The Theory of Mind Atlas
Tiffany L. Hutchins & Patricia A. Prelock © 2017
All entries in the Theory of Mind Atlas (ToMA) were developed for use with the Theory of Mind Inventory2 (ToMI-2) for the purposes of explaining theory of mind in the conduct of research and clinical practice.
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Item 56: My child can accurately identify and
reflect upon his/her own emotional states
Subscale(s): Advanced
.
This item is intended to tap emotional introspection which is the ability to identify and reflect
upon one’s own emotional states. Although there are a variety of ways in which we can know our own
minds and bodies, the topic of emotional introspection is devoted to emotional content which interplays
with, but is different from, other forms of consciousness including our ability to introspect about our
own actions (a.k.a. self-action-monitoring), intentions (self-intention-monitoring), and thoughts and
beliefs (a.k.a. self-belief or self-knowledge attribution).
Unlike the other forms of introspection, emotional introspection is considered to be a primary
form. Not only are emotional experiences an early evolutionary development but emotional
introspection provides a value assessment (e.g., positive, negative) that endows their subjects with
motive (e.g., approach, avoid; Seagar, 2002). Compared to other forms of introspection, emotional
introspection is also considered more complex owing, in part, to its three-component structure (Gaigg,
2012; Seagar, 2002). As Seagar (2002) argued, every emotional experience consists of some kind of
perception (e.g., seeing a bear), a bodily disturbance (e.g., heart begins to race), and an ‘evaluation’
component (a.k.a. ‘appraisal’, e.g., “feeling afraid”). It is this third evaluation component that
differentiates emotional from mere perceptual consciousness and which makes emotional introspection
more difficult and more prone to error compared to other forms of introspection. This difficulty is
compounded when one considers the complexity of the emotion under consideration not to mention
our human susceptibility to self-deception. Seagar (2002) illustrates the complexities of the evaluative
component of emotional introspection using an example from Jane Austen’s novel “Emma”:
“Persistently unable to acknowledge her love for Mr. Knightly, Emma finds herself somewhat
attracted to…Frank Churchill. Emma, whose most characteristic emotional state throughout
most of the novel is one of boredom, contrives to imagine that she is in love:
‘this sensation of listlessness, weariness, stupidity, this disinclination to sit down and employ
myself, this feeling of everything’s being dull and insipid about the house! I must be in love…’
(Austen, 1816/1966, p. 266).
This example falls under the [category]…of emotional introspection… Emma is conscious of
bodily sensations, and especially the (weakly negative) evaluative assessment of her
1
surroundings (characteristic of boredom or low level depression). She is also well aware of Frank
Churchill and the general expectation that he and she ought to be in love. Furthermore, Frank
Churchill is undeniably a possible matrimonial match for whom Emma definitely has some
feelings of genuine affection. But to know that she is in love with him, Emma has to correctly
assess the linkages amongst the components of her emotional state. This is not to say that it is
always difficult to know that one is in love, and Emma eventually achieves a more accurate self
assessment [when she realizes that she is, in fact, in love with Mr. Knightly]. But it is significant
that the vagueness or unclarity in the concept of love infects attempts at introspection about
love. In general, mental states which are expressed by ‘difficult’ or complex mental state
concepts are harder to instropect than simple or straightforward ones...But of equal significance
in a case such as Emma’s is the way that introspective assessment is itself an object of
evaluation” [i.e., it is recursive in nature]. (p. 684).
In summary, an evaluation component is central to emotional introspection and emotional
experience is a primary, yet complex, element of consciousness that is thoroughly integrated with high
level cognition. If the proposed three-part structure of emotional introspection (perceptual, bodily
disturbance, evaluation) is correct, one would expect to see disorders in which the functions of these
components dissociate. Indeed, several intriguing clinical phenomena, including an inability to
experience pain1 (which is sometimes reported in ASD), natural split-brain experiments2, and Capgras
Syndrome3 have been offered as evidence for the critical role played by the evaluation component of
emotional introspection.
Of course, emotional introspection is not all-or-none and is best construed along a continuum
from early, simple, or less developed forms to later, complex, or more developed forms. One
determinative factor for the complexity of emotional introspection appears to be the richness of our
knowledge about the mind. This is because the evaluative process that is central to emotional
introspection is conceptual in nature and thus requires an appropriate field of concepts for its
formulation. The notion of individual differences in the complexity of emotion introspection is
supported by research citing an association between emotional intelligence4 and performance on theory
of mind tasks (Barlow, Qualter, & Styliano, 2010; Furguson & Austin, 2010; Qualter, Barlow, & Styliano,
2011; Stone, Baron-Cohen, & Knight, 1998). It makes sense that the ability to identify and reflect upon
one’s own mental states would be correlated with performance on theory of mind tasks (in which
others’ perspectives must be inferred). In fact, an important theoretical question for philosophers and
psychologists is whether the same cognitive mechanism required for attributing thoughts and feelings to
others is also necessary for attributing these mental states to the self. As Frith and Happé (1999)
explained:
1
According to Seagar (2002) the aversiveness of pain was the first and primary element of consciousness emotion.
In these experiments, a ‘split brain’ patient is shown (via a clever optical device) an emotionally charged image
exclusively to her right hemisphere. Patients usually report experiencing disturbing emotions despite being
complete unaware of their source. Confabulations (the replacement of a gap in a person's memory or experience
by a falsification that he or she believes to be true) are also quite common.
3
A condition in which the afflicted sees close others - usually parents, children, spouse, or siblings – as imposters.
4
Emotional intelligence is similar to emotion introspection in that it refers to emotional awareness and analysis of
one’s own emotions but it is broader and typically includes awareness of others’ emotions as well as the ability to
problem-solve on the basis of this information (Mayer, Caruso, & Salovey, 2000). Moreover, the measurement of
emotional intelligence overwhelmingly assesses emotional knowledge as opposed to the online processing of
emotional information (Ferguson & Austin, 2010).
2
2
“At first glance the two attributions seem entirely different: our own mental states do not have
to be inferred through observation like those of others, and they may be less likely to be
erroneous. However, even though the input channels by which the relevant information is
received may well be different, a crucial part of the process is to distinguish mental states - be
they first-person or other people’s - from representations of the physical world…It seems
plausible that the mechanism that keeps representations of mental states separate from
representations of physical states is the same for self and other attribution. Even if the
appreciation of others’ mental state results in representations that are more error prone than
the representation of own mental states, this difference becomes trivial if one is unable to
represent mental states at all” (pp. 4-5).
In fact, there is very little evidence from the developmental literature5 to support the common
sense notion that we are aware of our own mental states before we are aware of others’ mental states:
“when children are able to report their own mental states, they are also able to report the mental states
of others. Conversely, when they cannot report and understand the psychological states of others, they
do not report those states of themselves” (Frith & Happé, 1999, p. 5). The cognitive structures for
representing one’s own and others’ mental states remain a topic of debate but the dominant view
seems to be that these are not separate systems (e.g., Carruthers, 2009; Frith & Happé, 1999; Gopnik,
1993; Hobson, 1990; Leslie, 1987; for a contrary view, see Nichols & Stitch, 2003; Westby & Robinson,
2014). Moreover, consistent with a Vygotskian view of cognitive development, it may be that it is
actually the ability to make inferences about others’ minds that is most facilitative for introspecting
about our own minds using a process in which we “are turning our mindreading capacities on ourselves”
(Carruthers, 2009, p. 123).
Because so little data are available that are specific to the construct of emotional introspection,
a brief review of the findings for emotional intelligence (a relative of emotional introspection; see
footnote 4) is warranted. Emotional intelligence is positively associated with life satisfaction, social
network quality, contentiousness, empathy, and social competence and negatively associated with
alexithyma6, psychological distress, neuroticism, loneliness, and depression (e.g., Austin, Evans,
Coldwater, & Potter, 2005; Brackett, Rivers, Shiffman, Lerner, & Salovey, 2006; Saklofske, Austin, &
Minski, 2003). Interestingly, the ability to focus attention on our past, present, or future subjective
experiences (another relative of emotional introspection known as ‘autonoetic’ [i.e., self-knowing]
consciousness7) is linked to competency with episodic memory (Gardiner, 2001; Wheeler, Stuss, &
Tulving, 1997). Episodic memory is a special kind of autobiographical memory in which people
consciously remember and ‘relive’ a personally-experienced event (e.g., going back in one’s mind to
remember the scene at a birthday party, knowing one’s place in that scene, and recalling the sights or
sounds). The empirical links between episodic memory and autonoetic consciousness are theoretically
important for understanding the processes involved in emotional introspection and underscore the
crucial role played by memory, the ability to form coherent mental representations, and mental-time
travel (see our description of item 57: future thinking).
5
Although see Carruthers (2009) who argues that developmental evidence is not relevant to this debate.
Alexithymia is considered a “subclinical condition characterized by difficulties in identifying and describing one’s
own emotional state” (Bird & Cook, 2013, p. 1).
7
Autonoetic consciousness is “the capacity to mentally represent and become aware of subjective experiences inn
the past, present, and future” (Wheeler et al., 1997, p. 331).
6
3
Lane (2006) proposed several developmentally-sequenced levels of emotional awareness that
ranged from a mere implicit awareness of physical sensations or bodily disturbances (i.e., somatic
symptoms) that are associated with an emotion to a richly endowed explicit awareness of complex
emotions. Like most theory of mind competencies, then, emotional introspection appears to undergo
key developments in toddlerhood and the preschool years (e.g., use of emotion terms to describe a
situation in which the child was happy, sad, mad, or scared). Still, researchers tend to construe the
ability to consciously and explicitly reflect upon and analyze one’s own emotional experiences as a late
stage or Advanced theory of mind competency that emerges in middle or late childhood (Ferrnyhough,
2015; Westby & Robinson, 2014) and that continues to develop into adulthood.
Emotional Introspection in ASD
Very little research has been conducted on ASD with regard to the specific topic of emotional
introspection. For this reason, the pertinent related bodies of literature are briefly reviewed here. As
noted above, there are many different ways that one can know and understand one’s self and review of
the ASD literature reveals a fascinating portrait of general strength and challenge areas in this regard
(for an excellent review, see Williams, 2010):
Intact/superior self-action-monitoring in ASD: Most studies/reviews on this topic conclude that
self-action-monitoring (i.e., the ability to distinguish between ‘self-caused’ and ‘world-caused’
changes in experience) are intact in ASD and may even be superior relative to neurotypical
samples (Frith & Hermelin, 1969; Williams, 2010; Williams & Happé, 2009a; but see Russell &
Hill, 2001; Russell & Jarrod, 1999, for conflicting results).
Impaired self-belief and self-knowledge attribution in ASD: Most studies/reviews on this topic
conclude that self-belief and self-knowledge attribution are impaired in ASD and that while
children with ASD tend to overestimate their knowledge of both self and others, they tend to
have the greater difficulty representing their own beliefs than the beliefs of other people
(Perner, Frith, Leslie, & Leekham, 1989; Williams, 2010; Williams & Happé, 2009b; but see Kazak,
Collis, & Lewis, 1997 who report null results).
Impaired self-intention-monitoring in ASD: Most studies/reviews on this topic conclude that
self-intention-monitoring (the ability to determine whether one’s own action was carried out
intentionally) is impaired in ASD (Phillips, Baron-Cohen, & Rutter, 1999; Williams, 2010; Williams
& Happé, 2009c; but see Russell & Hill, 2001, for conflicting results). For example, children with
ASD are more likely than learning-disabled children to incorrectly report that a knee-jerk reflex
was under their intentional control. Impairment in self-intention-monitoring is associated with
other impairments in theory of mind: a relation that holds after the effects of age and verbal
ability are removed (Lang & Perner, 2002; Williams & Happé, 2009c). “These result support the
view that individuals with autism have diminished awareness of their own intentions and that
this diminution is directly related to their impairments in recognizing others’ mental states”
(Williams, 2010, p. 479).
These patterns of strengths and challenges in self-knowing in ASD “provide strong support for a
taxonomy of self-awareness that clearly distinguishes between physical and psychological aspects of
self. Developmentally speaking, the case of autism seems also to demonstrate that one can have a
diminished awareness of the psychological self without any obvious implications for awareness of the
physical self” (Williams, 2010, p. 486). In light of the challenges identified with awareness of the
4
psychological self and the aforementioned complexity inherent in emotional introspection, one should
expect difficulty in this area as well. This conclusion is consistent with the finding that individuals with
ASD with high language and intellectual abilities score significantly lower than neurotypical individuals
on measures of emotional intelligence (see footnote 4; Montgomery, McCrimmon, Schewan, &
Saklofske, 2020; Petrides, Hudry, Michalaria, Swami, & Sevdalis, 2011) which, in turn, predicts levels of
social dysfunction (Montgomery, Stoesz, & McCrimmon, 2012). It also comports well with the finding
that although alexithymia (characterized by difficulties in identifying and communicating one’s own
emotions) affects approximately 10% of the general population (Mattila, Salminem, Nummi, &
Joukamaa 2006), the prevalence in ASD is estimated to be somewhere between 40 and 65% (Berthoz &
Hill, 2005; Hill, Berthoz, & Frith, 2004; Tani et al., 2004).
In both typical development and ASD, it appears that the ability to read others’ minds is strongly
associated with the ability to read one’s own (Frith & Happé, 1999; Moriguchi et al., 2006; Williams &
Happé, 2010): an observation that has been empirically confirmed in brain imaging studies specifically
focusing on the processing of emotional information in ASD (Bird, Silani, Brindley, White, Frith, & Singer,
2010; Silani, Bird, Brindley, Singer, Frith, & Frith, 2008). In short, these abilities tend to rise and fall
together but when capacities do diverge in ASD, it tends to be the case that the ability to read others’
minds is better than the ability to read one’s own! 8 (Williams, 2010; Williams & Happé 2009c; Williams,
Lind, & Happé, 2009). Although these intriguing results may at first seem out of keeping with the single
mechanism view (i.e., the view that there is one mechanism that supports the ability to reason about
the mental worlds of self and other; described above), it is elegantly reconciled with that view when one
imagines a single mechanism with two routes of access (one for self and one for other). This is important
in light of the findings that many individuals with ASD may not appreciate the value of having firstperson privileged access to their own inner states (Mitchell & O’Keefe, 2008). Indeed, when recalling
experienced events, individuals with ASD are less likely to than neurotypical samples to report taking a
first-person perspective and instead report taking a third-person (observer) view (Lind & Bowler, 2010).
As Williams (2010) further explained:
“A limited competence in recognizing mental states…is supplemented by the application of rulebound, cognitively acquired heuristics that are used to ‘solve’ theory of mind problems…Now,
the available information, to which such compensatory heuristics can be applied, clearly differs
in the cases of self and others. For example, one visually perceives the actions of other people
and can attribute mental states on the basis of these perceptions. Yet, one rarely visually
perceives one’s own actions (unless looking at oneself in a mirror or on a video recording).
Conversely, one has direct access to one’s own somatosensory experiences and inner imagery,
for example, but never has access to these in other people…When the theory of mind
mechanism is damaged (as it arguably is in ASD), repeated perception of regularities in others’
actions provides an opportunity to learn ‘behavior rules’, and thereby attribute mental to others
via compensatory heuristics. Such opportunities are less frequent in the case of one’s own
behavior, which one rarely visually perceives. As a result, self-awareness of mental state is most
at risk when the theory of mind mechanism, itself, is damaged” (p. 487).
Of course, discussions about self-awareness and emotional introspection lead to questions
about the subjective nature of experienced emotions in ASD and whether, in which ways, and to what
8
for the alternative argument see Bradford, Jentzsch, & Gomez (2015) and Tine & Lucariello (2012) but
note that the methodologies used may have been problematic (see Williams, 2010; Williams & Happé,
2009).
5
degree these experiences are equivalent to the experiences of neurotypical individuals. Anecdotal
parent-reports, self-reports, and the results of a several studies (some using a controversial ‘experience
sampling’ and interview methodology) suggest that both quantitative and qualitative differences exist
and that these differences may be profound in children with ASD with lower language and intellectual
abilities (e.g., Frith & Happé, 1999; Grandin, 1995/2006; Hurlbert, Happé, and Frith; 1994). This
conclusion is consistent with a large number of studies reporting impaired cognitive empathy but spared
affective empathy in ASD (see description of item 34) as well as altered physiological activity and
reported emotional reactions in ASD (Bolte, Feineis-Matthew, & Poustka, 2008). In summary, it seems
that many individuals with ASD will have trouble labeling and talking about their emotional lives but part
of this difficulty may also be due to the altered emotional experiences themselves: “rather than having
difficulties in accessing or reflecting on their feelings, [some] autistic individuals may experience feelings
differently because the processes that give rise to them are disrupted” (Gaigg & Bowler, 2008, p. 25,
also see Carmody & Lewis, 2012; Shalom, 2000; Lyons & Fitzgerald, 2013). The degree of disruption in
emotional introspection is likely associated with individual as well as situational factors. Specifically,
greater disruption is linked to autism severity and has been observed for more complex social emotions
(e.g., embarrassment) than for the basic emotions (e.g., fear) (Williams & Happé, 2010).
In ASD, difficulties in introspection are likely related to atypicalities in the development of selfconcept (e.g., Carmody & Lewis, 2012; Lyons & Fitzgerald, 2013). Another highly related factor is the
capacity for episodic memory. Semantic memory and episodic memory are two kinds of
autobiographical memory: semantic memory is akin to remembering facts whereas episodic memory
involves remembering one’s involvement vis-à-vis a personally experienced event. “Caution must be
exercised when attributing to people with autism memory processes of the episodic kind. I may know
that a particular event has happened to me in the past, and hence report details of the event quite
accurately, without actually remembering the event. Only this latter kind of ‘remembering’ is thought to
rely on metacognition” (Williams et al. 2010, p. 162).
While semantic memory seems relatively spared, episodic memory is known to be impaired in
many individuals with ASD (e.g., Lind & Bowler, 2010). It is also believed to be crucial in the
development of conscious awareness (Bowler, Gardiner, & Gaigg, 2007; Bowler, Gardiner, & Grice, 2000;
Wheeler et al., 1997). Individuals with ASD, even those with high language and intellectual abilities,
report fewer instances of episodic remembering leading researchers to argue that they “may have
subtle differences in the way they encode stimulus materials…The encoding differences may affect the
way individual items of information are inter-related, thus compromising category formation and use.
These differences may also affect the extent to which information can be manipulated flexibly and in a
manner that is thought to contribute directly to the development of self-conscious awareness” (Bowler
et al., 2006, p. 139).
The complexity of the processes involved in emotional introspection as well as the divergent
theories and competing views of the data have complicated efforts to develop interventions to support
emotional introspection (and self-conscious awareness more generally). For the time being, it seems
prudent to conclude that we do not know how to best support introspection in ASD but the most
promising treatment programs could potentially focus on supporting episodic memory (to support the
child’s ability to lay down a sufficiently strong record of what is being personally experienced) through
the use of a focused conversational approach (to support ‘inner speech’). Indeed, “…engaging in verbal
commentary may lead to events being encoded as ‘self-experienced’ and, hence, recalled more
accurately from memory” (Williams & Happé, 2009a, p. 259). Innovative peer-mediated theater
interventions, which incorporate video modeling (to facilitate observational learning) and which seek to
6
integrate the understanding of feelings, social interactions, and social cognition, are also proving to be
promising (Corbett et al., 2011; 2016).
Emotional Introspection in ADHD
It is well-documented that individuals with ADHD are more likely than typically developing (TD)
individuals to develop biased conceptions of their own and other’s behavior, that they are impaired in
emotion recognition, and that they often produce heightened emotional responses that are associated
with emotional dysregulation (e.g. Barkley, 1997). For these reasons, one might expect that individuals
with ADHD will also be at risk for poor understanding of their own inner mental states including those
involved in emotional introspection. In fact, the limited research on this topic strongly supports this
conclusion. For example, Casey (1996) found that children with ASD were impaired in emotion
recognition of others and of themselves (11% accuracy rate for both) compared to an approximate 50%
accurate rate for a neurotypical control sample. Subsequently, Rapport, Friedman, Tzelepis, and Van
Voorhis (2002) found that the self-reported intensity of one’s own experienced emotions was higher in
the ADHD group and that intensity level moderated emotion recognition: for the TD group, higher
intensity of experienced emotions predicted better emotion recognition but this trend was actually
reversed in ADHD. Rapport and colleagues (2002) concluded that the observed effects were not
explained by gross perceptual processes (e.g., face processing) or attentional aspects of emotion
recognition. Rather, it appears “that within moderate levels of experienced affect intensity, sensitivity to
one’s own emotions facilitates sensitivity to the emotions of others; however, extreme levels of
experiencing one’s own emotions disrupts the ability to be sensitive to the emotions of others” (p. 107).
More recently, Hutchins et al. (2016) compared typically developing TD males, males with ASD,
and males with ADHD for their comprehension of emotional introspection using caregiver report (i.e.,
item 56 of the Theory of Mind Inventory). Results revealed that emotional introspection was
significantly lower in the ASD and ADHD groups compared to the TD group and that there were no
differences between the ASD and ADHD groups. Hence, children with ADHD appear to be at risk for poor
emotional introspection. This result is consistent with the findings from the general emotion processing
literature in ADHD that individuals with ADHD are less attuned to emotional stimuli and that they
experience greater rates of alexithymia (although they are likely unaware of their difficulties in these
areas; Edel et al., 2010; Friedman et al., 2003). As was the case for ASD, it seems prudent to conclude
that we do not yet know how to best support emotional introspection in ADHD but the most promising
treatment programs potentially focus on supporting awareness and accurate appraisal of behaviors,
mental states, and attitudes of self and other.
Emotional Introspection in DoHH
DoHH children of hearing parents are at risk for “delayed emotional competence” (Meerum
Terwogt & Rieffe, 2004, p. 231) given the paucity of mental state talk and family conversations about
the mind that often characterized their early language-learning environment (Rieffe, Meerum Terwogt,
& Smit, 2003; see also our description of item 59: desire-based emotion). Yet, we are aware of only one
study that has specifically examined emotional introspection in children who are DoHH. Analyses of
caregiver report data (i.e., item 56 of the Theory of Mind Inventory) from a small sample of children
(ages 5 – 11) with corrected hearing loss revealed deficits in emotional introspection in 8.3% of children
(i.e., 1/12 children; Hutchins, Allen, & Schefer, 2017). This figure is consistent with a study Yasin et al.
(2012) who reported low levels of emotional intelligence (see footnote 4) in 9% of their sample of
7
children with hearing loss. Thus, difficulties in emotional introspection (and emotional intelligence) may
be rare (or slight) in children with hearing loss that is not complicated by additional neurological or
psychiatric conditions. Of course, more research is necessary to determine the precise extent to which
children with hearing loss may be at risk for poor emotional introspection.
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