that narcoleptic patients differed from healthy controls in processing emotional stimuli. From a behavioral point of view, these findings suggest that alterations in emotional processing may be driven, at least in part, by compensatory strategies to avoid or reduce the frequency of cataplexy attacks. Surprisingly, the only study exploring in NT1 the behavioural performances in emotional facial recognition found no differences between NT1 adults and controls. We hypothesize that narcoleptic patients may present an alteration in a more complex socio-cognitive ability that is related to emotional processing, namely Theory of Mind. This review aims to investigate the literature supporting this hypothesis and to propose possible future developments on this topic.

Functional near-infrared spectroscopy is a useful tool for multi-perspective psychobiological study of neurophysiological correlates of parenting behaviour

The quality of the relationship between caregiver and child has long-term effects on the cognitive and socio-emotional development of children. A process involved in human parenting is the bio-behavioural synchrony that occurs between the partners in the relationship during interaction. Through interaction, bio-behavioural synchronicity allows the adaptation of the physiological systems of the parent to those of the child and promotes the positive development and modelling of the child's social brain. The role of bio-behavioural synchrony in building social bonds could be investigated using functional near-infrared spectroscopy (fNIRS). In this paper we have (a) highlighted the importance of the quality of the caregiver-child relationship for the child's cognitive and socio-emotional development, as well as the relevance of infantile stimuli in the activation of parenting behaviour; (b) discussed the tools used in the study of the neurophysiological substrates of the parental response; (c) proposed fNIRS as a particularly suitable tool for the study of parental responses; and (d) underlined the need for a multi-systemic psychobiological approach to understand the mechanisms that regulate caregiver-child interactions and their bio-behavioural synchrony. We propose to adopt a multi-system psychobiological approach to the study of parental behaviour and social interaction.

Theory of mind tested by implicit false belief: a simple and full-fledged mental state attribution

About 40 years have passed since 'theory of mind (ToM)' research started. The false-belief test is used as a litmus test for ToM ability. The implicit false-belief test has renewed views of ToM in several disciplines, including psychology, psychiatry, and neuroscience. Many important questions have been considered via the paradigm of implicit false belief. We recently addressed the phylogenetic and physiological aspects of ToM using a version of this paradigm combined with the chemogenetic technique on Old World monkeys. We sought to create animal models for autism that exhibit behavioral phenotypes similar to human symptoms. The simultaneous manipulation of neural circuits and assessments of changes in phenotypes can help identify the causal neural substrate of ToM.

Late dominance of the right hemisphere during narrative comprehension

PET and fMRI studies suggest that auditory narrative comprehension is supported by a bilateral multilobar cortical network. The superior temporal resolution of magnetoencephalography (MEG) makes it an attractive tool to investigate the dynamics of how different neuroanatomic substrates engage during narrative comprehension. Using beta-band power changes as a marker of cortical engagement, we studied MEG responses during an auditory story comprehension task in 31 healthy adults. The protocol consisted of two runs, each interleaving 7 blocks of the story comprehension task with 15 blocks of an auditorily presented math task as a control for phonological processing, working memory, and attention processes. Sources at the cortical surface were estimated with a frequency-resolved beamformer. Beta-band power was estimated in the frequency range of 16-24 Hz over 1-sec epochs starting from 400 msec after stimulus onset until the end of a story or math problem presentation. These power estimates were compared to 1-second epochs of data before the stimulus block onset. The task-related cortical engagement was inferred from beta-band power decrements. Group-level source activations were statistically compared using non-parametric permutation testing. A story-math contrast of beta-band power changes showed greater bilateral cortical engagement within the fusiform gyrus, inferior and middle temporal gyri, parahippocampal gyrus, and left inferior frontal gyrus (IFG) during story comprehension. A math-story contrast of beta power decrements showed greater bilateral but left-lateralized engagement of the middle frontal gyrus and superior parietal lobule. The evolution of cortical engagement during five temporal windows across the presentation of stories showed significant involvement during the first interval of the narrative of bilateral opercular and insular regions as well as the ventral and lateral temporal cortex, extending more posteriorly on the left and medially on the right. Over time, there continued to be sustained right anterior ventral temporal engagement, with increasing involvement of the right anterior parahippocampal gyrus, STG, MTG, posterior superior temporal sulcus, inferior parietal lobule, frontal operculum, and insula, while left hemisphere engagement decreased. Our findings are consistent with prior imaging studies of narrative comprehension, but in addition, they demonstrate increasing right-lateralized engagement over the course of narratives, suggesting an important role for these right-hemispheric regions in semantic integration as well as social and pragmatic inference processing.

Perceiving social injustice during arrests of Black and White civilians by White police officers: An fMRI investigation

From social media to courts of law, recordings of interracial police officer-civilian interactions are now widespread and publicly available. People may be motivated to preferentially understand the dynamics of these interactions when they perceive injustice towards those whose communities experience disproportionate policing relative to others (e.g., non-White racial/ethnic groups). To explore these questions, two studies were conducted (study 1 neuroimaging n = 69 and study 2 behavioral n = 58). The fMRI study examined White participants' neural activity when viewing real-world videos with varying degrees of aggression or conflict of White officers arresting a Black or White civilian. Activity in brain regions supporting social cognition was greater when viewing Black (vs. White) civilians involved in more aggressive police encounters. Additionally, although an independent sample of perceivers rated videos featuring Black and White civilians as similar in overall levels of aggression when civilian race was obscured, participants in the fMRI study (where race was not obscured) rated officers as more aggressive and their use of force as less legitimate when the civilian was Black. In study 2, participants who had not viewed the videos also reported that they believe police are generally more unjustly aggressive towards Black compared with White civilians. These findings inform our understanding of how perceptions of conflict with the potential for injustice shape social cognitive engagement when viewing arrests of Black and White individuals by White police officers.

Differential Tracking of Linguistic vs. Mental State Content in Naturalistic Stimuli by Language and Theory of Mind (ToM) Brain Networks

Language and social cognition, especially the ability to reason about mental states, known as theory of mind (ToM), are deeply related in development and everyday use. However, whether these cognitive faculties rely on distinct, overlapping, or the same mechanisms remains debated. Some evidence suggests that, by adulthood, language and ToM draw on largely distinct-though plausibly interacting-cortical networks. However, the broad topography of these networks is similar, and some have emphasized the importance of social content / communicative intent in the linguistic signal for eliciting responses in the language areas. Here, we combine the power of individual-subject functional localization with the naturalistic-cognition inter-subject correlation approach to illuminate the language-ToM relationship. Using functional magnetic resonance imaging (fMRI), we recorded neural activity as participants (n = 43) listened to stories and dialogues with mental state content (+linguistic, +ToM), viewed silent animations and live action films with mental state content but no language (-linguistic, +ToM), or listened to an expository text (+linguistic, -ToM). The ToM network robustly tracked stimuli rich in mental state information regardless of whether mental states were conveyed linguistically or non-linguistically, while tracking a +linguistic / -ToM stimulus only weakly. In contrast, the language network tracked linguistic stimuli more strongly than (a) non-linguistic stimuli, and than (b) the ToM network, and showed reliable tracking even for the linguistic condition devoid of mental state content. These findings suggest that in spite of their indisputably close links, language and ToM dissociate robustly in their neural substrates-and thus plausibly cognitive mechanisms-including during the processing of rich naturalistic materials.

The marmoset as a model for investigating the neural basis of social cognition in health and disease

Social-cognitive processes facilitate the use of environmental cues to understand others, and to be understood by others. Animal models provide vital insights into the neural underpinning of social behaviours. To understand social cognition at even deeper behavioural, cognitive, neural, and molecular levels, we need to develop more representative study models, which allow testing of novel hypotheses using human-relevant cognitive tasks. Due to their cooperative breeding system and relatively small size, common marmosets (Callithrix jacchus) offer a promising translational model for such endeavours. In addition to having social behavioural patterns and group dynamics analogous to those of humans, marmosets have cortical brain areas relevant for the mechanistic analysis of human social cognition, albeit in simplified form. Thus, they are likely suitable animal models for deciphering the physiological processes, connectivity and molecular mechanisms supporting advanced cognitive functions. Here, we review findings emerging from marmoset social and behavioural studies, which have already provided significant insights into executive, motivational, social, and emotional dysfunction associated with neurological and psychiatric disorders.

The effects of hypnotherapy compared to cognitive behavioral therapy in depression: a NIRS-study using an emotional gait paradigm

Hypnotherapy (HT) is a promising approach to treating depression, but so far, no data are available on the neuronal mechanisms of functional reorganization after HT for depressed patients. Here, 75 patients with mild to moderate depression, who received either HT or Cognitive Behavioral Therapy (CBT), were measured before and after therapy using functional near-infrared spectroscopy. We investigated the patients' cerebral activation during an emotional human gait paradigm. Further, rumination was included as predictor. Our results showed a decrease of functional connectivity (FC) between two regions that are crucial to emotional processing, the Extrastriate Body Area (EBA) and the Superior Temporal Sulcus (STS). This FC decrease was traced back to an activation change throughout therapy in the right STS, not the EBA and was only found in the HT group, depending on rumination: less ruminating HT patients showed a decrease in right STS activation, while highly ruminating patients showed an increase. We carefully propose that this activation change is due to the promotion of emotional experiences during HT, while in CBT a focus lay on activating behavior and changing negative cognitions. HT seemed to have had differential effects on the patients, depending on their rumination style: The increase of right STS activation in highly ruminating patients might mirror the improvement of impaired emotional processing, whilst the decrease of activation in low ruminating patients might reflect a dismissal of an over-compensation, associated with a hyperactivity before therapy. We conclude that HT affects emotional processing and this effect is moderated by rumination.

Can we rewire criminal mind via non-invasive brain stimulation of prefrontal cortex? Insights from clinical, forensic and social cognition studies

Non-compliance with social and legal norms and regulations represents a high burden for society. Social cognition deficits are frequently called into question to explain criminal violence and rule violations in individuals diagnosed with antisocial personality disorder (APD), borderline personality disorder (BPD), and psychopathy. In this article, we proposed to consider the potential benefits of non-invasive brain stimulation (NIBS) to rehabilitate forensic population. We focused on the effects of NIBS of the prefrontal cortex, which is central in social cognition, in modulating aggression and impulsivity in clinical disorders, as well as in forensic population. We also addressed the effect of NIBS on empathy, and theory of mind in non-clinical and/or prison population. The reviewed data provide promising evidence on the beneficial effect of NIBS on aggression/impulsivity dyscontrol and social cognitive functions, suggesting its relevance in promoting reintegration of criminals into society.

Social synchronization of brain activity increases during eye-contact

Humans make eye-contact to extract information about other people’s mental states, recruiting dedicated brain networks that process information about the self and others. Recent studies show that eye-contact increases the synchronization between two brains but do not consider its effects on activity within single brains. Here we investigate how eye-contact affects the frequency and direction of the synchronization within and between two brains and the corresponding network characteristics. We also evaluate the functional relevance of eye-contact networks by comparing inter- and intra-brain networks of friends vs. strangers and the direction of synchronization between leaders and followers. We show that eye-contact increases higher inter- and intra-brain synchronization in the gamma frequency band. Network analysis reveals that some brain areas serve as hubs linking within- and between-brain networks. During eye-contact, friends show higher inter-brain synchronization than strangers. Dyads with clear leader/follower roles demonstrate higher synchronization from leader to follower in the alpha frequency band. Importantly, eye-contact affects synchronization between brains more than within brains, demonstrating that eye-contact is an inherently social signal. Future work should elucidate the causal mechanisms behind eye-contact induced synchronization.

Friends making eye-contact have higher inter-brain synchronization than strangers. Eye-contact affects neural synchronization between brains more than within a brain, highlighting that eye-contact is an inherently social signal.

The Relationship Among Mentalization, Mindfulness, Working Memory, and Schizotypal Personality Traits in the General Population

Individuals with high schizotypal traits are less able to observe, describe, and monitor inner feelings, thoughts, and experiences, commonly referred to as mindfulness and mentalization. High schizotypy is also associated with impaired working memory (WM). However, the relationship among mindfulness, mentalization, WM, and schizotypal traits is unknown. Three hundred individuals from the community (mean age: 38.0 years, SD = 10.5; 49.3% women) completed questionnaires examining schizotypal traits, mindfulness, and mentalization and performed working memory tasks. Results revealed that mentalization was a general predictor of schizotypal traits, including unusual experiences, cognitive disorganization, introverted anhedonia, and impulsive nonconformity, when the effect of mindfulness and working memory was controlled. We also found a positive correlation between mindfulness and mentalization. Low mindfulness and mentalization performances were associated with high schizotypy. However, poor working memory was only weakly linked to cognitive disorganization and introverted anhedonia. These findings suggest that weak mentalization is a core feature of schizotypy independent of mindfulness and working memory.

Processing of linguistic deixis in people with schizophrenia, with and without auditory verbal hallucinations

Auditory verbal hallucinations (AVH) are a key symptom of schizophrenia (SZ) defined by anomalous perception of speech. Anomalies of processing external speech stimuli have also been reported in people with AVH, but it is unexplored which specific dimensions of language are processed differently. Using a speech perception task (passive listening), we here targeted the processing of deixis, a key dimension of language governing the contextual anchoring of speech in interpersonal context. We designed naturalistic speech stimuli that were either non-personal and fact-reporting ('low-deixis' condition), or else involved rich deictic devices such as the grammatical first and second persons, direct questions, and vocatives ('high-deixis'). We asked whether neural correlates of deixis obtained with fMRI would distinguish patients with and without frequent hallucinations (AVH + vs AVH-) from controls and each other. Results showed that high-deixis relative to low-deixis was associated with clusters of increased activation in the bilateral middle temporal gyri extending into the temporal poles and the inferior parietal cortex, in all groups. The AVH + and AVH- groups did not differ. When unifying them, the SZ group as a whole showed altered activity in the precuneus, midline regions and inferior parietal cortex. These results fail to confirm deictic processing anomalies specific to patients with AVH, but reveal such anomalies across SZ. Hypoactivation of this network may relate to a cognitive mechanism for attributing and anchoring thought and referential speech content in context.

An attachment-based framework for disordered personality development: Implications for intersubjective psychodynamic psychotherapy

Infant-caregiver dyads show high heterogeneity in terms of compatibility. Several lines of evidence indicate that the modalities by which areas of good and poor fit were emotionally recognized and managed by caregivers influence the infant's personality development, the integration of their personality traits, the overall sense of authenticity, as well as the modalities of transference that typically manifest during psychodynamic psychotherapy. Within an intersubjective framework, the relationship between patient and psychotherapist will inevitably recreate compatibility issues, although the specific areas of incompatibility will likely differ from the scenarios present in the caregiver relationship. In other words, emotional friction may originate from personality traits that were not problematic in the first place. The author hypothesizes that disclosure of the challenges associated with the management of areas of incompatibility will not only promote emotional honesty within the dyad, but also offer an excellent opportunity for introjection. Such disclosures are not at risk of being interpreted as an attempt to build an intersubjective experience, but represent a window into authenticity, which in turn enables patients to develop awareness of their personality and relational traits, along with the challenges and vulnerabilities that occur when such traits interface with otherness.

A Precuneal Causal Loop Mediates External and Internal Information Integration in the Human Brain

Human brains interpret external stimuli based on internal representations. One untested hypothesis is that the default-mode network (DMN), widely considered responsible for internally oriented cognition, can decode external information. Here, we posit that the unique structural and functional fingerprint of the precuneus (PCu) supports a prominent role for the posterior part of the DMN in this process. By analyzing the imaging data of 100 participants performing two attention-demanding tasks, we found that the PCu is functionally divided into dorsal and ventral subdivisions. We then conducted a comprehensive examination of their connectivity profiles and found that at rest, both the ventral PCu (vPCu) and dorsal PCu (dPCu) are mainly connected with the DMN but also are differentially connected with internally oriented networks (IoN) and externally oriented networks (EoN). During tasks, the double associations between the v/dPCu and the IoN/EoN are correlated with task performance and can switch depending on cognitive demand. Furthermore, dynamic causal modeling (DCM) revealed that the strength and direction of the effective connectivity (EC) between v/dPCu is modulated by task difficulty in a manner potentially dictated by the balance of internal versus external cognitive demands. Our study provides evidence that the posterior medial part of the DMN may drive interactions between large-scale networks, potentially allowing access to stored representations for moment-to-moment interpretation of an ever-changing environment.SIGNIFICANCE STATEMENT The default-mode network (DMN) is widely known for its association with internalized thinking processes, e.g., spontaneous thoughts, which is the most interesting but least understood component in human consciousness. The precuneus (PCu), a posteromedial DMN hub, is thought to play a role in this, but a mechanistic explanation has not yet been established. In this study we found that the associations between ventral PCu (vPCu)/dorsal PCu (dPCu) subdivisions and internally oriented network (IoN)/externally oriented network (EoN) are flexibly modulated by cognitive demand and correlate with task performance. We further propose that the recurrent causal connectivity between the ventral and dorsal PCu supports conscious processing by constantly interpreting external information based on an internal model, meanwhile updating the internal model with the incoming information.

Learning positive social information reduces racial bias as indexed by N400 response

The present study used EEG/ERPs to detect the activation of implicit stereotypical representations associated to other-race (OR) people and the modulation of such activation through the previous presentation of positive vs. neutral social information. Electrophysiological signals were recorded in 40 Italian Caucasian participants, unaware of the overall study's purpose. They were presented with 285 sentences that could either violate, non-violate (e.g., "the Roma girl was involved in a robbery) or be neutral with regard to stereotypical concepts concerning other-race people (e.g. Asians, Africans, Arabic). ERPs were time-locked to the terminal words. Prior to the sentence reading task, participants were exposed to a 10 minutes colourful video documentary. While the experimental group was presented a video containing images picturing other-race characters involved in "prestigious" activities that violated stereotypical negative assumptions (e.g. a black neurosurgeon leading a surgery team), the control group viewed a neutral documentary about flora and fauna. EEG signals were then recorded during the sentence reading task to explore whether the previous exposure to the experimental video could modulate the detection of incongruence in the sentences violating stereotypes, as marked by the N400 response. A fictitious task was adopted, consisted in detecting rare animal names. Indeed, only the control group showed a greater N400 response (350-550 ms) to words incongruent with ethnic stereotypes compared to congruent and neutral ones, thus suggesting the presence of a racial bias. No N400 response was found for the experimental group, suggesting a lack of negative expectation for OR individuals. The swLORETA inverse solution, performed on the prejudice-related N400 showed that the Inferior Temporal and the Superior and Middle Frontal Gyri were the strongest N400 intra-cortical sources. Regardless of the experimental manipulation, Congruent terminal words evoked a greater P300 response (500-600 ms) compared to incongruent and neutral ones and a late frontal positivity (650-800 ms) was found to be larger to sentences involving OR than own-race characters (either congruent or incongruent with the prejudice) thus possibly indicating bias-free perceptual in-group/out-group categorization processes. The data showed how it is possible to modulate a pre-existing racial prejudice (as reflected by N400 effect) through exposure to positive media-driven information about OR people. Further follow-up studies should determine the duration in time, and across contexts, of this modulatory effect.

Are We Right about the Right TPJ? A Review of Brain Stimulation and Social Cognition in the Right Temporal Parietal Junction

In the past decade, the functional role of the TPJ (Temporal Parietal Junction) has become more evident in terms of its contribution to social cognition. Studies have revealed the TPJ as a ‘distinguisher’ of self and other with research focused on non-clinical populations as well as in individuals with Autism and Type I Schizophrenia. Further research has focused on the integration of self-other distinctions with proprioception. Much of what we now know about the causal role of the right TPJ derives from TMS (Transcranial Magnetic Stimulation), rTMS repetitive Transcranial Magnetic Stimulation), and tDCS (transcranial Direct Cortical Stimulation). In this review, we focus on the role of the right TPJ as a moderator of self, which is integrated and distinct from ‘other’ and how brain stimulation has established the causal relationship between the underlying cortex and agency.

Measuring social cognition in frontotemporal lobar degeneration: a clinical approach

Alterations in social cognition, a broad term indicating our ability to understand others and adapt our behavior accordingly, have been the focus of growing attention in the past years. Some neurological conditions, such as those belonging to the frontotemporal lobar degeneration (FTLD) spectrum, are associated to varying degrees with social cognition deficits, encompassing problems with theory of mind (ToM), empathy, perception of social stimuli, and social behavior. In this review, we outline a clinical framework for the evaluation of social cognition and discuss its role in the assessment of patients affected by a range of FTLD conditions.

Social cognition in the FTLD spectrum: evidence from MRI

Over the past few years, there has been great interest in social cognition, a wide term referring to the human ability of understanding others' emotions, thoughts, and intentions, to empathize with them and to behave accordingly. While there is no agreement on the classification of social cognitive processes, they can broadly be categorized as consisting of theory of mind, empathy, social perception, and social behavior. The study of social cognition and its relative deficits is increasingly assuming clinical relevance. However, the clinical and neuroanatomical correlates of social cognitive alterations in neurodegenerative conditions, such as those belonging to the frontotemporal lobar (FTLD) spectrum, are not fully established. In this review, we describe the current understanding of social cognition impairments in different FTLD conditions with respect to MRI.

The Intentional Stance Test-2: How to Measure the Tendency to Adopt Intentional Stance Towards Robots

In human-robot interactions, people tend to attribute to robots mental states such as intentions or desires, in order to make sense of their behaviour. This cognitive strategy is termed "intentional stance". Adopting the intentional stance influences how one will consider, engage and behave towards robots. However, people differ in their likelihood to adopt intentional stance towards robots. Therefore, it seems crucial to assess these interindividual differences. In two studies we developed and validated the structure of a task aiming at evaluating to what extent people adopt intentional stance towards robot actions, the Intentional Stance task (IST). The Intentional Stance Task consists in a task that probes participants' stance by requiring them to choose the plausibility of a description (mentalistic vs. mechanistic) of behaviour of a robot depicted in a scenario composed of three photographs. Results showed a reliable psychometric structure of the IST. This paper therefore concludes with the proposal of using the IST as a proxy for assessing the degree of adoption of the intentional stance towards robots.

Dissecting functional contributions of the social brain to strategic behavior

Social interactions routinely lead to neural activity in a "social brain network" comprising, among other regions, the temporoparietal junction (TPJ) and the dorsomedial prefrontal cortex (dmPFC). But what is the function of these areas? Are they specialized for behavior in social contexts or do they implement computations required for dealing with any reactive process, even non-living entities? Here, we use fMRI and a game paradigm separating the need for these two aspects of cognition. We find that most social-brain areas respond to both social and non-social reactivity rather than just to human opponents. However, the TPJ shows a dissociation from the dmPFC: its activity and connectivity primarily reflect context-dependent outcome processing and reactivity detection, while dmPFC engagement is linked to implementation of a behavioral strategy. Our results characterize an overarching computational property of the social brain but also suggest specialized roles for subregions of this network.

Measuring advanced theory of mind: Do story-based tasks work?

INTRODUCTION

Although much is known about theory of mind (ToM) development during childhood, data on how these skills develop in adolescence is scarce. This cavity is due in part to the limited knowledge about measures of advanced theory of mind.

METHODS

The study examined the relation among six common story-based tasks designed to measure advanced ToM in two age groups of Polish adolescents: early (13-year-olds; 78 girls) and late (16-year-olds; 143 girls) adolescents.

RESULTS

Factor models for individual tasks were constructed, followed by an examination of the underlying structure that explained the variability of factor scores. Only in half of the tasks, the results revealed an age-related increase in advanced ToM. Contrary to expectation, results showed a lack of correlations among story-based advanced ToM tasks in the two adolescent groups.

CONCLUSIONS

The results suggest a lack of coherence among advanced story-based ToM tasks and the need for further development of reliable and valid advanced ToM measures which are sensitive enough to show increasingly complex social reasoning abilities in adolescence.

Impaired Perception of Unintentional Transgression of Social Norms after Prefrontal Cortex Damage: Relationship to Decision Making, Emotion Recognition, and Executive Functions

OBJECTIVE

Patients with prefrontal cortex damage often transgress social rules and show lower accuracy in identifying and explaining inappropriate social behavior. The objective of this study was to examine the relationship between the ability to perceive other unintentional transgressions of social norms and both decision making and emotion recognition as these abilities are critical for appropriate social behavior.

METHOD

We examined a group of patients with focal prefrontal cortex damage (N = 28) and a group of matched control participants (N = 28) for their abilities to detect unintentional transgression of social norms using the "Faux-Pas" task of theory of mind, to make advantageous decisions on the Iowa gambling task, and to recognize basic emotions on the Ekman facial affect test.

RESULTS

The group of patients with frontal lobe damage was impaired in all of these tasks compared with control participants. Moreover, all the "Faux-Pas", Iowa gambling, and emotion recognition tasks were significantly associated and predicted by executive measures of inhibition, flexibility, or planning. However, only measures from the Iowa gambling task were associated and predicted performance on the "Faux-Pas" task. These tasks were not associated with performance in recognition of basic emotions. These findings suggest that theory of mind, executive functions, and decision-making abilities act in an interdependent way for appropriate social behavior. However, theory of mind and emotion recognition seem to have distinct but additive effects upon social behavior. Results from VLSM analysis also corroborate these data by showing a partially overlapped prefrontal circuitry underlying these cognitive domains.

The Brain Structure and Intrinsic Characters of Falsification Thinking in Conditional Proposition Testing

Wason's selection task (WST) as a representative of the field of conditional proposition testing has been explored by multiple disciplines for more than 50 years, but the neural basis of its key falsification thinking remains unclear. Considering that the accuracy of individuals in WST has stability over time, we believe that falsification thinking has a specific brain structural basis and intrinsic neural characteristics. To test this hypothesis, we studied individuals who were able to complete the WST using T1-weighted MRI (using voxel-based morphology (VBM) analysis) and resting electroencephalogram (EEG) (using microstate analysis, which can reflect stable cognitive characteristics of individuals) techniques. First, VBM analysis found that, compared with the verification group, the gray matter volume (GMV) of the left inferior temporal gyrus and the right superior temporal region of the falsification group was larger, whereas the GMV in the cerebellum of the verification group was significantly larger than that of the falsification group. Subsequently, the results of the microstate analysis of the resting EEG data showed that the contribution of class A of the falsification group, which is closely related to the language network, is significantly higher than that of the verification group. Our structural MRI and resting EEG results consistently show that the structure and intrinsic activity pattern of the temporal lobe in individuals with falsification thinking are specific. Furthermore, the findings may provide potential insights into the role of the temporal lobe (which is also a brain region of language processing) in thought.

The neural basis of decision-making during time-based inter-role conflict

Time-based inter-role conflict is a type of conflict in which individuals are faced with simultaneous role pressures from different role domains. Some researchers have applied a decision-making perspective to investigate inter-role conflict; however, the neural basis of inter-role decision-making has rarely been discussed. In the current study, a collection of inter-role conflict scenarios with high/low levels of conflict were selected, and sixty college students were recruited to make choices between the conflicting student and family/friend demands in each scenario while their brain activities were recorded using functional magnetic resonance imaging. Blood oxygen level-dependent conjunction analysis found that making decisions in inter-role conflict activated brain areas, including the bilateral medial prefrontal cortex (mPFC), bilateral temporoparietal conjunction (TPJ), bilateral posterior cingulate cortex (PCC), and bilateral anterior temporal lobe. Direct comparisons between high versus low conflict situations showed increased activation of the left dorsal anterior cingulate. A generalized psychophysiological interaction analysis further showed enhanced connectivity among the mPFC, PCC, and bilateral TPJ in high conflict versus low conflict situations. Our study improved understanding of the relationship between brain and inter-role decision-making and provided an empirical examination on the psychological process propositions.

Interracial Contact Differentially Shapes Brain Networks Involved in Social and Non-Social Judgments From Faces: A Combination of Univariate and Multivariate Approaches

The present work explores the relationship between interracial contact and the neural substrates of explicit social and non-social judgments about both racial ingroup and outgroup targets. Convergent evidence from univariate and multivariate partial least squares (PLS) analyses reveals that contact shapes the recruitment of brain regions involved in social cognition similarly for both ingroup and outgroup targets. Results support the hypothesis that increased contact is associated with generalized changes in social cognition toward both ingroup and outgroup faces. Specifically, regardless of target race, low- and average-contact perceivers showed the typically observed increased recruitment of temporoparietal junction and dorsomedial prefrontal cortex during social compared to perceptual judgments. However, high-contact perceivers did not show selective recruitment of these brain regions for social judgments. Complimenting univariate results, multivariate PLS analyses reveal that greater perceiver contact leads to reduced co-activation in networks of brain regions associated with face processing (e.g. fusiform gyrus) and salience detection (e.g. anterior cingulate cortex and insula). Across univariate and multivariate analyses, we found no evidence that contact differentially impacted cross-race face perception. Instead, when performing either a social or a novel perceptual task, interracial contact appears to broadly shape how perceivers engage with all faces.

The Impact of Social Cognition on the Real-Life of People with Epilepsy

Background. Previous research has demonstrated the impairment of social cognition (SC) in people with epilepsy. It is associated with worse social functioning and quality of life; however, the influence on real-life outcomes is unknown. The purpose of this study was to investigate how SC is associated with epilepsy variables and real-life outcomes (education, employment and relationships) among patients with epilepsy (PWE). Methods. Eighty-one PWE completed tasks of theory of mind (ToM) (faux pas recognition (FPRT) and Happé Strange Stories test (HST)) and emotion recognition (ER) (Reading of the Mind in the Eyes (RMET)). Variables reflecting their education, employment and relationship status were treated as endpoints in search of association with SC. Data from a matched group (n = 30) of healthy controls (HCs) were used for comparison of ToM abilities. Results. ToM scores were lower among PWE as compared to HCs (U = 1816.0, p < 0.0001 (HST), U = 1564.5, p = 0.020 (FPRT)). All SC tests were associated with the level of education (OR = 1.22, 95% confidence interval (CI) = 1.09 to 1.36 (RMET), OR = 1.20, 95% CI = 1.02 to 1.40 (HST), OR = 0.93, 95% CI = 0.87 to 1.00 (FPRT)). The results of ToM and ER testing were not associated with employment (χ² = 33.423, p < 0.0001) if adjusted for the level of education (B = 0.804, OR = 2.23 (95% CI = 1.33 to 3.76), p = 0.002). SC abilities did not differ between PWE who were single and those in a relationship (U = 858.5, p = 0.541 (HST)), t= −1.236, p = 0.220 (RMET), U = 909.5, p = 0.271 (FPRT)). Conclusion. Better social cognition skills are linked to a higher level of education among PWE. SC probably has less influence on professional achievements and interpersonal relationships.

Enhanced insightfulness and neural activation induced by metaphorical solutions to appropriate mental distress problems

Although the neural correlates of novelty and appropriateness of creative insight during cognitive tasks have been investigated in several studies, they have not been examined during mental distress in a psychotherapeutic setting. This study aimed to reveal the promoting effects of novelty and appropriateness processing on therapeutic insight in a micro-psychotherapeutic setting. We examined the effects of appropriateness (between-subject factor: appropriateness group, 20 participants; inappropriateness group, 21 participants) by manipulating the preceding negative scenarios that either fit or did not fit the subsequent solutions, and those of novelty (within-subject factor) by varying the linguistic expressions for describing solutions (metaphorical, literal, or problem-restatement). Event-related functional magnetic resonance images were collected. We found the following effects: an interactive effect of the two factors on insightfulness and activation in the bilateral hippocampus and amygdala, right superior frontal gyrus, and left superior/middle temporal gyrus; a simple effect of novelty on activation in the bilateral inferior frontal gyrus, fusiform gyrus, and inferior/middle occipital gyrus; and a simple effect of appropriateness on activation in the left inferior parietal lobule. Our findings indicate that solutions with high novelty and appropriateness generate the highest levels of therapeutic insightfulness as well as the strongest activation in the hippocampus and amygdala, which may be involved in episodic memory encoding.