This article includes discussion of theory of mind, simulation theory, and theory theory. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.
Theory of mind refers to the cognitive ability to make inferences about others’ mental states (eg, beliefs, intentions, and desires) and use them to understand and predict behavior. Theory of mind plays a central role in human social interactions. In this article, the author explains how the concept has emerged and reviews ongoing research into the cognitive mechanisms and neurophysiological bases underlying theory of mind, relations between theory of mind and other cognitive abilities, and clinical applications.
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• Theory of mind refers to the cognitive ability to make inferences about others’ mental states.
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• Theory of mind plays a central role in human social interactions.
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• Findings from imaging and lesion studies indicate that theory of mind reasoning is supported by a widely distributed neural system.
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• Research on theory of mind has opened new windows into understanding the neuropathological bases of psychiatric and neurologic disorders in which social cognitive and theory of mind skills may be specifically impaired.
Historical note and terminology
Theory of mind refers to the cognitive ability to make inferences about others’ mental states (eg, beliefs, intentions, and desires) to explain and predict behavior. The term was coined by Premack and Woodruff, who tested whether a chimpanzee could recognize and respond to the goals of an actor struggling to solve staged problems (66). After observing videotapes of these problems, the chimpanzee correctly selected photographs that depicted solutions to the actor’s implicit desires or goals, as opposed to those that depicted other associated events. Many researchers disagreed that this finding reflected an understanding of mental states, and that many similar results with nonhuman primates might better be explained by making nonmentalistic inferences or learning behavior regularities (20; 39). This controversy sparked a strong interest in how to best test for theory of mind abilities in nonhuman species and very young human children. The “false belief” task became a standard assessment method because predicting that someone will act on their false belief requires the subject to recognize that others have representations of the world that differ from the subject’s own.
In a seminal developmental study, Wimmer and Perner investigated young children’s understanding of beliefs, finding that children around 5 years of age consistently passed false belief tasks, and children around 3 years of age consistently failed (91). These initial experiments in nonhuman primates and children launched an extensive research effort into the theory of mind abilities of these populations over the next 40 years. Current evidence from nonhuman primates is mixed, with strong evidences that they make sophisticated use of social cues, for instance, attending to what others can see or hear, and show no evidence of attributing false beliefs (38; 29; 56), with the exception of 2 studies with great apes (50; 49). In human children, however, a number of studies suggest that human infants reason about others’ goals, perceptions, and even false beliefs when tested in “implicit” theory of mind tasks that use infants’ looking time as a proxy for expectancy-violation (Woodward 1998; 62; 55). There is significant debate about the developmental onset of false belief understanding, the extent to which theory of mind abilities undergo significant conceptual development between infancy and the preschool years (89), the existence of implicit or automatic theory of mind (51), and the extent to which various tasks purported to measure theory of mind tap a unitary construct in either young children or adults (65; 86).
Perhaps because of its wide-ranging application to almost all questions of human social cognition and behavior, theory of mind research has extended well beyond the domains of comparative and developmental psychology. Philosophers and cognitive scientists question the mechanisms underlying these abilities and the types of experiments that can test for a mentalistic rather than behavior-based understanding of behavior. Neurologists and cognitive neuroscientists are interested in the neural bases of various theory of mind skills. Clinicians have investigated theory of mind impairments in individuals with a range of disorders, with a growing body of research implicating theory of mind deficits in most psychiatric and neurologic syndromes (Cotter et al 2018).