Why Pragmatics and Theory of Mind Do Not (Completely) Overlap

Comparing pragmatic abilities across multiple languages in adults with ADHD: Insights from a self-report questionnaire

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with pragmatic language impairments in children, but less is known about the communicative abilities of adults with ADHD, especially when using a second or third language. In this study, we developed a questionnaire to collect self-report measures of a set of pragmatic skills in a person's first, second and third language, comparing adults with and without an ADHD diagnosis. One hundred seventy-nine multilingual adults with (N = 91) and without ADHD (N = 88) completed the survey. As predicted, adults with ADHD reported more pragmatic difficulties than the control group. More specifically, people with ADHD showed pronounced impairments in regulating their behaviour in spoken interactions in the form of excessive talking, frequently interrupting others, and speaking without thinking first. Notably, these types of hyperactive and impulsive behaviours were significantly reduced when people with ADHD communicated in a second or third language. For pragmatic difficulties related to inattention such as concentrating on a conversation, both groups tended to be more inattentive in their third language compared to their first and second language. The understanding of non-literal language was only affected by ADHD in the first language and was generally more taxing in a language with lower proficiency levels. Our study contributes to a more nuanced understanding of how ADHD affects different kinds of communicative abilities in multilingual adults. It also has implications for clinical practice, highlighting the importance of assessing symptoms of inattention, hyperactivity, and impulsivity in a person's dominant language.

Endophenotyping social cognition in the broader autism phenotype

Relatives of individuals with autism spectrum disorder (ASD) may display milder social traits of the broader autism phenotype (BAP) providing potential endophenotypic markers of genetic risk for ASD. We performed a case-control comparison to quantify social cognition and pragmatic language difficulties in the BAP (n = 25 cases; n = 33 controls) using the Faux Pas test (FPT) and the Goldman-Eisler Cartoon task. Using deep phenotyping we then examined patterns of inheritance of social cognition in two large multiplex families and the spectrum of performance in 32 additional families (159 members; n = 51 ASD, n = 87 BAP, n = 21 unaffected). BAP individuals showed significantly poorer FPT performance and reduced verbal fluency with the absence of a compression effect in social discourse compared to controls. In multiplex families, we observed reduced FPT performance in 89% of autistic family members, 63% of BAP relatives and 50% of unaffected relatives. Across all affected families, there was a graded spectrum of difficulties, with ASD individuals showing the most severe FPT difficulties, followed by the BAP and unaffected relatives compared to community controls. We conclude that relatives of probands show an inherited pattern of graded difficulties in social cognition with atypical faux pas detection in social discourse providing a novel candidate endophenotype for ASD.

Meaning as mentalization

The way we establish meaning has been a profound question not only in language research but in developmental science as well. The relation between linguistic form and content has been loosened up in recent pragmatic approaches to communication, showing that code-based models of language comprehension must be augmented by context-sensitive, pragmatic-inferential mechanisms to recover the speaker's intended meaning. Language acquisition has traditionally been thought to involve building a mental lexicon and extracting syntactic rules from noisy linguistic input, while communicative-pragmatic inferences have also been argued to be indispensable. Recent research findings exploring the electrophysiological indicator of semantic processing, the N400, have raised serious questions about the traditional separation between semantic decoding and pragmatic inferential processes. The N400 appears to be sensitive to mentalization-the ability to attribute beliefs to social partners-already from its developmental onset. This finding raises the possibility that mentalization may not simply contribute to pragmatic inferences that enrich linguistic decoding processes but that the semantic system may be functioning in a fundamentally mentalistic manner. The present review first summarizes the key contributions of pragmatic models of communication to language comprehension. Then, it provides an overview of how communicative intentions are interpreted in developmental theories of communication, with a special emphasis on mentalization. Next, it discusses the sensitivity of infants to the information-transmitting potential of language, their ability to pick up its code-like features, and their capacity to track language comprehension of social partners using mentalization. In conclusion, I argue that the recovery of meaning during linguistic communication is not adequately modeled as a process of code-based semantic retrieval complemented by pragmatic inferences. Instead, the semantic system may establish meaning, as intended, during language comprehension and acquisition through mentalistic attribution of content to communicative partners.

Weighing the role of social cognition and executive functioning in pragmatics in the schizophrenia spectrum: A systematic review and meta-analysis

Pragmatic impairment is diffused in schizophrenia spectrum disorders, but the literature still debates its neurocognitive underpinnings. This systematic review and meta-analysis aimed to investigate the neurocognitive correlates of pragmatic disorders in schizophrenia and determine the weight of social cognition and executive functioning on such disorders. Of the 2,668 records retrieved from the literature, 16 papers were included in the systematic review, mostly focused on non-literal meanings and discourse production in schizophrenia. Ten studies were included in the meta-analysis: pragmatics was moderately associated with both social cognition and executive functions (especially inhibition), but the link with social cognition was stronger. The mediation analysis showed that social cognition mediated the relationship between executive functions and pragmatics. Based on this, we proposed a hierarchical neurocognitive model where pragmatics stems from social cognition, while executive functions are the fertile ground supporting the other two domains, and we discuss its theoretical and clinical implications.

Social cognition in adult survivors of brain tumors: studying the relationship between theory of mind and quality of life

OBJECTIVE

The present study is the first to examine theory of mind (ToM) sequelae in a sample of adult survivors of primary brain tumors, and to investigate the assumed relationship between ToM and health-related quality of life (HRQoL).

METHOD

Participants were 40 long-term adult survivors of primary brain tumors and 40 matched healthy controls. They completed ToM tests (Faux-Pas test and Advanced ToM task) and two questionnaires assessing HRQoL (36-Item Short-Form Health Survey and EORTC QLQ-C30/QLQ-BN20). Their relatives also completed an observer-rated version of the SF-36 questionnaire.

RESULTS

Survivors performed worse than controls only on the Advanced ToM task. Overall, patients and caregivers reported more problems than healthy controls and their relatives regarding both global HRQoL and its social/emotional aspects. No relationship was found between ToM and HRQoL scores.

CONCLUSION

Adult survivors of primary brain tumors may exhibit ToM deficits several years after treatment and report more problems on social/emotional HRQoL components. Our findings highlight the need to consider these late effects in survivors' long-term follow-up, even if the clinical involvement of ToM deficits still needs to be elucidated. The assessment of ToM deficits and their potential impact on survivors' everyday life is thoroughly discussed.

Assessing Theory of Mind in Children: A Tablet-Based Adaptation of a Classic Picture Sequencing Task

Correctly assessing children's theory of mind (TOM) is essential to clinical practice. Yet, most tasks heavily rely on language, which is an obstacle for several populations. Langdon and Coltheart's (Cognition 71(1):43-71, 1999) Picture Sequencing Task (PST), developed for research purposes, avoids this limitation through a minimally-verbal procedure. We thus developed a tablet adaptation of this task for individual application, engaging children's motivation and allowing response times collection. To assess this tablet-PST, we first tested a large sample of neurotypical children (6-11 years-old, N = 248), whose results confirmed the task's structural and content validity, and permitted the construction of three standardized clinical indices. In a second experiment, we applied those to previously diagnosed autistic children (N = 23), who were expected to show atypical TOM performance. Children's outcomes were consistent with what was hypothesized and confirmed the task's external validity and moderate clinical sensitivity. The tablet-PST thus appears as a suitable tool, providing detailed profiles to inform clinical decisions.

Exploring Cognitive-Pragmatic Heterogeneity Following Acquired Brain Injury: A Cluster Analysis of Hint Comprehension

PURPOSE

Difficulties understanding nonliteral language (especially hints) are frequently reported following acquired brain injury (ABI). Several cognitive mechanisms, such as context processing, executive functions, and theory of mind (ToM), may underlie these disorders. However, their role remains controversial, mainly because of the characteristic heterogeneity of this population. Therefore, our study aimed to identify cognitive-pragmatic profiles in individuals with ABI.

METHOD

A new task of hint comprehension, manipulating executive demand, markers of hints, and ToM and neuropsychological tests were administered to 33 participants with frontal ABI and 33 control participants. Cluster analysis, a method sensitive to profile heterogeneity, was applied and coupled with error analysis.

RESULTS

We highlighted two cognitive-pragmatic profiles. One subgroup of participants with ABI exhibited contextual insensitivity, leading them to infer the utterance meaning based on linguistic decoding alone-literal meaning. This difficulty in understanding hints was associated with deficits in working memory, inhibition, and ToM. The second subgroup of participants with ABI showed difficulty with literal statements, associated with impaired inhibition and ToM. In addition, the two subgroups differed only on the ToM task. This result suggests that various types of ToM deficit (misunderstanding vs. incorrect attribution of mental states) could contribute to the variability of the pragmatic profiles observed (difficulties in interpreting hints vs. literal statements).

CONCLUSION

The experimental design adopted in this study provides valuable insight into the explanatory hypotheses of nonliteral language comprehension disorders and has important clinical implications.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24069516.

Can Narrative Skills Improve in Autism Spectrum Disorder? A Preliminary Study with Verbally Fluent Adolescents Receiving the Cognitive Pragmatic Treatment

Autism spectrum disorder (ASD) is a neurodevelopmental condition affecting social and communicative skills, including narrative ability, namely the description of real-life or fictive accounts of temporally and causally related events. With this study, we aimed to determine whether a communicative-pragmatic training, i.e., the version for adolescents of the Cognitive-Pragmatic Treatment, is effective in improving the narrative skills of 16 verbally fluent adolescents with ASD. We used a multilevel approach to assess pre- and post-training narrative production skills. Discourse analysis focused on micro- (i.e., mean length of utterance, complete sentences, omissions of morphosyntactic information) and macrolinguistic measures (i.e., cohesion, coherence errors, lexical informativeness). Results revealed a significant improvement in mean length of utterance and complete sentences and a decrease in cohesion errors. No significant change was found in the other narrative measures investigated. Our findings suggest that a pragmatically oriented training may be useful in improving grammatical efficiency in narrative production.

The relationship between metaphor skills and Theory of Mind in middle childhood: Task and developmental effects

Theoretical pragmatics in the post-Gricean tradition argued that metaphor requires understanding of how another person sees the world. Yet, it is unclear what role mindreading plays in developing metaphor skills. Here we examined the relationship between metaphor and Theory of Mind (ToM) in middle childhood by using two different tasks. In addition to the Physical and Mental Metaphors task (PMM), based on the verbal explanation of physical and mental metaphors, we revived the Referential Metaphors task for children (Noveck, Bianco, & Castry, 2001), where metaphorical and literal referents are presented in a narrative context. The sample included 169 8-, 9-, and 10-year-old children, assessed also for ToM (via the Strange Stories) and other linguistic and cognitive skills as control variables. In the PMM, ToM supported the understanding of mental (but not physical) metaphors in 9-year-olds only, whereas in the Referential Metaphors task ToM supported accuracy of understanding metaphors (but not literal items) in younger children as well. At age 10, ToM effects were negligible in both tasks. These findings suggest that ToM has a task-specific role in metaphor, linked to the characteristics of the items in the task at stake, being for instance greater for metaphors with mental (compared to physical) content and for non-literal (compared to literal) referents. The findings also suggest that the relationship between ToM and metaphor skills is developmental sensitive, as children start to capitalize on ToM earlier in development when the metaphor context is richer, and these effects fade with age. Theoretically, these data argue in favor of the relevance-theoretic account of metaphor, spelling out different ways in which ToM might support metaphor resolution across tasks, for instance by providing better access to the psychological lexicon (i.e., terms referring to mental states) and better context processing, serving as a springboard to achieve sophisticated pragmatic skills in middle childhood.

Children's processing of written irony: An eye-tracking study

Ironic language is challenging for many people to understand, and particularly for children. Comprehending irony is considered a major milestone in children's development, as it requires inferring the intentions of the person who is being ironic. However, the theories of irony comprehension generally do not address developmental changes, and there are limited data on children's processing of verbal irony. In the present pre-registered study, we examined, for the first time, how children process and comprehend written irony in comparison to adults. Seventy participants took part in the study (35 10-year-old children and 35 adults). In the experiment, participants read ironic and literal sentences embedded in story contexts while their eye movements were recorded. They also responded to a text memory question and an inference question after each story, and children's levels of reading skills were measured. Results showed that for both children and adults comprehending written irony was more difficult than for literal texts (the "irony effect") and was more challenging for children than for adults. Moreover, although children showed longer overall reading times than adults, processing of ironic stories was largely similar between children and adults. One group difference was that for children, more accurate irony comprehension was qualified by faster reading times whereas for adults more accurate irony comprehension involved slower reading times. Interestingly, both age groups were able to adapt to task context and improve their irony processing across trials. These results provide new insights about the costs of irony and development of the ability to overcome them.

The neurobiological map of theory of mind and pragmatic communication in autism

Children with autism often have difficulty with Theory of Mind (ToM), the ability to infer mental states, and pragmatic skills, the contextual use of language. Neuroimaging research suggests ToM and pragmatic skills overlap, as the ability to understand another's mental state is a prerequisite to interpersonal communication. To our knowledge, no study in the last decade has examined this overlap further. To assess the emerging consensus across neuroimaging studies of ToM and pragmatic skills in autism, we used coordinate-based activation likelihood estimation (ALE) analysis of 35 functional magnetic resonance imaging (MRI) studies (13 pragmatic skills, 22 ToM), resulting in a meta-analysis of 1,295 participants (647 autistic, 648 non-autistic) aged 7 to 49 years. Group difference analysis revealed decreased left inferior frontal gyrus (LIFG) activation in autistic participants during pragmatic skills tasks. For ToM tasks, we found reduced anterior cingulate cortex (ACC), medial prefrontal cortex (MPFC), and temporoparietal junction (TPJ) activation in autistic participants. Collectively, both ToM and pragmatic tasks showed activation in IFG and superior temporal gyrus (STG) and a reduction in left hemispheric activation in autistic participants. Overall, the findings underscore the cognitive and neural processing similarities between ToM and pragmatic skills, and their underlying neurobiological differences in autism.

The fuzzy boundaries of the social (pragmatic) communication disorder (SPCD): Why the picture is still so confusing?

Introduction

Since the introduction of Social (Pragmatic) Communication Disorder (SPCD) in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) in 2013, a debate has arisen in the scientific community about its usefulness in differential diagnosis for other clinical categories such as Autism Spectrum Disorder (ASD) and Specific Language Impairment (SLI). Indeed, SPCD criteria share a common deficit in communication and pragmatic skills with these diagnostic entities. Available assessment tools seem scarce and not sensitive enough to clarify diagnostic criteria and clinical boundaries. This study aims to review the existing literature on diagnostic screening for SPCD to highlight confounding variables in the domains examined, overlap with other diagnostic entities, and lack of specificity of available assessment tools in identifying the core deficits of the disorder.

Methods

The search strategy was defined by combining the following keywords: "social pragmatic communication disorder," "DSM-5," "differential diagnosis," and "child." The search was performed in three databases: Medline (PubMed), Scopus, and Web of Science. All studies published between 2013 and April 2023, written in English, and with a major focus on SPCD were included in the review.

Results

After the screening for the eligibility, 18 studies were included in the review. Most of these studies aimed to investigate the differential diagnosis between SPCD and other diagnostic categories (e.g., specific language impairment and autism spectrum disorder). Of these researches, only 6 were ad hoc experimental studies, while the others were based on previously collected databases.

Conclusions

SPCD seems to have its own peculiarities and characteristics, indicating its clinical relevance, as emphasized by the DSM-5. However, the lack of specific instruments and a number of confounding variables make it difficult to identify and differentiate SPCD from other diagnostic entities. Further research is needed to overcome the lack of specific clinical instruments and lack of empirical studies.

The complexity of theory of mind deficit in schizophrenia: A cross-sectional analysis of baseline data from a longitudinal schizophrenia study

A large number of trials have supported the functional significance of Theory of Mind (ToM) impairment in schizophrenia. However, the nature and the extent of the impairment are still unclear. Reviews on the topic suggest that, in many cases, studies use only one tool to assess the levels of difficulty in the field, limiting the validity of the measurement to one aspect of ToM. On the other hand, the divergence of the used assessment tools makes it hard to compare the result of these studies. Thus, we decided to use additional assessment tools to evaluate the extent of ToM in order to describe several aspects of the phenomenon. A hierarchical cluster analysis of variables was used on a sample of 68 participants with schizophrenia or schizoaffective disorder, to determine the similarity between variances of the assessed ToM subcomponents. Further cross-sectional correlational analysis was then performed to investigate the association between the identified clusters and other used measures (e.g.: neurocognition). The statistical analysis supported a five-cluster model. Identified clusters illustrate the difference between Hypo and HyperToM as well as the degree of ToM task complexity, allowing for a more accurate description of the nature of ToM deficit in schizophrenia.

N400 differences between physical and mental metaphors: The role of Theories of Mind

Whether Theory of Mind (ToM) contributes to metaphor understanding has been largely investigated in language acquisition and decay. Yet we know very little about the role of ToM in real-time processing of metaphors in neurotypical adults. Here, we tested the relationship between ToM and metaphor through Event Related Potentials (ERPs) by capitalizing on the difference between metaphors inviting inferences on physical (Boxers are pandas) vs. mental aspects (Teachers are books). Physical metaphors involved a larger and sustained negativity compared to mental ones. This pattern resembled concreteness effects and suggests that physical metaphors may benefit from both verbal and perceptual information. Moreover, higher scores in the Reading the Mind in the Eyes Test (RMET), but not in the Animation task, were associated with a reduction of the N400 amplitude for both physical and mental metaphors. When exploring the ERP temporal trajectory with Generalized Additive Mixed Modeling, earlier differences between metaphors characterized individuals with higher RMET scores. Among the various ToM components, thus, emotion recognition seems to be involved in the processing of metaphors in general, with an earlier impact on the mental type. These findings highlight the multifaceted nature of metaphor, at the crossroad of language, social and perceptual experience.

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.

Specific learning disorders in young adults: Investigating pragmatic abilities and their relationship with theory of mind, executive functions and quality of life

BACKGROUND

Specific Learning Disorders (SLD) are lifelong conditions often associated with language difficulties, executive dysfunctions, and psychological problems. Previous research has shown that communicative-pragmatic ability may be impaired in SLD. However, the role of other cognitive abilities in explaining pragmatic difficulties has still not been fully investigated. The relationship between pragmatics and quality of life is not yet clear, as well.

AIMS

Firstly, the study assessed pragmatic comprehension abilities in adults with SLD. Secondly, we examined the relationship between pragmatics, theory of mind, executive functions and quality of life.

METHOD AND PROCEDURES

We enrolled 26 adults with SLD and 30 adults without SLD. Standardized tests assessing pragmatic comprehension, theory of mind and executive functions were used. The quality of life was investigated with a self-reported questionnaire.

OUTCOMES AND RESULTS

Pragmatic comprehension abilities were compromised in young adults with SLD. In this clinical population we also found a link between pragmatic comprehension and visual theory of mind. Finally, independently from the presence of SLD, pragmatics abilities were in relationship with quality of life.

CONCLUSIONS AND IMPLICATIONS

Overall, these data highlight the importance of including pragmatic abilities both in the clinical evaluation, as well as in psychological intervention for adults with SLD.

Efforts for the Correct Comprehension of Deceitful and Ironic Communicative Intentions in Schizophrenia: A Functional Magnetic Resonance Imaging Study on the Role of the Left Middle Temporal Gyrus

Deficits in social cognition and more specifically in communication have an important impact on the real-life functioning of people with schizophrenia (SZ). In particular, patients have severe problems in communicative-pragmatics, for example, in correctly inferring the speaker's communicative intention in everyday conversational interactions. This limit is associated with morphological and functional alteration of the left middle temporal gyrus (L-MTG), a cerebral area involved in various communicative processes, in particular in the distinction of ironic communicative intention from sincere and deceitful ones. We performed an fMRI study on 20 patients with SZ and 20 matched healthy controls (HCs) while performing a pragmatic task testing the comprehension of sincere, deceitful, and ironic communicative intentions. We considered the L-MTG as the region of interest. SZ patients showed difficulties in the correct comprehension of all types of communicative intentions and, when correctly answering to the task, they exhibited a higher activation of the L-MTG, as compared to HC, under all experimental conditions. This greater involvement of the L-MTG in the group of patients could depend on different factors, such as the increasing inferential effort required in correctly understanding the speaker's communicative intentions, and the higher integrative semantic processes involved in sentence processing. Future studies with a larger sample size and functional connectivity analysis are needed to study deeper the specific role of the L-MTG in pragmatic processes in SZ, also in relation to other brain areas.

Individual Differences in Indirect Speech Act Processing Found Outside the Language Network

Face-to-face communication requires skills that go beyond core language abilities. In dialogue, we routinely make inferences beyond the literal meaning of utterances and distinguish between different speech acts based on, e.g., contextual cues. It is, however, not known whether such communicative skills potentially overlap with core language skills or other capacities, such as theory of mind (ToM). In this functional magnetic resonance imaging (fMRI) study we investigate these questions by capitalizing on individual variation in pragmatic skills in the general population. Based on behavioral data from 199 participants, we selected participants with higher vs. lower pragmatic skills for the fMRI study (N = 57). In the scanner, participants listened to dialogues including a direct or an indirect target utterance. The paradigm allowed participants at the whole group level to (passively) distinguish indirect from direct speech acts, as evidenced by a robust activity difference between these speech acts in an extended language network including ToM areas. Individual differences in pragmatic skills modulated activation in two additional regions outside the core language regions (one cluster in the left lateral parietal cortex and intraparietal sulcus and one in the precuneus). The behavioral results indicate segregation of pragmatic skill from core language and ToM. In conclusion, contextualized and multimodal communication requires a set of interrelated pragmatic processes that are neurocognitively segregated: (1) from core language and (2) partly from ToM.

Semantic systems are mentalistically activated for and by social partners

A recently discovered electrophysiological response, the social N400, suggests that we use our language system to track how social partners comprehend language. Listeners show an increased N400 response, when themselves not, only a communicative partner experiences a semantic incongruity. Does the N400 reflect purely semantic or mentalistic computations as well? Do we attribute language comprehension to communicative partners using our semantic systems? In five electrophysiological experiments we identified two subcomponents of the social N400. First, we manipulated the presence-absence of an Observer during object naming: the semantic memory system was activated by the presence of a social partner in addition to semantic predictions for the self. Next, we induced a false belief—and a consequent miscomprehension—in the Observer. Participants showed the social N400, over and above the social presence effect, to labels that were incongruent for the Observer, even though they were congruent for them. This effect appeared only if participants received explicit instructions to track the comprehension of the Observer. These findings suggest that the semantic systems of the brain are not merely sensitive to social information and contribute to the attribution of comprehension, but they appear to be mentalistic in nature.

EXPRESS: An eye-tracking investigation of the cognitive processes involved in the comprehension of simple and complex communicative acts

Indirect speech acts communicate more than their literal meaning, and their comprehension relies on the listener's ability to draw the appropriate inferences in a given context. We used eye-tracking to investigate the cognitive processing involved in the comprehension of simple (direct) and complex (unconventional indirect) communicative acts, a more general distinction that applies not only to sincere speech acts, but also to irony and deceit. We recorded the eye movements of 40 participants while they read 60 stories (20 sincere, 20 deceitful, 20 ironic) consisting of a context and a target answer. For each story, we created two different contexts so that the same identical target answer was a simple (direct) and a complex (unconventional indirect) communicative act, respectively. We also assessed the indirectness of simple and complex communicative acts, as well as participants' working memory (WM) and Theory of Mind (ToM). Eye-pattern analysis showed that complex communicative acts were more difficult to understand than simple acts; differences between simple and complex acts held for all the pragmatic phenomena investigated, though processing differences were greater for sincere acts than for irony and deceit. We found a role of indirectness and ToM in the pragmatic processing of simple and complex acts, whereas the role of WM was modest. The present findings underscore the importance of adopting an encompassing theory that can account for different types of indirect speech acts, such as sincere, deceitful and ironic acts; they also suggest the importance of assessing individual differences in inferential and cognitive abilities.

Establishing a role of the semantic control network in social cognitive processing: A meta-analysis of functional neuroimaging studies

The contribution and neural basis of cognitive control is under-specified in many prominent models of socio-cognitive processing. Important outstanding questions include whether there are multiple, distinguishable systems underpinning control and whether control is ubiquitously or selectively engaged across different social behaviours and task demands. Recently, it has been proposed that the regulation of social behaviours could rely on brain regions specialised in the controlled retrieval of semantic information, namely the anterior inferior frontal gyrus (IFG) and posterior middle temporal gyrus. Accordingly, we investigated for the first time whether the neural activation commonly found in social functional neuroimaging studies extends to these 'semantic control' regions. We conducted five coordinate-based meta-analyses to combine results of 499 fMRI/PET experiments and identified the brain regions consistently involved in semantic control, as well as four social abilities: theory of mind, trait inference, empathy and moral reasoning. This allowed an unprecedented parallel review of the neural networks associated with each of these cognitive domains. The results confirmed that the anterior left IFG region involved in semantic control is reliably engaged in all four social domains. This supports the hypothesis that social cognition is partly regulated by the neurocognitive system underpinning semantic control.

The comprehension of grammaticalized implicit meanings in SPCD and ASD children: A comparative study

BACKGROUND

Autism spectrum disorder (ASD) and social pragmatic communication disorder (SPCD) are two neurodevelopmental disorders with many similarities in affected individuals' impairments in social-communicative and pragmatic development. A central question pertaining to their differentiation concerns whether the distinction is truly qualitative or, instead, quantitative in nature, and indeed, defining the boundary between SPCD and ASD with IQ in the normal range often presents differential-diagnostic difficulties. While deficits in the comprehension of certain linguistically systematic implicit verbal meanings have been targeted by experimental research in ASD, to date they have not been investigated in controlled experiments in SPCD.

AIMS

The empirical objectives of our study are twofold. First, it is explored whether the comprehension of a set of highly systematic, grammaticalized implicit meanings is impaired in ASD and SPCD children compared to their typically developing (TD) peers, and whether ASD and SPCD children differ from each other in accessing these verbal meanings. Second, it is investigated whether receptive grammatical competence and first-order ToM abilities are associated with children's performance in any way and whether there is a difference in this regard between the ASD and the SPCD group.

METHODS & PROCEDURES

Our main experiment, using a sentence-picture verification task, tested the comprehension of highly systematic implicit verbal meanings, including grammaticalized implicatures, presuppositions, and entailments. The experiment was complemented with a false-belief (ToM) task and a test of receptive grammar, among other measures. Seventy-one 4-to-9-year-old children participated in the study (ASD: n=19, SPCD: n=13, TD controls: n=39).

OUTCOMES & RESULTS

While both children with SPCD and children with ASD performed significantly more poorly than the TD group, only the comprehension profile of the SPCD group differed significantly from that of the TD group. Importantly, while ASDs' performance exhibited an association with their ToM results, the performance of SPCDs showed a correlation with their receptive grammar skills. By contrast, the performance of TDs correlated with neither.

CONCLUSIONS & IMPLICATIONS

These findings reveal potential divergences in the cognitive developmental mechanisms that underlie the semantic-pragmatic difficulties in the two clinical groups, suggesting that the communicative impairments in ASD and in SPCD differ qualitatively, rather than quantitatively. Specific implications for theories of pragmatic impairments in ASD and in SPCD are discussed.

WHAT THIS PAPER ADDS

What is already known on the subject Linguistically systematic implicit meanings are understudied both in ASD and in SPCD. Within this domain of verbal meaning, the majority of relevant experimental work on ASD, concentrated on generalized (mostly: scalar) implicatures, has yielded somewhat divergent results, while the comprehension difficulties in SPCD have remained barely charted territory. Linguistically more highly conventionalized implicit verbal meanings have not been experimentally investigated in either neurodevelopmental disorder. What this study adds A primary finding of our study is that although both the SPCD and the ASD group show significant deficit in the comprehension of highly conventional, grammaticalized implicit meanings, SPCD children may diverge more in their comprehension profile from their TD peers than ASD children. Another key result is that the comprehension of grammaticalized implicit meanings is linked with different cognitive functions in ASD and in SPCD. While comprehension performance is associated with ToM in ASD but not in SPCD or in TD, it is correlated with receptive grammar skills in SPCD but not in ASD or in TD. Clinical implications of this study These findings provide potential support for the hypothesis that the difference between ASD and SPCD is qualitative rather than quantitative in nature, thereby casting doubt on the conception that pragmatic limitations in SPCD are to be approached as a less severe form of similar deficits in ASD. Uncovering differences in the underlying cognitive sources and in the comprehension deficits of children with ASD and SPCD are critical for the improvement of the accuracy of SPCD children's early diagnosis and timely therapeutic intervention.

Understanding indirect requests for information in high-functioning autism

Few works have addressed the processing of indirect requests in High-Functioning Autism (HFA), and results are conflicting. Some studies report HFA individuals’ difficulties in indirect requests comprehension; others suggest that it might be preserved in HFA. Furthermore, the role of Theory of Mind in understanding indirect requests is an open issue. The goal of this work is twofold: first, assessing whether comprehension of indirect requests for information is preserved in HFA; second, exploring whether mind-reading skills predict this ability. We tested a group of (n = 14; 9–12 years) HFA children and two groups of younger (n = 19; 5–6 years) and older (n = 28; 9–12 years) typically developing (TD) children in a semi-structured task involving direct, indirect and highly indirect requests for information. Results suggested that HFA can understand indirect and highly indirect requests, as well as TD children. Yet, while Theory of Mind skills seem to enhance older TD children understanding, this is not the case for HFA children. Therefore, interestingly, they could rely on different interpretative strategies.

¿El entrenamiento en lectura de creencias puede influir sobre la competencia pragmática?: un estudio sobre las relaciones de estas capacidades cognitivas en la infancia

Con el objetivo de indagar respecto a la influencia de la lectura de creencias sobre la competencia pragmática, en el presente estudio 56 niños de entre 48 y 54 meses pertenecientes al programa Buen Comienzo de la ciudad de Medellín participaron en un diseño experimental pre-post con grupo control. Para la evaluación de la lectura de creencias se adaptaron al español cuatro pruebas de la escala de Wellman y Liu (2004), mientras que para evaluar la competencia pragmática se adaptaron cuatro situaciones comunicativas propuestas por Sacco et al. (2008). Para la manipulación de la variable se llevaron a cabo 10 sesiones de entrenamiento en lectura de creencias. De acuerdo con los resultados intragrupo, el programa de entrenamiento fue efectivo para mejorar la variable entrenada, pues el grupo experimental mejoró su desempeño en la lectura de creencias (p = .007; d = –.663) y en la competencia pragmática (p = .007; d = .648); no obstante, aunque se encontraron diferencias significativas entre el grupo experimental y el grupo control para la lectura de creencias (p = .001; d = .472), no fue así para el desempeño en la competencia pragmática (p = .340; d = .143). A la luz de estos resultados, no es posible asegurar una relación de influencia de la lectura de creencias sobre la competencia pragmática; sin embargo, se encontró un modelo de regresión lineal satisfactorio cuando se incluyeron en los análisis variables sociodemográficas. Al final del artículo se discute respecto a la necesidad de integrar variables de contexto cuando se indaga por una posible relación de influencia de una variable psicológica sobre otra.

The Neural Substrate of Speech Act Recognition

Pragmatic competence demands linguistic, but also communicative, social and cognitive competence. Successful use of language in social interaction requires mutual understanding of the speaker's intentions; without it, a conversation cannot proceed. The term speech act refers to what a speaker intends to accomplish when saying something. The purpose of this study was to contribute to the identification of the neural substrate of speech act recognition and to the characterization of the cognitive processes that may be involved. The recognition of speech acts resulted in greater activation of frontal regions, precuneus and posterior cingulate gyrus. From all cognitive and behavioral measures obtained, only the scores in mental flexibility predicted the change in blood oxygen level dependent (BOLD) signal in the precuneus. These results, support the idea that speech act recognition requires the inference of intention, executive functions, including memory and entails the activation of areas of social cognition that participate in several brain networks i.e., the Intention Processing, the Default Mode and Theory of Mind networks, and areas involved in planning and guiding behavior.

Children with hearing impairment and early cochlear implant: A pragmatic assessment

Extensive research has demonstrated the benefits of cochlear implants (CI) in contributing to improve the linguistic skills of children with hearing impairment; however, few studies have focused on the development of pragmatic ability and its relationship with age of implantation. Pragmatics is the ability to use language in different contexts and its development has crucial implications, e.g., social inclusion and professional attainments. In this study, we conducted a comprehensive assessment of pragmatic ability using the Language Pragmatic Abilities (APL Medea), a battery composed by five different tasks: Comprehension of Metaphors, Implicit meaning, Comics, Situations and Colors Game (a perspective taking task). Eighteen children with early CI, belonging to 3 different age groups (6; 11-7; 11, 8; 0-8; 11 and 9; 0-9; 11 years-old), and twenty-four children with typical development (Control Group) participated to the study. We also investigated how the precocity of CI, i.e., age of first implantation, may affect the pragmatic development. Globally, children with CI obtained lower scores in the APL Medea battery than typically hearing children. However, focusing on the Medea tasks separately, children with CIs differed from their hearing peers only in Comics and Colors Game tasks. Finally, age of implantation was a moderate but significant predictor of pragmatic performance.

What is the contribution of executive functions to communicative-pragmatic skills? Insights from aging and different types of pragmatic inference

The role of executive functions in supporting the pragmatics of communication has been extensively examined in clinical populations, but is still under-explored in healthy aging. In this study we addressed the role of executive skills, including inhibition, working memory, and cognitive flexibility, in older adults' communicative-pragmatic abilities. Pragmatics was extensively assessed by measuring the understanding of figurative language, narrative texts, humor, and implicatures. A hierarchical regression analysis using composite scores evidenced a global effect of executive functions on communicative-pragmatic abilities, beyond demographic and theory of mind aspects. More fine-grained analyses showed that working memory was the strongest predictor of all pragmatic tasks. Specifically, comprehending narratives and humor seemed to capitalize primarily upon working memory, whereas figurative language and implicatures relied on working memory and to some extent cognitive flexibility. Conversely, inhibition did not stand out as a robust predictor of pragmatics. We argue that working memory allows for the simultaneous consideration of multiple pieces of information needed for pragmatic inferencing, and that only once working memory has played its role other executive aspects, such as cognitive flexibility and inhibition, might come into play. Overall, this study highlights the diverse role of executive skills in pragmatics in aging, and more generally contributes to shed light on pragmatic competence in older adults.

Pragmatic abilities in early Parkinson's disease

Language impairment in Parkinson's disease (PD) has been investigated at different levels of linguistic skills. Only a few studies dealt with pragmatic abilities in PD, and these suggest an impairment of pragmatic skills, which might affect quality of life. However, previous studies enrolled patients with heterogeneous symptom severity. The goal of this study is twofold: first, to investigate whether pragmatic skills are compromised at the early stage of PD; second, to explore whether an early pragmatic impairment is explained by a decay of a specific cognitive function. We assessed pragmatic abilities (discourse production, comprehension of narratives, humour, and figurative language), and a cluster of cognitive functions (memory, verbal fluency, inhibition, shifting, and ToM) in a sample of early PD patients and a group of age-matched healthy controls. Early PD patients showed impaired general pragmatic skills (the ability to perform different pragmatic tasks in language production and comprehension), as well as a deficit in the production and comprehension individual scores. Our results suggest that good general cognitive skills (a good overall cognitive level) and high education support patients' pragmatic competence. Inhibitory processes have been found to predict patients' ability to understand figurative language, such as metaphors, and this might be related to frontal lobe dysfunctions.

Scalar and ad-hoc pragmatic inferences in children: guess which one is easier

Several studies investigated preschoolers' ability to compute scalar and ad-hoc implicatures, but only one compared children's performance with both kinds of implicature with the same task, a picture selection task. In Experiment 1 (N = 58, age: 4;2-6;0), we first show that the truth value judgment task, traditionally employed to investigate children's pragmatic ability, prompts a rate of pragmatic responses comparable to the picture selection task. In Experiment 2 (N = 141, age: 3;8-9;2) we used the picture selection task to compare scalar and ad-hoc implicatures and linked the ability to derive these implicatures to some cognitive and linguistic measures. We found that four- and five-year-olds children performed better on ad-hoc than on scalar implicatures. Furthermore, we found that morphosyntactic competence was associated with success in both kinds of implicatures, while performance on mental state reasoning was positively associated with success on scalar but not ad-hoc implicatures.

Understanding communicative intentions in schizophrenia using an error analysis approach

Patients with schizophrenia (SCZ) have a core impairment in the communicative-pragmatic domain, characterized by severe difficulties in correctly inferring the speaker's communicative intentions. While several studies have investigated pragmatic performance of patients with SCZ, little research has analyzed the errors committed in the comprehension of different communicative acts. The present research investigated error patterns in 24 patients with SCZ and 24 healthy controls (HC) during a task assessing the comprehension of different communicative acts, i.e., sincere, deceitful and ironic, and their relationship with the clinical features of SCZ. We used signal detection analysis to quantify participants' ability to correctly detect the speakers' communicative intention, i.e., sensitivity, and their tendency to wrongly perceive a communicative intention when not present, i.e., response bias. Further, we investigated the relationship between sensitivity and response bias, and the clinical features of the disorder, namely symptom severity, pharmacotherapy, and personal and social functioning. The results showed that the ability to infer the speaker's communicative intention is impaired in SCZ, as patients exhibited lower sensitivity, compared to HC, for all the pragmatic phenomena evaluated, i.e., sincere, deceitful, and ironic communicative acts. Further, we found that the sensitivity measure for irony was related to disorganized/concrete symptoms. Moreover, patients with SCZ showed a stronger response bias for deceitful communicative acts compared to HC: when committing errors, they tended to misattribute deceitful intentions more often than sincere and ironic ones. This tendency to misattribute deceitful communicative intentions may be related to the attributional bias characterizing the disorder.

A novel virtual reality-based theory of mind intervention for outpatients with schizophrenia: A proof-of-concept pilot study

Schizophrenia is a severe and highly disabling mental illness. Although several pharmacological solutions are available to alleviate symptoms of schizophrenia, they do not seem to provide solution for accompanying social dysfunctions. To handle this unmet clinical need, many innovative interventions have been developed recently. Considering the promising results on this field and the development trend, characterized by the growing proportion of included interactive technology, our research team developed a novel virtual reality (VR)-based targeted theory of mind (ToM) intervention (VR-ToMIS) for stable outpatients with schizophrenia. VR-ToMIS is a nine-session long structured and individualized method that uses cognitive and behavioural therapeutic techniques in an immersive VR environment. Our study was a randomized, controlled pilot study. Twenty-one patients have been recruited and randomly allocated to either VR-ToMIS or passive VR condition. Patients assigned to passive VR condition could use the same VR software as the VR-ToMIS group, but without any interventions. Effects on psychiatric symptoms, neurocognitive and social cognitive functions, pragmatic language skills and quality of life were evaluated by using analysis of covariance. According to our results, VR-ToMIS was associated with improvements in negative symptoms, in one neurocognitive field (immediate memory), ToM and pragmatic language skills, but no significant change in quality of life scores was detected. Significant changes in VR-ToMIS group were associated with moderate to large therapeutic effects (η_p ²  = .24-.46, φ = .55-.67). On the background of the presented pilot results, VR-ToMIS is concluded to be feasible and tolerable.

Beyond the motor account of amyotrophic lateral sclerosis: Verbal humour and its relationship with the cognitive and pragmatic profile

BACKGROUND

Amyotrophic Lateral Sclerosis (ALS) was traditionally described as a disease restricted to the motor system. However, recent findings suggested that it also affects cognition, especially executive functions, social cognition, language and pragmatics. A relevant issue in current research is thus the description of the cognitive phenotype of ALS and the identification of the most vulnerable aspects.

AIMS

The focus was on a communicative phenomenon placed at the crossroads of pragmatic and other cognitive domains, namely humour, which till now has been poorly explored in ALS. The first aim was to investigate whether ALS is associated with impairments in understanding and appreciating jokes. The second aim was to explore the predictors of humour comprehension and appreciation in patients, to confirm the involvement of pragmatic skills and to explore the role of other cognitive and clinical aspects.

METHODS & PROCEDURES

A total of 30 non-demented patients with ALS and 27 controls were assessed with a task of verbal humour comprehension and appreciation, including two types of jokes: phonological and mental. We also administered a battery of pragmatic and other language tasks, and cognitive and socio-cognitive tasks. Mixed-effects models were used to test differences in the humour task between the two groups. Multiple regressions determined the best predictors of humour comprehension and appreciation in patients.

OUTCOMES & RESULTS

Patients obtained lower comprehension accuracy scores than controls in the humour task, independently of the type of joke. Conversely, patients and controls did not differ in joke appreciation and both rated mental jokes as funnier than the phonological ones. Patients' comprehension accuracy was predicted by pragmatic skills and ALS severity, whereas appreciation was predicted by several clinical variables and, to a smaller extent, by language skills.

CONCLUSIONS & IMPLICATIONS

The findings suggest that humour is a very vulnerable aspect in ALS, and that impairment in humour comprehension might be part of the larger cognitive impairment, being linked to pragmatic impairment. Clinical variables were also important, especially in relation to humour appreciation. More generally, these data speak in favour of pragmatics as a relevant aspect to sketch the cognitive phenotype of ALS. On the practical level, these findings point to the need of supporting communication at large, not only motor-related aspects such as dysarthria but also social-pragmatic aspects such as understanding jokes, to increase well-being in ALS. What this paper adds What is already known on this subject The literature of the last decades has shown that ALS comes with impairment in several cognitive domains, affecting especially executive functions as well as language. There is also initial evidence that the pragmatics of communication and humour comprehension are impaired, although non-serious talk has been documented in conversational interaction among people with ALS. What this paper adds to existing knowledge This study offers compelling evidence of an impairment in the comprehension of jokes in ALS, whereas the appreciation of joke funniness seems to be spared. The study also highlights the interplay of cognitive factors (especially pragmatics) and clinical factors (related to disease severity) in predicting the patients' performance in the humour task. What are the potential or actual clinical implications of this work? The study's findings call for the need of increased awareness among scholars as well as practitioners and caregivers of the profile of humour comprehension and appreciation in ALS. On a practical level, we highlight the need of assessing humour comprehension and adapting the communicative style accordingly. Second, we recommend that intervention programmes targeting communication in ALS go beyond speech-related difficulties and include pragmatic aspects such as humour. Considering the important communicative and social function of humour, as well as its use as a coping strategy, humour interventions are key to improve the quality of life of individuals with ALS.

Familiarity, empathy and comprehension of metaphors in patients with borderline personality disorder

Research on figurative language has a long tradition in psychiatry, as it is employed in psychotherapy and its (mis)comprehension plays a substantial role in differential diagnostics of schizophrenic spectrum disorders. Although often associated with empathy and mentalization, it has never been addressed in borderline personality disorder (BPD). Therefore, this study investigated metaphor comprehension and its relationship to cognitive and affective empathy in 20 patients with BPD and 20 matched healthy controls who completed a metaphor task comprising conventional metaphors (CM), novel metaphors (NM), meaningless stimuli (MS), and a rating scale of familiarity, a factor known to influence performance. For cognitive and affective empathy, the interpersonal reactivity index was applied. At first patients with BPD seemed to have significantly more problems in comprehending CM, but not NM or MS, and were less familiar with CM. When familiarity with the stimulus was controlled, this difference disappeared. As for empathy, only fantasy was positively related to familiar CM beyond borderline symptoms. Results indicate that the comprehension of novel metaphorical meaning is preserved in patients with BPD.

Pragmatics Always Matters: An Expanded Vision of Experimental Pragmatics

Much of the work in experimental pragmatics is devoted to testing empirical hypotheses that arise within the study of linguistic and philosophical pragmatics. The focus in much of this work is focused on those aspects of communicated meaning that are “inferred” rather than understood through linguistic “coding” processes. Under this view, pragmatic meanings emerge secondarily after purely linguistic meanings are accessed or computed. Our aim in this article is to greatly broaden the scope of experimental pragmatic studies by calling for much greater emphasis on the complete pragmatics of language use. Pragmatics is continuously present and constrains people’s real-time production and processing of language in context. Experimental pragmatics should attend more to the particularities of pragmatic experience through closer examination of the people we study, the specific tasks used to assess understanding, as well as the actual complex meanings people interpret in diverse contexts. The many specifics of human pragmatics demand the study and theoretical inclusion of many bodily, linguistic, and situational factors that make up each instance of meaning making.

Pragmatics, Theory of Mind and executive functions in schizophrenia: Disentangling the puzzle using machine learning

OBJECTIVE

Schizophrenia is associated with a severe impairment in the communicative-pragmatic domain. Recent research has tried to disentangle the relationship between communicative impairment and other domains usually impaired in schizophrenia, i.e. Theory of Mind (ToM) and cognitive functions. However, the results are inconclusive and this relationship is still unclear. Machine learning (ML) provides novel opportunities for studying complex relationships among phenomena and representing causality among multiple variables. The present research explored the potential of applying ML, specifically Bayesian network (BNs) analysis, to characterize the relationship between cognitive, ToM and pragmatic abilities in individuals with schizophrenia and healthy controls, and to identify the cognitive and pragmatic abilities that are most informative in discriminating between schizophrenia and controls.

METHODS

We provided a comprehensive assessment of different aspects of pragmatic performance, i.e. linguistic, extralinguistic, paralinguistic, contextual and conversational, ToM and cognitive functions, i.e. Executive Functions (EF)-selective attention, planning, inhibition, cognitive flexibility, working memory and speed processing-and general intelligence, in a sample of 32 individuals with schizophrenia and 35 controls.

RESULTS

The results showed that the BNs classifier discriminated well between patients with schizophrenia and healthy controls. The network structure revealed that only pragmatic Linguistic ability directly influenced the classification of patients and controls, while diagnosis determined performance on ToM, Extralinguistic, Paralinguistic, Selective Attention, Planning, Inhibition and Cognitive Flexibility tasks. The model identified pragmatic, ToM and cognitive abilities as three distinct domains independent of one another.

CONCLUSION

Taken together, our results confirmed the importance of considering pragmatic linguistic impairment as a core dysfunction in schizophrenia, and demonstrated the potential of applying BNs in investigating the relationship between pragmatic ability and cognition.

A leopard cannot change its spots: A novel pragmatic account of concretism in schizophrenia

Concretism is a well-known feature of schizophrenia, tracing back to the early descriptions of the disease and commonly associated with the literal interpretation of figurative expressions such as proverbs, metaphors, and idioms. However, figurative expressions are not all alike in terms of linguistic and pragmatic processes. Determining if some figurative types are more impaired than others and if the type of task affects the performance constitutes an open issue with implications for the description of the clinical profile and for treatment. We run a fine-grained assessment of figurative language comprehension by comparing 47 patients with schizophrenia and 39 controls in three figurative types (idioms, metaphors, proverbs) presented in two response formats (multiple-choice, verbal-explanation), considering also the role of cognitive and clinical variables and the impact on quality of life. Mixed-effects models analysis revealed that: i) patients performed worse than controls across figurative types and response formats, indicating a diffuse impairment; ii) there is an interplay of figurative type and response format, which makes verbal-explanation of proverbs especially challenging; iii) in patients, problems in figurative language are largely connected with formal thought disorder and global IQ. Moreover, multiple-choice of metaphors was associated with patients' quality of life. This study offers a novel account of concretism, framed in pragmatics and figurative language processing. Adopting this perspective allowed us to describe the nuances of concretism, which areas in the figurative domain are especially challenging for patients and which ones capture differences in functioning, in order to guide intervention programs and integration in society.

The Ability of Patients With Schizophrenia to Comprehend and Produce Sincere, Deceitful, and Ironic Communicative Intentions: The Role of Theory of Mind and Executive Functions

Patients with schizophrenia are often described as impaired in several cognitive domains. Specifically, patients with schizophrenia often exhibit problems in solving tasks requiring theory of mind (ToM), i.e., the ability to ascribe mental states to oneself and others, communicative-pragmatic ability, i.e., the ability to use language and non-verbal expressive means to convey meaning in a given context, and executive functions (EF). This study aims to investigate the role of cognitive functions, such as general intelligence, selective attention, processing speed, and especially EF (working memory, cognitive flexibility, inhibition, and planning), and ToM in explaining the performance of individual with schizophrenia in comprehending and producing communicative acts expressed with different communicative intentions (i.e., sincere, deceitful, and ironic), and realized through linguistic and extralinguistic/non-verbal expressive means. Thirty-two patients with schizophrenia and an equal number of healthy controls performed tasks aiming to investigate their capacity to comprehend and produce sincere, deceitful, and ironic communicative acts in addition to a series of cognitive tasks evaluating EF and ToM. The results indicated that individuals with schizophrenia performed worse than the controls in the comprehension and production of all pragmatic phenomena investigated, as well as in all the cognitive functions examined. The patients with schizophrenia also exhibited an increasing trend of difficulty in comprehending and producing sincere, deceitful, and ironic communicative acts expressed through either linguistic or extralinguistic means. Furthermore, a multiple regression analysis of the patients' performance on the pragmatic tasks revealed that overall, the role of attention, general intelligence, and processing speed did not appear to significantly explain the patients' communicative-pragmatic performance. The inclusion of EF into the analysis did not contribute to increase the explained variance of the patients' ability to comprehend and produce the various pragmatic phenomena investigated. Only the addition of ToM could significantly increase the explained variance, but only in the comprehension and production of deceit expressed by language and the production of sincere communicative acts, also limited to linguistic production. We conclude that neither EF nor ToM are able to explain the decreasing trend detected in the patients' pragmatic performance.

Interpreting physical and mental metaphors: Is Theory of Mind associated with pragmatics in middle childhood?

We investigated the association between individual differences in metaphor understanding and Theory of Mind (ToM) in typically developing children. We distinguished between two types of metaphors and created a Physical and Mental Metaphors task, echoing a similar distinction for ToM. Nine-year-olds scored lower than older age-groups in ToM as well as in the interpretation of mental, but not physical, metaphors. Moreover, nine-year-olds (but not older children) who are better in ToM are also better in interpreting mental, but not physical, metaphors. This suggests that the link between metaphor and ToM is stronger when metaphorical interpretation involves mental aspects, and it is more evident in early rather than later childhood.