Theory of Mind and Social Functioning in Health and Psychopathology: A Social Neuroscience Perspective

Abstract

As a highly social species, our social connectedness carries important consequences for our physical and mental well-being. Navigating the social world and developing social connections, however, is challenging for people with schizophrenia, making it difficult for them to reap the benefits of social relationships. Though treatments for social dysfunction are clearly warranted, it remains unclear as to what factors influence daily social behavior, leaving the pathophysiological mechanisms of social dysfunction and potential targets for intervention unknown. In the current dissertation, I present three studies evaluating the hypothesis that the neural network supporting theory of mind (ToM) – the process by which we attribute and reason about the mental states of others – is one important determinant of social functioning in schizophrenia, individuals at familial risk for schizophrenia, and romantic couples. Using fMRI and behavioral methods, I find that individuals with schizophrenia (Paper 1) and individuals at familial risk for schizophrenia (Paper 2) exhibit disruption to the ToM network. Furthermore, neural activity in aspects of the ToM network captures variance in laboratory-based assessments of ToM and daily-reported ToM, social enjoyment/motivation, and other aspects of social functioning in these groups. FMRI and experience-sampling data from romantic couples (Paper 3) suggest that recruitment of the ToM network may support healthy social relationships by affecting the well-being of social partners. Together, the findings are consistent with the notion that the neurocognitive system supporting ToM is one important factor underlying social functioning in health, psychopathology, and at risk states. As such, this work may carry important implications regarding the pathophysiological processes connecting social dysfunction to illness onset and exacerbation, endophenotypes, and treatment. These findings point towards important future directions, which include elucidating how the dynamic relations between neural function and behavior, as well as ToM and other social processes (e.g., social anhedonia and withdrawal), interact and unfold over the course of development in the service of healthy social behavior and the expression of psychopathology.