The Use of "Literary Fiction" to Promote Mentalizing Ability

Possible Worlds Theory: How the Imagination Transcends and Recreates Reality

The imagination is central to human social life but undervalued worldwide and underexplored in psychology. Here, we offer Possible Worlds Theory as a synthetic theory of the imagination. We first define the imagination, mapping the mental states it touches, from dreams and hallucinations to satire and fiction. The conditions that prompt people to imagine range from trauma to physical and social deprivation, and they challenge the sense of reality, stirring a need to create possible worlds. We theorize about four cognitive operations underlying the structure of the mental states of the imagination. We then show how people embody the imagination in social behaviors such as pretense and ritual, which give rise to experiences of a special class of feelings defined by their freedom from reality. We extend Possible Worlds Theory to four domains-play, spirituality, morality, and art-and show how in flights of the imagination people create new social realities shared with others.

Beyond beauty: Does visual art facilitate social cognitive skills?

Engaging with art can move individuals through a myriad of emotions, provoke reflective thoughts, and lead to new ideas. Could art also influence interpersonal outcomes pertaining to the ways we interact with others and navigate the social world, that is, our suite of social cognitive skills? Here, we focus on visual art to explore the effect of art engagement on personal aesthetic experience and social cognitive skills. Across two studies, using veridical paintings and matched non-art photos, we examined the effect of art engagement on emotional (e.g., awe, being moved) and eudaimonic experiences (e.g., reflective thoughts), as well as social cognitive skills pertaining to Theory of Mind (ToM) and recognition of other's emotions. Further, we varied the depth with which participants engaged with the experiences of the characters in the artworks, to assess whether deep social information processing could boost the effect of art engagement on social cognitive skills. Our findings showed that art engagement altered personal aesthetic experience through changes in emotional and eudaimonic outcomes. However, we did not find any support for the effect of art engagement on social cognitive skills: Neither engaging with art, nor art in combination with deep social information processing, influenced performance on social cognitive skills of ToM and emotion recognition. The effect of art engagement on personal aesthetic experience and the absence of effect on social cognitive skills highlight the nuanced nature of individuals' interactions with art. We discuss these results considering the varied ways of engagement with different artforms and in relation to different operationalizations of social cognitive skills.

Designing, implementation and evaluation of story reading: a solution to increase general empathy in medical students

BACKGROUND

Communication and mutual understanding among healthcare providers is a significant concern within the healthcare system, and enhancing empathy is one way to foster effective communication and mutual understanding. The aim of this research is to evaluate and compare the impact of story reading on the level of empathy in medical students at Mazandaran University of Medical Sciences.

METHODS

The study employed an intervention educational design (a quasi-experimental), with a convenience sample of 51 medical students selected as the statistical population. The process of story reading was conducted over six two-hour virtual sessions in the students' classroom, spanning six weeks. Selected stories were discussed in an online virtual class under the supervision of an instructor, focusing on story elements. To assess students' empathy in this educational program, the Davis General Empathy Questionnaire was administered before each of the six sessions, after, and one week later at the end of the course. Statistical analysis of the collected data was performed using repeated measures analysis of variance and Bonferroni's post hoc test through SPSS version 28 software, with a significance level set at 0.05.

RESULTS

The findings revealed that 27 participants (58.7%) were female students, with the remaining being male students, having an average age of 19.5 ± 0.86 years. The level of general empathy among the students significantly increased after the intervention compared to before the intervention (P<0.001). Furthermore, the analysis of variance with repeated measures indicated a significant effect of the story reading program on enhancing empathy in terms of emotional and cognitive transfer among students in the intervention group (P<0.001).

CONCLUSIONS

The research findings suggest that the story reading program effectively enhances the overall sense of empathy among medical students at the University of Medical Sciences. Therefore, implementing this method in universities, higher education centers, libraries, and psychology centers for teaching empathy can be valuable in fostering empathy skills and improving healthcare.

Normative values and diagnostic optimisation of three social cognition measures for autism and schizophrenia diagnosis in a healthy adolescent and adult sample

Awareness of the importance of assessing social cognition skills under conditions showing atypical social behaviours has increased over the years. However, the evaluation of the psychometric properties of the measures and the availability of normative values for the clinical context are still limited. This study aims to revise, provide normative values, and evaluate the clinical validity of the Italian version of three social cognition measures: Advanced Theory of Mind (A-ToM) task, the Emotion Attribution Task (EAT), and the Social Situation Task (SST). Measures were administered to 580 adolescents and adult healthy controls (age range 14-50). We performed differential item functioning and Rasch analysis to revise each task, so normative data of the revised measures were calculated. Moreover, the revised measures were administered to 38 individuals with autism spectrum disorder (ASD) and 35 individuals with schizophrenia spectrum disorders (SSD): ASD and SSD were matched by age, gender, and IQ with a control sample to evaluate clinical validity. ROC analysis showed that the SST is the best measure differentiating between healthy and clinical groups, compared to the A-ToM (AUCASD = 0.70; AUCSSD = 0.65) and EAT (AUCASD = 0.67; AUCSSD = 0.50), which showed poorer performance. For SSD diagnosis, two SST subscales (Violation and Gravity score) indicated the best accuracy (AUCs of 0.88 and 0.84, respectively); for the ASD diagnosis, we propose a combined score between the SST subscale and A-ToM (AUC = 0.86). The results suggest that the proposed measures can be used to support the diagnostic process and clinical practice.

Autism and intention attribution test: a non-verbal evaluation with comic strips

BACKGROUND

Despite autism spectrum disorder (ASD) and mentalization being two words often associated in the literature, the assessment of this ability in individuals with ASD in the clinical setting is still limited. Indeed, there are no standardized Theory of Mind (ToM) tests that are adaptable to different cognitive profiles, such as individuals with language poverty, and intellectual or memory impairments. This study proposes a non-verbal test (Intentions Attribution-Comic Strip Test; IA-CST) to evaluate the ability to infer the intentions of others, a basic component of ToM, in the clinical setting.

METHOD

In Study 1, the test was administered to 261 healthy individuals and we performed structural validation using Exploratory Graph Analysis. In Study 2, the final version of the test was administered to 32 individuals with ASD to assess the known group validity of the measure by comparing their scores with a sample of IQ-matched controls. Moreover, we performed logistic regression and ROC curve to preliminarily assess the diagnostic performance of the IA-CST.

RESULTS

The IA-CST resulted in a 3-dimension measure with good structural stability. Group comparison indicated that the ASD group shows significantly lower performance in intention attribution but not in inferring causal consequences. The test demonstrated known group validity and that, preliminarily, it is suitable for implementation within the clinical practice.

CONCLUSIONS

The results support the IA-CST as a valid non-verbal task for evaluating intentions attribution in the clinical setting. Difficulties in ToM are early and relevant in ASD, so assessing these aspects is valuable for structuring individualized and evidence-based interventions.

Is reading fiction associated with a higher mind-reading ability? Two conceptual replication studies in Japan

Previous studies have revealed that reading fiction is associated with dispositional empathy and theory-of-mind abilities. Earlier studies established a correlation between fiction reading habits and the two measures of social cognition: trait fantasy (i.e., the tendency to transpose oneself into fictitious characters) and performance on the Reading the Mind in the Eyes Test (RMET; a test of the ability to identify others' mental states based on their eyes). Recently, experimental studies have shown that brief exposure to fiction enhances RMET performance. Nevertheless, these studies have been conducted only in Western countries, and few published studies have investigated these relationships in Asian countries. This research aims to address this gap. Study 1, which involved 338 Japanese undergraduates, conceptually replicated the previously reported correlations between fiction reading and fantasy and RMET scores (after statistically controlling for the effect of outliers). However, Study 2, which involved 304 Japanese undergraduates, failed to replicate the causal relationship. Participants read an excerpt either from literary fiction or from nonfiction, or engaged in a calculation task, before completing the RMET. Brief exposure to literary fiction did not increase the RMET score. In sum, this study replicated the associations of fiction reading with fantasy and RMET scores in Japan, but failed to replicate the causal relationship.

Adolescent leisure reading and its longitudinal association with prosocial behavior and social adjustment

Reading is a popular leisure activity for children, teenagers, and adults. Several theories agree that reading might improve social cognition, but the empirical evidence remains tentative, with research on adolescents especially lacking. We employed a very large, and nationally representative, longitudinal dataset from the National Educational Panel Study (NEPS) in Germany to examine this hypothesis. Specifically, we tested whether reading prospectively predicted future self-reported prosocial behavior and social adjustment in adolescents, controlling for a number of covariates. Two-way cross-lagged panel analyses probed the longitudinal relationship between leisure reading and these social outcomes from Grade 6 to Grade 9. In addition, we examined the effect of cumulative reading experience across Grades 5-8 on future social outcomes, using structural equation modeling. We also explored the unique contributions of cumulative reading experience in different literary genres (classic literature, popular literature, nonfiction, comic books). Cumulative reading in general did not predict future prosocial behavior and social adjustment. However, cumulative reading of modern classic literature was positively associated with later prosocial behavior and social adjustment. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on 08 November 2021. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/KSWY7 .

The effect of reading literary fiction on the theory of mind skills among persons with schizophrenia and normal controls

Introduction

Recent research data suggest that theory of mind (ToM) skills may improve after reading literary fiction. However, beside this short term favorable effect, regular long-term reading of literary fiction may also support ToM development or may improve ToM performance. The presence of impaired ToM abilities is well-documented in schizophrenia; however, the role of reading in these deficits is unknown. In the present study our aim was to assess the effect of prior reading experiences on theory of mind performance in patients with schizophrenia, and in healthy controls.

Materials and methods

ToM assessment was done with the Short Story Task, which is based on the interpretation of a Hemingway short story. After reading the short story, questions were asked in an interview format regarding comprehension, explicit and implicit ToM skills, then comparative analysis of schizophrenia patients was performed (n = 47) and matched to a normal control (n = 48) group concerning deficits of ToM abilities. Participants were also stratified according to their prior reading experiences.

Results

Previous reading experience was associated with better comprehension and explicit ToM performance both in patients with schizophrenia, and in healthy controls. However, the explicit ToM performance of patients with prior reading was still weaker compared to healthy controls with reading experiences. Path model analysis revealed that reading had a direct positive effect on ToM, and an indirect effect through improving comprehension.

Conclusions

Prior reading experience is associated with better ToM performance not just in healthy controls but also in patients living with schizophrenia. Previous reading experience also improves comprehension, which in turn has a favorable impact on ToM. Our results support the idea that literary fiction reading may have a therapeutic potential in the rehabilitation of schizophrenia.

On the Evaluation of Engagement in Immersive Applications When Users Are on the Autism Spectrum

New generation wearable devices allow for the development of interactive environments tailored for Virtual Reality (VR)- and Augmented Reality (AR)-based treatment of Autism Spectrum Disorders (ASD). Experts agree on their potential; however, there is lack of consensus on how to perform trials and the need arises for evaluation frameworks, methods, and techniques appropriate for the ASD population. In this paper, we report on a study conducted with high-functioning ASD people in the 21-23 age range, with the objectives of (1) evaluating the engagement of two headsets offering distinct immersive experiences, (2) reasoning on the interpretation of engagement factors in the case of ASD people, and (3) translating results into general guidelines for the development of VR/AR-based ASD treatment. To this aim, we (1) designed two engagement evaluation frameworks based on behavioral observation measures, (2) set up two packages of reference immersive scenarios, (3) defined the association between metrics and scenarios, and (4) administered the scenarios in distinct sessions for the investigated headsets. Results show that the immersive experiences are engaging and that the apparent lack of success of some evaluation factors can become potential advantages within the framework of VR/AR-based ASD treatment design.

Stories in Action

Stories have played a central role in human social and political life for thousands of years. Despite their ubiquity in culture and custom, however, they feature only peripherally in formal government policymaking. Government policy has tended to rely on tools with more predictable responses-incentives, transfers, and prohibitions. We argue that stories can and should feature more centrally in government policymaking. We lay out how stories can make policy more effective, specifying how they complement established policy tools. We provide a working definition of stories' key characteristics, contrasting them with other forms of communication. We trace the evolution of stories from their ancient origins to their role in mediating the impact of modern technologies on society. We then provide an account of the mechanisms underlying stories' impacts on their audiences. We conclude by describing three functions of stories-learning, persuasion, and collective action.

Eliciting empathetic drives to prosocial behavior during stressful events

In the current pandemic situation, psychological science is increasingly considered by public health policy. Empathy is mainly recognized as a crucial drive for prosocial behavior. However, this rich body of evidence still lacks visibility and implementation. Effective social programs are needed, and little is known about how to elicit empathetic drives. The paper gives first a clear foundation to the role of empathy during stressful events. It provides then a comprehensive overview of innovative interventions triggering empathic response in the public such as fiction, film, and theater. Moreover, it integrates interactive ways of sharing personal views that could elicit empathetic feelings in different people. Advances deriving from this perspective could be of significant public interest in the current and future health crises and help authorities develop innovative social programs, which should be the focus of further scientific inquiry.

How We Tell Apart Fiction from Reality

The human ability to tell apart reality from fiction is intriguing. Through a range of media, such as novels and movies, we are able to readily engage in fictional worlds and experience alternative realities. Yet even when we are completely immersed and emotionally engaged within these worlds, we have little difficulty in leaving the fictional landscapes and getting back to the day-to-day of our own world. How are we able to do this? How do we acquire our understanding of our real world? How is this similar to and different from the development of our knowledge of fictional worlds? In exploring these questions, this article makes the case for a novel multilevel explanation (called BLINCS) of our implicit understanding of the reality–fiction distinction, namely that it is derived from the fact that the worlds of fiction, relative to reality, are bounded, inference-light, curated, and sparse.

Reading about minds: The social-cognitive potential of narratives

It is often argued that narratives improve social cognition, either by appealing to social-cognitive abilities as we engage with the story world and its characters, or by conveying social knowledge. Empirical studies have found support for both a correlational and a causal link between exposure to (literary, fictional) narratives and social cognition. However, a series of failed replications has cast doubt on the robustness of these claims. Here, we review the existing empirical literature and identify open questions and challenges. An important conclusion of the review is that previous research has given too little consideration to the diversity of narratives, readers, and social-cognitive processes involved in the social-cognitive potential of narratives. We therefore establish a research agenda, proposing that future research should focus on (1) the specific text characteristics that drive the social-cognitive potential of narratives, (2) the individual differences between readers with respect to their sensitivity to this potential, and (3) the various aspects of social cognition that are potentially affected by reading narratives. Our recommendations can guide the design of future studies that will help us understand how, for whom, and in what respect exposure to narratives can advantage social cognition.

Qualitative Differences in Attribution of Mental States to Other People in Autism and Schizophrenia: What are the Tools for Differential Diagnosis?

The differential diagnosis between schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD) remains an important clinical question, because they have overlap in clinical diagnosis. This study explored the differences between ASD (n = 44) and SSD patients (n = 59), compared to typically developing peers (n = 63), in completing an advanced Theory of Mind (ToM) task. The outcome found several differences between groups. The SSD patients showed greater difficulty in understanding social scenarios, while ASD individuals understood the stories, but did not correctly identify the protagonist's intention. The interesting aspect of the results is that some ToM stories are more informative about the mentalistic reasoning of the two clinical groups, namely, the stories that investigate pretend, persuasion, double bluff and ironic joke constructs.

Exposure to Literary Fiction Is Associated With Lower Psychological Essentialism

We investigated the impact of exposure to literary and popular fiction on psychological essentialism. Exposure to fiction was measured by using the Author Recognition Test, which allows us to separate exposure to authors of literary and popular fiction. Psychological essentialism was assessed by the discreteness subscale of the psychological essentialism scale in Study 1, and by the three subscales of the same scale (such as discreteness, informativeness, and biological basis) in Study 2 that was pre-registered. Results showed that exposure to literary fiction negatively predicts the three subscales. The results emerged controlling for political ideology, a variable that is commonly associated with psychological essentialism, and level of education.

Exploring the Relationship Between Fiction Reading and Emotion Recognition

Fiction reading experience affects emotion recognition abilities, yet the causal link remains underspecified. Current theory suggests fiction reading promotes the simulation of fictional minds, which supports emotion recognition skills. We examine the extent to which contextualized statistical experience with emotion category labels in language is associated with emotion recognition. Using corpus analyses, we demonstrate fiction texts reliably use emotion category labels in an emotive sense (e.g., cry of relief), whereas other genres often use alternative senses (e.g., hurricane relief fund). Furthermore, fiction texts were shown to be a particularly reliable source of information about complex emotions. The extent to which these patterns affect human emotion concepts was analyzed in two behavioral experiments. In experiment 1 (n = 134), experience with fiction text predicted recognition of emotions employed in an emotive sense in fiction texts. In experiment 2 (n = 387), fiction reading experience predicted emotion recognition abilities, overall. These results suggest that long-term language experience, and fiction reading, in particular, supports emotion concepts through exposure to these emotions in context.

Mind reading improvements in mentalization-based therapy training

The psychological strain of many psychiatric disorders arises from difficulties encountered in social interactions. Social withdrawal is often the first symptom of neuropsychiatric disorders. The authors explore the various options for training social cognition skills. Social cognition was assessed using the Movie for the Assessment of Social Cognition (MASC). After completion of mentalization-based therapy (MBT) training, MASC scores improved significantly in health care providers (p = .006, r = .57). Mentalizing (operationalized with reflective functioning [RF]) was assessed in the MBT group (Group A) and compared with RF in a control group (Group B). RF was significantly higher in Group A (RF = 4.35, SD = 1.19) than in Group B (RF = 3.43, SD = 1.70) (p = .0385; Cohen's d = 0.65). MBT might be a promising intervention in social cognition training. Mentalizing skills might be associated with attitude.

Moral Decision-Making, Stress, and Social Cognition in Frontline Workers vs. Population Groups During the COVID-19 Pandemic: An Explorative Study

On March 9, 2020, Italy has gone into "lockdown" because of COVID-19 pandemic, with a national quarantine. All non-essential working activities and schools of all levels have been temporarily closed: consequently, the entire population have been forced to dramatically change their daily habits. The pandemic raised important psychological, moral, social, and economic issues. Our research focused on the moral decision-making of people during an emergency. This paper reports two studies. The aim of Study 1 was to evaluate moral decision-making, level of perceived stress, ability of mentalizing and empathy in university students and Italian workers. 224 front-line workers (FLW), 413 second-line workers (SLW), and 663 university students (US), during Italian Phase 1 of lockdown, completed an online questionnaire. The results of Study 1 showed that participants in the FLW group are more likely to choose utilitarian solutions and judge as morally acceptable actions finalized to saving lives of more people if this requires sacrificing a low number of individuals. At the same time, decision-making was experienced as less unpleasant and less arousing with respect to the other two groups, demonstrating a greater ability to keep emotional control under pressure. In Study 2, we compared the same variables used in Study 1, selecting two professional categories from the FLW group engaged in emergency during COVID-19, namely healthcare providers (n = 82) and public safety personnel (n = 117). Our results showed that healthcare providers were more stressed and emotionally involved than public safety personnel, with higher empathic concern and arousal in moral decision-making. We suggest it is essential providing immediate psychological support and monitoring physical and emotional well-being for workers in the front-line during emergencies like the COVID-19 pandemic, in order to prevent experiences of moral distress or mental health problems.

The effect of exposure to fiction on attributional complexity, egocentric bias and accuracy in social perception

We investigated the effects of long-term exposure to literary and popular fiction on attributional complexity, egocentric bias and accuracy. Results of a pre-registered study showed that exposure to literary fiction is positively associated with scores on the attributional complexity scale. Literary fiction is also associated with accuracy in mentalizing, measured via the Reading the Mind in the Eyes test, and with accuracy in predicting average social attitudes. The predicted negative association between literary fiction and egocentric bias emerged only when education and gender were controlled for–a covariance analysis that was not pre-registered. Exposure to popular fiction is associated solely with attributional complexity, but negatively. We discuss the significance of these findings in the context of the emerging literature regarding the relationship between fiction and social cognition.

Persons With Schizophrenia Misread Hemingway: A New Approach to Study Theory of Mind in Schizophrenia

INTRODUCTION

Theory of Mind (ToM) is a key component of social cognition. Recently the Short Story Task (SST) was developed as a new measurement of ToM. SST uses a short story of Ernest Hemingway to assess ToM skills. SST proved to be a suitable tool, and sensitive to individual differences among healthy subjects. Our aim was to test SST to evaluate the ToM skills of persons with schizophrenia.

MATERIALS AND METHODS

SST was used to assess ToM skills. After reading the short story "The End of Something" a structured interview was done with 14 questions. Spontaneous mental state reasoning, explicit mental state inference and comprehension of nonmental aspects of the story were evaluated. 47 persons with schizophrenia in remission and 48 healthy controls were assessed and compared.

RESULTS

Persons with schizophrenia performed significantly more poorly in the explicit mental state inference questions. Ceiling effect was not detectable in explicit ToM scores. Patients made less spontaneous mental state references as well, although the occurrence of spontaneous mental state terms was infrequent in both groups. Patients were also less accurate in answering comprehension questions, but the difference was not significant after Bonferroni correction.

DISCUSSION

Our results lined up with the original findings and we found SST to be a sensitive tool to explore the individual differences in ToM performance, not only among healthy subjects, but also among persons with schizophrenia especially in explicit mental state inferences without observing the ceiling effect. We found, however, SST to be less sensitive to measure spontaneous mental state reasoning and also the lack of the use of another ToM test to assess convergent validity of SST for indicating ToM deficits in schizophrenia stands as a limitation of current study.

Graded Empathy: A Neuro-Phenomenological Hypothesis

The neuroscience of empathy has enormously expanded in the past two decades, thereby making instrumental progress for the understanding of neural substrates involved in affective and cognitive aspects of empathy. Yet, these conclusions have relied on ultrasimplified tasks resulting in the affective/cognitive dichotomy that was often modeled and overemphasized in pathological, developmental, and genetic studies of empathy. As such, the affective/cognitive model of empathy could not straightforwardly accommodate and explain the recent surge of neuroscientific data obtained from studies employing naturalistic approaches and intergroup conditions. Inspired by phenomenological philosophy, this article paves the way for a new scientific perspective on empathy that breaks thorough the affective/cognitive dichotomy. This neuro-phenomenological account leans on phenomenological analyses and can straightforwardly explain recent neuroscience data. It emphasizes the dynamic, subjective, and piecemeal features of empathic experiences and unpicks the graded nature of empathy. The graded empathy hypothesis postulates that attending to others' expressions always facilitates empathy, but the parametric modulation in the levels of the empathic experience varies as a function of one's social interest (e.g., via intergroup or inter-personal cues) in the observed other. Drawing on multiple resources that integrate neuroscience with phenomenology, we describe the potential of this graded framework in an era of real-life experimentation. By wearing lenses of neuro-phenomenology, this original perspective can change the way empathy is considered.

Social Mind and Long-Lasting Disease: Focus on Affective and Cognitive Theory of Mind in Multiple Sclerosis

The role of social cognition, including theory of mind (ToM), in affecting quality of life (QoL) along the course of diseases has been reported. This is a considerable aspect in chronic pathologies, such as multiple sclerosis (MS), in which supporting and maintaining QoL is of crucial importance. We aimed to investigate the relation between ToM, clinical variables and neuropsychological profile in a cohort of adults with long lasting disease, such as different clinical MS phenotypes (Relapsing Remitting -RR- versus Progressive -Pr). In particular, our study focuses on (1) how (affective and cognitive) ToM impairment occurs in different phenotypes, (2) whether MS ToM impairment is secondary to or independent from cognitive deficit and (3) whether ToM deficit impacts QoL. 42 adults with MS (18 M: 24 F, 52.38 ± 10.31 mean age, 21.24 ± 10.94 mean disease duration, 26 RR and 16 Pr) and 26 matched healthy controls (HC) (7 M: 19 F, 51.35 ± 12.42 mean age) were screened with a neuropsychological and ToM battery, assessing both affective and cognitive components. We found statistically significant groups differences in cognitive but not affective ToM, with a lower performance in PrMS than those with a RRMS disease course. Also, significant predictive effects of neuropsychological tests on ToM were identified in MS group. Finally, MS people with different level of affective ToM differed significantly in QoL. ToM deficit in moderately disabled people with MS involves cognitive but not affective ToM components with implications on QoL. It also appears to be related to cognitive performance. As neurological and neurocognitive profiles influence mentalizing in MS, ToM evaluation should be considered for inclusion in clinical screening.

Stories and the Promotion of Social Cognition

Engaging with fictional stories and the characters within them might help us better understand our real-world peers. Because stories are about characters and their interactions, understanding stories might help us to exercise our social cognitive abilities. Correlational studies with children and adults, experimental research, and neuropsychological investigations have all helped develop our understanding of how stories relate to social cognition. However, there remain a number of limitations to the current evidence, some puzzling results, and several unanswered questions that should inspire future research. This review traces multiple lines of evidence tying stories to social cognition and raises numerous critical questions for the field.

Reading Literary Fiction and Theory of Mind: Three Preregistered Replications and Extensions of Kidd and Castano (2013)

Scholars from diverse disciplines have proposed that reading fiction improves intersubjective capacities. Experiments have yielded mixed evidence that reading literary fiction improves performance on the Reading the Mind in the Eyes Test, a test of Theory of Mind. Three preregistered experiments revealed mixed results. Applying the “small telescopes” method developed by Simonsohn revealed two uninformative failures to replicate and one successful replication. On a measure of the importance of intentions to moral judgments, results were more mixed, with one significant effect in the expected direction, one nonsignificant effect, and one significant effect in the unexpected direction. In addition, two experiments yielded support for the exploratory but preregistered hypothesis that characters in popular fiction are perceived as more predictable and stereotypic than those in literary fiction. These findings help clarify the sociocognitive effects of reading literary fiction and refine questions for future research.

Finding Purpose: Honing the Practice of Making Meaning in Medicine

Despite decades of advances in diagnosing and treating a broad range of illnesses, many changes in our health care system impede true caregiving, leaving patients and practitioners dissatisfied and creating an emotional burden for practitioners that contributes to the staggering rates of physician burnout. Given this dissatisfaction and disconnection, practitioners and patients alike can benefit from structured opportunities to explore the expectations, assumptions, and emotions that shape our understanding of health and illness, and thus our experiences within the health care system. This article demonstrates how group discussions of poetry-something that might seem irrelevant to medical practice or physical wellness-can foster communication, connection, and collective reflection for physicians, interprofessional health care teams, and groups that include practitioners, patients, and families, allowing participants to once again find meaning in medicine.

Does Originality Evoke Understanding? The Relation between Literary Reading and Empathy

It is easy enough to theorize about the impact of literary reading on empathic reactions, but to empirically prove such effects is more difficult. This article provides a concise overview of the theoretical and empirical evidence that literary reading has an effect on empathy (in its multiple forms), distinguishing between the effects of literariness, narrativity and fictionality. Subsequently, it discusses the results of 2 recently conducted studies into reading and empathic understanding. As will become clear, we are still quite a long way from knowing when and how (literary) reading has an effect on empathy for others. Suggestions are offered how future studies can tackle this issue.

Psychology of Narrative Art

Artistic narrative has been recognized in fictional genres such as poetry, plays, novels, short stories, and films. It occurs also in nonfictional genres such as essays and biographies. We review evidence on the empirical exploration of effects of narrative, principally fiction, on how it enables people to become more empathetic, on how foregrounded phrases encourage readers to recognize the significance of events as if for the first time in ways that tend to elicit emotion, and on how literary works can help people to change their own personalities. We then suggest 3 principles that characterize narrative art in psychological terms: a focus on emotion and empathy, a focus on character, and a basis of indirect communication.

Imaginary Engagement, Real-World Effects: Fiction, Emotion, and Social Cognition

Prior research has shown that cumulative written fiction exposure is correlated with ( Mar, Oatley, Hirsch, de la Paz, & Peterson, 2006 ; Mar, Oatley, & Peterson, 2009 ) and 1-time exposure to literary fiction increases (e.g., Black & Barnes, 2015a ; Kidd & Castano, 2013 ) performance on an emotion-reading task. However, Panero and colleagues (2016) found that although lifetime fiction exposure is a reliable predictor of performance, the causal effects previously observed may be more fragile (see also Samur, Tops, & Koole, 2017 ). The current article is an exploration of the extent to which the ability of fiction to affect social cognition may depend not only on what is read, but also how one reads. Specifically, an argument is made that the effect of fiction on social cognition may depend on the degree to which the reader contributes imaginatively to the text and that, although drawing meaning from literary fiction may require high levels of imaginative engagement, popular and genre fiction may allow for engaging in this way. This stance is discussed with respect to the role that emotional investment in a story and its characters might play in influencing readers of popular fiction to read in a “literary” way.

An IRT Analysis of the Reading the Mind in the Eyes Test

The Reading the Mind in the Eyes Test (RMET; Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001 ), originally designed for use in clinical populations, has been used with increasing frequency as a measure of advanced social cognition in nonclinical samples (e.g., Domes, Heinriches, Michel, Berger, & Herpertz, 2007 ; Kidd & Castano, 2013 ; Mar, Oatley, Hirsh, de la Paz, & Peterson, 2006 ). The purpose of this research was to use item response theory to assess the ability of the RMET to detect differences at the high levels of theory of mind to be expected in neurotypical adults. Results indicate that the RMET is an easy test that fails to discriminate between individuals exhibiting high ability. As such, it is unlikely that it could adequately or reliably capture the expected effects of manipulations designed to boost ability in samples of neurotypical populations. Reported effects and noneffects from such manipulations might reflect noise introduced by inaccurate measurement; a more sensitive instrument is needed to verify the effects of manipulations to enhance theory of mind.

Start making sense: Art informing health psychology

Growing evidence suggests that the arts may be useful in health care and in the training of health care professionals. Four art genres - novels, films, paintings and music - are examined for their potential contribution to enhancing patient health and/or making better health care providers. Based on a narrative literature review, we examine the effects of passive (e.g. reading, watching, viewing and listening) and active (e.g. writing, producing, painting and performing) exposure to the four art genres, by both patients and health care providers. Overall, an emerging body of empirical evidence indicates positive effects on psychological and physiological outcome measures in patients and some benefits to medical training. Expressive writing/emotional disclosure, psychoneuroimmunology, Theory of Mind and the Common Sense Model of Self-Regulation are considered as possible theoretical frameworks to help incorporate art genres as sources of inspiration for the further development of health psychology research and clinical applications.

The Effect of Reading a Short Passage of Literary Fiction on Theory of Mind: A Replication of Kidd and Castano (2013)

The results reported by Kidd and Castano (2013) indicated that reading a short passage of literary fiction improves theory of mind (ToM) relative to reading popular fiction. However, when we entered Kidd and Castano’s results in a p-curve analysis, it turned out that the evidential value of their findings is low. It is good practice to back up a p-curve analysis of a single paper with an adequately powered direct replication of at least one of the studies in the p-curve analysis. Therefore, we conducted a direct replication of the literary fiction condition and the popular fiction condition from Kidd and Castano’s Experiment 5 to scrutinize the effect of reading literary fiction on ToM. The results of this replication were largely consistent with Kidd and Castano’s original findings. Furthermore, we conducted a small-scale meta-analysis on the findings of the present study, those of Kidd and Castano and those reported in other published direct replications. The meta-analytic effect of reading literary fiction on ToM was small and non-significant but there was considerable heterogeneity between the included studies. The results of the present study and of the small-scale meta-analysis are discussed in the light of reading-times exclusion criteria as well as reliability and validity of ToM measures.

The role of sleep in aesthetic perception and empathy: A mediation analysis

The ability to experience aesthetics plays a fundamental role in human social interactions, as well as the capacity to feel empathy. Some studies have shown that beauty perception shares part of the neural network underlying emotional and empathic abilities, which are also known to affect sleep quality and duration. In this study, we evaluated for the first time the effects of sleep on the relation between aesthetic perception and empathic abilities in healthy subjects using a mediation analysis approach. One-hundred and twenty-six subjects participated in this study. One-hundred and one subjects slept at home (Sleep Group). The remaining 25 subjects were tested as controls after 1 night of sleep deprivation to assess the effects of lack of sleep on aesthetic perception and empathy (Sleep-Deprived Group). All participants underwent one testing session in which they performed a battery of empathy tests and an aesthetic perception task (Golden Beauty). The results showed that sleep duration mediates the relationship between empathy and aesthetic perception in the sleep group. The mediation effect of sleep was more evident on the emotional empathy measures. Conversely, in the sleep deprivation group the lack of correlations among empathy, aesthetic perception and sleep variables did not allow to perform the mediation analysis. These results suggest that adequate sleep duration may play a significant role in improving cognitive and emotional empathic abilities as well as the capability to give accurate aesthetic judgements.

Watching More Closely: Shot Scale Affects Film Viewers' Theory of Mind Tendency But Not Ability

Recent research debates the effects of exposure to narrative fiction on recognition of mental states in others and self, referred to as Theory of Mind. The current study explores the mechanisms by which such effects could occur in fictional film. Using manipulated film scenes, we conducted a between subject experiment (N = 136) exploring how film shot-scale affects viewers' Theory of Mind. Specifically, in our methods we distinguish between the trait Theory of Mind abilities (ToM ability), and the state-like tendency to recognize mental states in others and self (ToM tendency). Results showed that close-up shots (compared to long shots) of a character was associated with higher levels of Theory of Mind tendency, when the facial expression was sad but not when it was neutral. And this effect did not transfer to other characters in the film. There was also no observable effect of character depiction on viewers' general Theory of Mind ability. Together the findings suggest that formal and content features of shot scale can elicit Theory of Mind responses by directing attention toward character mental states rather than improving viewers' general Theory of Mind ability.