Baron-Cohen, S, Wheelwright, S, Hill, J, Raste, Y and Plumb, I (2001), The ‘Reading the Mind in the Eyes’ Test revised version: a study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2): 241–51

Original Journal Article

Summary

An investigation by Baron-Cohen et al. examined theory of mind in adults, including those with Asperger syndrome or autism. It was designed to improve on the 1997 ‘Reading the Mind in the Eyes’ test. This study used experiments and correlations.

Psychology Being Investigated

Theory of Mind

Concept – Theory of mind is the ability to attribute mental states—beliefs, intents, desires, emotions, knowledge—to oneself and others and to understand that others have beliefs, desires, and intentions that are different from one’s own.

In Context of Study – This study uses the ‘Reading the Mind in the Eyes’ Test to evaluate an advanced form of theory of mind. Participants are shown photographs of the eye region of faces and are asked to deduce the mental state of the person in the photo. This tests their ability to infer others’ thoughts and feelings based on minimal cues.

Social Sensitivity

Concept – Social sensitivity refers to the ability to perceive and respond appropriately to the social cues and emotional states of others.

In Context of Study – The revised test is designed to assess social sensitivity by testing the ability to read subtle social cues from the eyes, a key aspect of social interaction. It’s postulated that people with Asperger Syndrome or High-functioning Autism might show differences in social sensitivity, as manifested by their performance on this test.

Background

The study is grounded in a rich background of research in psychology, particularly in the areas of theory of mind, autism spectrum disorders, and social cognition.

1. Theory of Mind in Autism Spectrum Disorders

  • Early Research – Theory of mind research began to gain prominence in the 1980s. One of the pivotal studies was Baron-Cohen’s 1985 paper which proposed that children with autism have difficulty with theory of mind tasks.
  • Autism and Social Cognition – Subsequent research established a link between autism spectrum disorders (ASD) and challenges in social cognition, including difficulties in understanding others’ mental states.

2. The Original ‘Reading the Mind in the Eyes’ Test

  • Initial Development – The original ‘Reading the Mind in the Eyes’ Test, developed by Baron-Cohen et al. in 1997, was one of the first tools designed to measure subtle theory of mind deficits in adults, particularly focusing on the ability to read complex mental states from photographs of the eye region.
  • Findings from the Original Test – This test revealed that individuals with Asperger Syndrome or high-functioning autism had difficulties in recognizing complex mental states, suggesting theory of mind deficits.

3. Gender Differences in Social Cognition

  • Empirical Studies – Research in the late 20th century began to explore gender differences in social cognition, with findings often indicating that women tend to outperform men in tasks involving empathy and reading emotional states.
  • Relevance to Autism – This line of research became relevant in understanding ASD, as autism is more commonly diagnosed in males, and some theories proposed a link between extreme male brain theory and autism.

4. Advancements in Understanding Social Sensitivity

  • Social Sensitivity – Studies in social psychology and neuroscience expanded the understanding of social sensitivity, encompassing not just theory of mind but also the ability to navigate and interpret social cues and emotional signals.
  • Eye Contact and Social Interaction – The role of eye contact and facial expressions in social interaction became a crucial area of study, underpinning the importance of the eye region in social communication.

5. Critiques and Developments in Theory of Mind Research

  • Critiques of Early Models – While early models of theory of mind were influential, they faced critiques for oversimplifying complex social cognitive processes.
  • Neuroscientific Approaches – Advances in neuroimaging and cognitive neuroscience provided new insights into the neural mechanisms underlying theory of mind and social cognition.

Conclusion

The revised version of the ‘Reading the Mind in the Eyes’ Test by Baron-Cohen et al. builds upon these foundational studies and theories. It incorporates advancements in the understanding of theory of mind, nuances in social cognition in autism, gender differences in empathy and social sensitivity, and the critical role of the eyes in interpreting mental states. This comprehensive background allows the study to explore theory of mind and social sensitivity in a more sophisticated and nuanced manner, especially in relation to autism spectrum disorders.

Improving on the Original Eyes Test

The original version of the ‘Reading the Mind in the Eyes’ Test had several issues that the revised study aimed to improve on:

  1. Binary Response Format – The test initially involved a forced choice between only two response options, limiting the ability to detect nuanced understanding of mental states​​.
  2. Inclusion of Basic and Complex Mental States – The original test included both basic and complex mental states, some of which were too easy and risked producing ceiling effects. The revised version focused solely on complex mental states to increase difficulty​​.
  3. Items Solvable by Gaze Direction – Some items in the original version could be solved by merely observing the gaze direction, making it too easy for those with subtle mind-reading difficulties. These items were excluded in the revised version​​.
  4. Gender Bias in Photographs – The original version had more female than male faces, which might have introduced bias. The revised version corrected this by ensuring an equal number of male and female faces​​.
  5. Semantic Opposites as Choices – The test initially used semantic opposites as choices (e.g., ‘concerned’ vs. ‘unconcerned’), making it too easy. The revised version increased difficulty by ensuring that foil words had the same emotional valence as the target word​​.
  6. Narrow Range of Scores – The scoring range in the original test was too narrow to effectively identify individual differences. The revised version aimed to have a wider range of scores for better differentiation​​.
  7. Comprehension Issues with Words – The original test didn’t account for potential comprehension problems with the words themselves, particularly concerning for patients with High-Functioning Autism (HFA) who might have experienced language delays. The revised version included a glossary of all mental state terms to address this issue​​.

These improvements aimed to make the revised test more challenging and sensitive, thereby better capturing subtle individual differences in social cognition and theory of mind abilities.

Aims

  1. Testing Adults with AS or HFA – The primary aim was to test a group of adults with Asperger Syndrome (AS) or High-Functioning Autism (HFA) using the revised version of the test. This was to verify if the deficits observed in these groups in the original version of the test and related tests could be replicated. The original studies had identified significant differences between these groups and controls, and this aim sought to confirm these findings with the improved test.
  2. Investigating the Relationship with Autism Spectrum Quotient (AQ) – The study aimed to explore if there was an inverse correlation between performance on the revised Eyes Test and scores on the Autism Spectrum Quotient (AQ) in a sample of normal adults. The AQ is a self-report questionnaire designed to measure the extent of autistic traits in individuals with a normal IQ, with higher scores indicating more traits related to the autism spectrum.
  3. Examining Gender Differences – Another aim was to see if the sex difference observed in the first version of the test, where females showed superiority in performance, would be replicated in the revised test. This aspect of the research aimed to explore potential gender-related differences in social sensitivity and theory of mind abilities​​.

Methodology

Participants and Sampling

  • The study included adults with Asperger Syndrome (AS) or high-functioning autism (HFA) (N = 15) and a large control group of normal adults (N = 239).
  • Participants with AS or HFA were recruited through advertisements in support group magazines and had been diagnosed at specialist centres.
  • Control group participants were drawn from various sources, including adult community and education classes and public libraries, ensuring a diverse sample in terms of occupations and educational levels.

Groups

Group 1 – Adults with Asperger Syndrome or High-Functioning Autism (AS/HFA)

  • Number of participants: 15 (all male).
  • Method of recruitment: Through advertisements in the UK National Autistic Society magazine or equivalent support groups.
  • Diagnosed at specialist centres using established criteria.
  • Socioeconomic and educational levels similar to Group 2.
  • Given the short WAIS-R test (Wechsler 1939) and scored in the normal range (Mean IQ = 115, SD = 16.1).

Group 2 – Normal Adults

  • Number of participants: 122.
  • Recruitment: From adult community and education classes in Exeter or public library users in Cambridge.
  • Varied daytime occupations and educational levels, some with no education beyond secondary school, others with occupational training or college degrees.

Group 3 – Normal Adult Students

  • Number of participants: 103 (53 male, 50 female).
  • All were undergraduate students at Cambridge University.
  • Comprised mainly of science students (71 out of 103) and others in various subjects.
  • Not representative of the general population due to stringent entrance requirements of the university (typically three A grades at Advanced Level school leaving examinations).

Group 4 – IQ-Matched Controls from the General Population

  • Number of participants: 14.
  • These individuals were IQ matched with Group 1 (Mean IQ = 116, SD = 6.4)​​.

Procedure

  • The Revised Eyes Test was administered individually in a controlled setting.
  • Participants were presented with photographs showing the eye region of different actors and actresses and were asked to select from multiple-choice options the word that best described what the person in the photograph was thinking or feeling.
  • A glossary of mental state terms was provided, and participants could consult it if they were unsure of a word’s meaning.

Variables

  • The primary variable measured was the ability to interpret mental states from the eye region of faces.
  • The Autism Spectrum Quotient (AQ), measuring autistic traits in adults, was used to investigate its correlation with the Revised Eyes Test scores.

Controls and Comparisons

  • To ensure the validity of the test in differentiating specific social cognition skills, a gender recognition control task was included for participants with AS/HFA.
  • The study also compared results based on gender to investigate potential differences in social sensitivity between males and females.

Results

Group Comparisons in the Eyes Test

  • The study involved four groups: adults with Asperger Syndrome (AS)/High-Functioning Autism (HFA), general population controls, students, and IQ-matched controls.
  • A significant main effect of group was found on the Revised Eyes Task.
  • Group 1 (AS/HFA adults) performed significantly worse than the other three groups in understanding emotions through the eyes, while the other three groups did not differ significantly from each other.

Gender Differences

  • A near-significant sex difference was observed, with females scoring higher than males. However, the interaction was not significant.

Autism Spectrum Quotient (AQ) Scores

  • Group 1 (AS/HFA adults) scored significantly higher on the AQ compared to Groups 3 (students) and 4 (IQ-matched controls).
  • Group 1 scored significantly higher than Groups 3 and 4, between which there was no difference.

Control Task Performance

  • All subjects with AS/HFA scored 33 or above out of 36 on the gender recognition control task, suggesting that their ability to recognize gender based on the eyes was intact.

No Within-Group Differences for Students

  • Among the student group (Group 3), there were no significant differences in performance according to the subject studied.

These results suggest that adults with AS/HFA have specific difficulties in reading complex emotions and mental states from the eyes, as opposed to recognizing basic gender cues. Additionally, these individuals show higher autistic traits as measured by the AQ. The study provides valuable insights into the social cognitive differences associated with autism spectrum conditions. ​

Conclusions

Modification of the Eyes Test – The revised version of the Eyes Test is a more sensitive measure for assessing adult social intelligence. It effectively detects individual differences in social perception and cognition.

Utility in AS/HFA Diagnosis – The test is validated as a tool for identifying subtle impairments in social intelligence among adults with Asperger Syndrome or High-Functioning Autism, who otherwise demonstrate normal intelligence.

Broader Clinical Relevance – The Revised Eyes Test may also be applicable in assessing social intelligence in clinical groups beyond the autistic spectrum, such as individuals with brain damage affecting the amygdala or prefrontal cortex.

Gender Differences in Social Intelligence – The study notes a trend towards female superiority in social intelligence in the general population, although this finding warrants further investigation due to the small effect size.

Independence from General Intelligence – The test measures a specific aspect of intelligence that is distinct from general, non-social intelligence, as indicated by the lack of correlation between performance on the test and IQ scores.

Link with Autistic Traits – There is an inverse relationship between performance on the Revised Eyes Test and scores on the Autism Spectrum Quotient, suggesting that the test is effective in measuring a range of autistic traits.

Suggestions for Future Research – The study suggests the potential for using dynamic stimuli in future versions of the test to better reflect real-world conditions and the exploration of response times using computer-based test formats to further understand individual differences in social intelligence.

Strengths

Contribution to Clinical Practice and Further Research – The study’s findings have significant implications for clinical practice, especially in diagnosing and understanding AS/HFA. Furthermore, the study lays a foundation for future research, suggesting the use of dynamic stimuli and response time analyses, potentially paving the way for more nuanced and effective diagnostic tools in the field of social cognition.

Internal Validity – Controlled Variables and Specific Measures – The study’s design ensures high internal validity by controlling for various factors that could potentially confound the results. For instance, the inclusion of a gender recognition control test helps isolate social intelligence deficits specifically associated with Asperger Syndrome or High-Functioning Autism (AS/HFA) from general cognitive abilities. This control measure, along with the use of the Revised Eyes Test, which is a specific measure for assessing social intelligence, ensures that the study measures what it intends to, enhancing its internal validity.

External Validity – Diverse Participant Sampling – The study’s use of diverse participant groups enhances its external validity. By including adults with AS/HFA, normal adults, normal adult students, and IQ-matched controls from the general population, the study ensures a broad representation of the population. This diverse sampling allows for the generalization of the findings to a wider population, making the study’s conclusions more applicable beyond the specific sample used. Moreover, the inclusion of different demographic groups (e.g., gender, educational background, and occupational status) in the control groups adds to the robustness of the study’s external validity.

Weaknesses

Sample Size and Composition – One notable limitation is the relatively small sample size, particularly for groups such as the adults with Asperger Syndrome or High-Functioning Autism (AS/HFA), and the IQ-matched controls from the general population. A small sample size can limit the statistical power of the study, potentially affecting the reliability of the findings. Additionally, the composition of some groups, like the all-male group of adults with AS/HFA, raises concerns about gender representation and limits the generalizability of the results to a wider population.

Static Nature of Test Stimuli – The Revised Eyes Test relies on static images to assess social intelligence. This approach may not fully capture the dynamic nature of social interactions in real-life scenarios. Static images lack the motion and temporal dynamics inherent in actual social exchanges, which could be crucial for understanding and interpreting social cues. This limitation suggests that the test might not completely replicate the complexities of real-world social cognition and might miss certain subtleties that dynamic stimuli would reveal.

Potential for Cultural Bias – The study primarily involves participants from specific geographical and cultural backgrounds (e.g., the United Kingdom, particularly Cambridge and Exeter). This raises the possibility of cultural bias, as social intelligence and the interpretation of social cues can vary significantly across different cultures. Therefore, the findings and the effectiveness of the Revised Eyes Test might not be fully applicable or accurate across diverse cultural contexts. This limitation affects the external validity and cultural generalisability of the study.

Multiple-Choice Questions