Helena Drury

Interpretation of mentalistic actions and sarcastic remarks: Effects of frontal and posterior lesions on mentalising

Recent work has linked mentalising ability to ventromedial frontal brain regions, the temporal poles and the temporo-parietal junction. The present study set out to examine the performance of participants with focal frontal and posterior lesions and a matched healthy control group on mentalising tasks with different types of pragmatic materials. Four types of materials were used: control physical events, human actions, and direct and indirect sarcastic remarks. Ability to interpret these was tested by asking participants both to explain the events, actions or remarks, and then to choose the best solution from four alternatives presented. Those with frontal lesions were impaired in comprehension of each of the sets of mentalistic materials, but were intact in comprehension of the control non-mentalistic items. There was some evidence linking the generation of free responses for the mentalistic materials to lateral frontal regions; this may be mediated by executive skills. There was also evidence linking selection amongst alternative solutions to right frontal regions, particularly ventromedial areas. There was little evidence that posterior regions played any significant part, at least for the present mentalistic materials. Errors in sarcasm comprehension made by participants with frontal lesions revealed that these were not always literal in nature, suggesting two separable components in comprehension: appreciating that a meaning is not intended literally, and understanding the specific meaning in the social context.

Tourette's syndrome (TS): inhibitory performance in adults with uncomplicated TS.

Tourettes syndrome (TS) is a neurodevelopmental disorder linked with frontostriatal dysfunction. Previous work has shown some evidence of mild performance deficits on a range of different tasks that involve inhibitory processes. The present study evaluated this in adult participants with uncomplicated TS. Interference control was measured using the Stroop and flanker tasks and a Stroop-flanker task that combined the inhibitory demands of both. Motor inhibition was measured using a letter continuous performance test (CPT) task and word CPT tasks that manipulated the inhibitory demands using compatible and incompatible words. The TS group was found to be slower than the control group on most measures, but showed differential slowing under conditions with enhanced inhibitory demands on the combined Stroop-flanker and the incompatible CPT tasks. The findings suggest that TS-alone is linked to mild impairments in aspects of inhibitory function, and that these can be detected by relatively powerful inhibitory manipulations. A range of different types of inhibitory tasks may be sensitive to TS-alone, and this may depend on both the type of inhibition and the strength of the inhibitory manipulation.

Emotional processing and executive functioning in children and adults with Tourette's syndrome

Tourettes syndrome (TS) is predominantly a childhood disorder, with many of those who meet diagnostic criteria in childhood experiencing a remission of symptoms in adulthood. This indicates that the influence of TS on cognitive and emotional processing can best be understood by examining performance in both adults and children with TS. The present study examined emotional processing using a battery of face and prosody tasks with increasing levels of difficulty (same-different emotion discrimination, emotion naming, and emotion naming with conflict for prosody only). Experiment 1 compared the performance of children with TS-alone (n = 16) or TS+ADHD (n = 15) to healthy matched control children (n = 27). Compared to healthy control children, no significant group differences were found for those with TS-alone. Children with TS+ADHD showed subtle impairments on the more difficult emotion processing tasks relative to healthy control children, and differences were more pronounced for anger items (voice emotion naming, p < .05; voice emotion naming with conflict, p < .01). Experiment 2 compared the performance of adults with TS-alone (n = 23) to healthy matched controls (n = 21). No significant group differences were found, other than evidence of subtle impairment in the adults with TS-alone on the most complex task, again particularly for anger items (p < .05). Separate measurement of executive skills detected no evidence of impairment in children or adults with TS and little in the way of correlational evidence linking emotion recognition and executive skills. Implications of the findings for our understanding of emotion processing in TS are discussed.

Judgements of social inappropriateness in adults with Tourette's syndrome.

Introduction. Socially inappropriate behaviour has frequently been reported in Tourettes syndrome (TS), but has not been studied experimentally. The current study was designed to examine the appropriateness of self-disclosures in TS using an emotional self-disclosure task. Methods. Adult participants with TS-alone (20) and matched controls (20) were compared on two social judgement tasks, one examining the regulation of behaviour in an emotional self-disclosure task requiring participants to generate examples of autobiographical events, and the other examining mentalistic judgement of others’ behaviour on a faux pas task. Results. Those with TS-alone and controls showed no group differences for judges’ or participants’ ratings of inappropriateness on the self-disclosure task, although only the self-ratings of the control group corresponded to the judges’ ratings. On the faux pas task, those with TS-alone were impaired relative to controls in detecting socially inappropriate behaviour. There was also some evidence of executive dysfunction in the TS-alone group. Conclusions. TS-alone is linked to a mixed pattern of preserved and impaired performance on social cognition measures, and further work is needed to determine the contributions of social and/or executive contributions to everyday functioning.

Punishment and Sympathy Judgments: Is the Quality of Mercy Strained in Asperger's Syndrome?

This study examined reasoning about wrongdoing in people with Asperger’s syndrome (AS) and matched healthy controls in relation to car accident scenarios. The two groups made similar judgments with respect to degree of driver negligence for both fines imposed and sympathy ratings. They also made similar judgments of fines in relation to the type of justification given for the drivers’ actions. However, the AS group differentiated more in sympathy judgments relating to good and poor justifications. The AS group thus appeared to show preserved judgment with respect to compensation and sympathy for the victim and fines for the driver, but expressed less sympathy towards drivers with poor justifications for their actions.

Judgments of Cause and Blame: Sensitivity to Intentionality in Asperger’s Syndrome

Sensitivity to intentionality in people with Asperger’s syndrome (AS) and matched controls was investigated using two scenario-based tasks. The first compared intentional and unintentional human actions and physical events leading to the same negative outcomes. The second compared intentional actions that varied in their subjective and objective likelihood of bringing about a negative outcome. Whilst adults with AS did not differ from controls in their judgments of causality, or in their blame judgments in relation to non-mentalistic factors, they showed heightened sensitivity to mentalistic considerations in their attributions of blame. They made greater differentiation than controls between intentional and unintentional actions, and also between actions that the protagonists believed to be likely versus unlikely to lead to negative consequences.

Self-reported emotion regulation in adults with Tourette's syndrome

Recent work has reported mild impairments in social and emotional processing in Tourettes syndrome (TS), but deliberate attempts to use specific emotion regulation strategies have not been investigated previously. In the present study, adult participants with TS and no comorbidities (TS-alone) were compared to healthy control participants on several self-report measures assessing habitual use of reappraisal and suppression emotion regulation strategies. There were no group differences on measures of reappraisal, but the TS-alone group reported using suppression more frequently than the control group and this was true across a range of negative emotions. The groups did not differ on symptomatology scores of anxiety or depression, although more frequent use of suppression was associated with higher depressive symptomatology for the TS-alone group only. Further work is needed to examine potential factors that may influence emotion regulation in TS, including increased emotional reactivity or expertise in applying strategies to suppress tic symptoms.

Effortful and automatic cognitive inhibition in adults with Tourette's syndrome.

OBJECTIVE Inhibition has been widely investigated in Tourettes syndrome (TS), but some inhibitory processes have received more attention than others. This study examined the relatively underresearched construct of cognitive inhibition in adults with TS and no comorbidities (TS-alone), using tasks thought to tap automatic (without conscious intent) and effortful (with deliberate intent) inhibitory processes. METHOD Adult participants with TS-alone (n = 20) and healthy controls (n = 21) were compared on a retrieval-induced forgetting task thought to tap automatic cognitive inhibition and a directed forgetting task thought to tap effortful cognitive inhibition. Both tasks involved effortful memory as well as the key inhibitory effects. RESULTS Both the TS-alone and control groups showed typical inhibitory effects on both tasks, but the TS-alone group showed generally poorer effortful memory on both tasks. CONCLUSIONS The findings appear to indicate intact cognitive inhibition in adults with TS-alone, with some evidence of impairment in effortful processing. This highlights the importance of using tasks related to different inhibitory processes to explore cognitive performance in TS-alone, and suggests that any inhibitory impairment associated with TS-alone is mild and relatively circumscribed.

Comprehension of direct and indirect sarcastic remarks in children and adolescents with Tourette’s syndrome

ABSTRACT Previous research has reported that aspects of social cognition such as nonliteral language comprehension are impaired in adults with Tourette’s syndrome (TS), but little is known about social cognition in children and adolescents with TS. The present study aims to evaluate a measure of sarcasm comprehension suitable for use with children and adolescents (Experiment 1), and to examine sarcasm comprehension in children and adolescents with TS-alone or TS and attention deficit hyperactivity disorder (ADHD; Experiment 2). In Experiment 1, the measure of sarcasm comprehension was found to be sensitive to differences in nonliteral language comprehension for typically-developing children aged 10 to 11 years old compared to children aged 8 to 9 years old; the older group performed significantly better on the comprehension of scenarios ending with either direct or indirect sarcastic remarks, whereas the two age groups did not differ on the comprehension of scenarios ending with sincere remarks. In Experiment 2, both the TS-alone and TS+ADHD groups performed below the level of the control participants on the comprehension of indirect sarcasm items but not on the comprehension of direct sarcasm items and sincere items. Those with TS+ADHD also performed below the level of the control participants on measures of interference control and fluency. The findings are discussed with reference to the possible contribution of executive functioning and mentalizing to the patterns of performance.