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Journal of Clinical and Experimental
Neuropsychology
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Understanding advanced theory of mind and
empathy in high-functioning adults with autism
spectrum disorder
Danielle Mathersul
a
, Skye McDonald
a
& Jacqueline A. Rushby
a
a
School of Psychology , University of New South Wales , Sydney , NSW , Australia
Published online: 25 Jun 2013.
To cite this article: Danielle Mathersul , Skye McDonald & Jacqueline A. Rushby (2013) Understanding advanced
theory of mind and empathy in high-functioning adults with autism spectrum disorder, Journal of Clinical and
Experimental Neuropsychology, 35:6, 655-668, DOI: 10.1080/13803395.2013.809700
To link to this article: http://dx.doi.org/10.1080/13803395.2013.809700
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Journal of Clinical and Experimental Neuropsychology, 2013
Vol. 35, No. 6, 655668, http://dx.doi.org/10.1080/13803395.2013.809700
Understanding advanced theory of mind and empathy in
high-functioning adults with autism spectrum disorder
Danielle Mathersul, Skye McDonald, and Jacqueline A. Rushby
School of Psychology, University of New South Wales, Sydney, NSW, Australia
It has been argued that higher functioning individuals with autism spectrum disorders (ASDs) have specic decits
in advanced but not simple theory of mind (ToM), yet the questionable ecological validity of some tasks reduces the
strength of this assumption. The present study employed The Awareness of Social Inference Test (TASIT), which
uses video vignettes to assess comprehension of subtle conversational inferences (sarcasm, lies/deception). Given
the proposed relationships between advanced ToM and cognitive and affective empathy, these associations were
also investigated. As expected, the high-functioning adults with ASDs demonstrated specic decits in compre-
hending the beliefs, intentions, and meaning of nonliteral expressions. They also had signicantly lower cognitive
and affective empathy. Cognitive empathy was related to ToM and group membership whereas affective empathy
was only related to group membership.
Keywords: Autism; Aspergers; Theory of mind; Sarcasm; Empathy; Ecological validity.
Autism spectrum disorders (ASDs), including
autism (both low-functioning autism and high-
functioning autism, HFA) and Aspergers syn-
drome, are pervasive developmental disorders
characterized by severe impairments in the devel-
opment of a broad range of social and psycho-
logical functions, usually apparent before the age
of three years (American Psychiatric Association,
APA, 2000). Core diagnostic criteria of ASDs
include marked impairment in social interaction
(poor socialemotional reciprocity, difculty estab-
lishing and maintaining developmentally appropri-
ate relationships), decits in the use of nonver-
bal communication behaviors (such as eye gaze,
facial expression, and gestures), and the presence of
repetitive and stereotyped behaviors (APA, 2000).
Where lower functioning individuals typically dis-
play marked decits in language, higher functioning
individuals (e.g., Aspergers, HFA) usually have an
1
Recent changes to diagnostic criteria in the Diagnostic and Statistical Manual of Mental DisordersFifth Edition (DSM5) have
removed the distinction between autism and Aspergers (American Psychiatric Association, APA, 2013); therefore, for the purposes of
the present study, these individuals are referred to as high-functioning individuals with ASDs.
D.M. is supported by an Australian Postgraduate Award (APA). J.A.R. is supported by an Australian National Health and Medical
Research Council (NHMRC) Postdoctoral Fellowship (Clinical Training; APP1013796). This research was funded by the Australian
National Health and Medical Research Council (NHMRC). We would like to thank the individuals who gave their time to participate
in this study and the clinicians who assisted with participant recruitment.
Address correspondence to: Danielle Mathersul, School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia
(E-mail: d.mathersul@unsw.edu.au).
IQwithin the normal range (APA, 2000). Therefore,
for the current study, high-functioning individu-
als were examined, in order to isolate the extent
of social decits in ASDs whilst avoiding possi-
ble confounds associated with language and IQ
decits.
1
It has been argued that poor theory of mind
underlies the social decits seen in ASDs (e.g.,
Baron-Cohen, 1991; Happ, 1994). Theory of mind
(ToM; also referred to as social intelligence, men-
talizing, or cognitive empathy) is the ability to
understand the mental states of others and thus
infer their feelings, thoughts, intentions, beliefs,
desires, and potential behavioral reactions to situ-
ations (Baron-Cohen, 1988; Frith, 1989). A ToM
decit in ASDs was rst demonstrated almost three
decades ago (Baron-Cohen, Leslie, & Frith, 1985),
and since then there has been wide support for
a ToM decit in ASDs (see Philip et al., 2012;
2013 Taylor & Francis
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656 MATHERSUL, MCDONALD, RUSHBY
Yirmiya, Erel, Shaked, & Solomonica-Levi, 1998,
for reviews). In that rst study (Baron-Cohen et al.,
1985), 80% of a sample of 3-year-old children with
ASDs failed simple, rst-order false-belief ToM
tasks (the Sally-Anne story, in which it has to
be understood that one character acts on a false
belief; Wimmer & Perner, 1983). Further investi-
gation (at the age of 7 years; Baron-Cohen, 1989)
demonstrated that those children with ASDs who
passed simple ToM tasks failed more advanced,
second-order false-belief ToM tasks (e.g., stories
where it has to be understood that one charac-
ter has thoughts/beliefs about another characters
thoughts; Perner & Wimmer, 1985). In support of
these early studies, more recent investigations have
shown that while higher functioning children and
adults with ASDs have intact simple ToM abil-
ities, they are impaired on advanced ToM tasks
such as second-order false belief (Happ, 1994),
recognition of faux pas (i.e., appreciating the cir-
cumstances surrounding a social blunder; Baron-
Cohen, ORiordan, Stone, Jones, & Plaisted, 1999),
strange stories task (i.e., stories involving nonlit-
eral expressions such as tact, sarcasm, irony, and
bluff; Happ, 1994), hinting tasks (i.e., the ability
to understand intentions; Craig, Hatton, Craig, &
Bentall, 2004), and nonverbal tasks such as inter-
preting inanimate stimuli designed to move so as
to suggest agency (Castelli, Frith, Happ, & Frith,
2002; Hubert et al., 2007; although see Pilowsky,
Yirmiya, Arbelle, & Mozes, 2000, for evidence of
more extensive decits).
However, a major confound to date in this
research is the arbitrary and articial nature of
the stimuli used, which casts doubt upon the link
between ToM decits and social decits in ASDs.
For example, rst- and second-order false-belief
tasks, recognition of faux pas (social blunders),
and the strange stories task (nonliteral expressions)
are all abstract text-based measures of mentaliz-
ing judgments and inferences, and their relation-
ship to everyday functioning is unclear. Animated
tasks such as the triangles (Castelli, Happ, Frith,
& Frith, 2000) or point-light motion displays
(Heberlein, Adolphs, Tranel, & Damasio, 2004) are
a step towards increased ecological validity but
remain abstract relative to the demands of every-
day social interaction. Notably, there are strong
arguments over whether the most commonly used
test of advanced ToM, the reading the mind
in the eyes task, which requires participants to
select a descriptor for the mental state of a per-
son based on a photo of the eye region alone
(Baron-Cohen, Jolliffe, Mortimore, & Robertson,
1997; Baron-Cohen, Ring, et al., 1999; Baron-
Cohen, Wheelwright, Hill, Raste, & Plumb, 2001),
is actually a measure of ToM at all (Jarrold, Butler,
Cottington, & Jimenez, 2000; Johnston, Miles, &
McKinlay, 2007) or rather a measure of complex
emotion recognition. Indeed, performance on this
task is not correlated to other tests of ToM (Brent,
Rios, Happ, & Charman, 2004; Spek, Scholte,
& van Berckelaer-Onnes, 2010), and performance
in ASDs is mixed, with some studies demonstrat-
ing impaired performance (Baron-Cohen et al.,
1997; Baron-Cohen, Ring, et al., 1999; Baron-
Cohen, Wheelwright, Hill, et al., 2001; Craig et al.,
2004) whilst others demonstrate intact performance
(Couture et al., 2010; Roeyers, Buysse, Ponnet, &
Pichal, 2001).
Audiovisual vignettes of indirect speech acts
provide closer correlates to real-life situations
than either faces showing static emotional expres-
sions or prose passages describing social blunders.
The Awareness of Social Inference Test (TASIT;
McDonald, Flanagan, & Rollins, 2002) uses video
vignettes depicting conversational exchanges to
assess basic emotion recognition, as well as the abil-
ity to understand more subtle emotions, speaker
beliefs and intentions, and counterfactual remarks
such as sarcasm and deception. This test has
been used extensively within the traumatic brain
injury population (McDonald & Flanagan, 2004;
McDonald, Flanagan, Rollins, & Kinch, 2003;
McDonald & Saunders, 2005) and more recently
in schizophrenia (Chung, Mathews, & Barch,
2011; Kern et al., 2009; Sparks, McDonald, Lino,
ODonnell, & Green, 2010) and dementia (Kipps,
Nestor, Acosta-Cabronero, Arnold, & Hodges,
2009; Rankin et al., 2009). TASIT performance is
associated with conventional text-based ToM tasks
and static emotion recognition (McDonald et al.,
2006). It is both sensitive to clinical conditions and
also predictive of real-world function (McDonald,
Flanagan, Martin, & Saunders, 2004). TASIT is
designed to tap understanding of the speakers
beliefs (rst-order ToM), intentions (i.e., what the
speaker thinks or wants the other person to think:
second-order ToM), and emotions and pragmatic
meaning in both sincere, straightforward interac-
tions and counterfactual/indirect speech where the
speaker says one thing but knows and means oth-
erwise (sarcasm), or says one thing meaning to be
believed while knowing otherwise (lies/deception).
The rst aim of the present study was to inves-
tigate ToM in high-functioning adults with ASDs
using TASIT as an ecologically valid test focused
on everyday conversational interactions.
ToM decits in high-functioning ASDs pro-
vide critical evidence for the argument that social
cognitionthat is, the ability to process and inter-
pret uniquely social informationis modular and
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THEORY OF MIND & EMPATHY IN HIGH-FUNCTIONING ASDS 657
independent of nonsocial cognition such as IQ.
Convergent evidence from both lesion and neu-
roimaging studies implicate a specic set of neural
networks underpinning social cognition, including
the amygdala, orbitofrontal cortex (OFC), medial
PFC (mPFC), anterior cingulate cortex (ACC), and
insula (see Adolphs, 1999, 2001; Phillips, Drevets,
Rauch, & Lane, 2003, for reviews). Interestingly,
research in the past decade has suggested that
advanced ToM may be separated into two dis-
tinct abilities, cognitive and affective ToM, which
are associated with different neural networks
(Shamay-Tsoory & Aharon-Peretz, 2007; Shamay-
Tsoory, Tomer, Berger, & Aharon-Peretz, 2003).
Specically, tasks such as second-order false belief
rely on cognitive knowledge about beliefsthat is,
an appreciation of the difference between what the
speaker and the listener know (cognitive ToM).
In contrast, tasks such as recognition of faux
pas rely on empathic knowledge about emotions
that is, recognition of how the listener is feeling
(affective ToM). Ability to understand sarcasm and
deception appears to rely upon both (McDonald &
Flanagan, 2004).
Affective ToM is strongly linked to affective
empathy (e.g., emotion recognition, responsivity,
and expression; self-reection), whereas cognitive
ToM is more closely related to cognitive empa-
thy (e.g., perspective taking, cognitive exibility;
Blair, 2008; Davis, 1980, 1983; Rankin, Kramer,
& Miller, 2005; Shamay-Tsoory & Aharon-Peretz,
2007; Shamay-Tsoory et al., 2003). Impaired empa-
thy is considered a central characteristic of ASDs,
with some prominent researchers in the eld rec-
ommending the use of empathy measures to com-
plement diagnostic tools (e.g., Baron-Cohen &
Wheelwright, 2004; Baron-Cohen, Wheelwright,
Skinner, Martin, & Clubley, 2001). Two studies
of high-functioning individuals with ASDs found
decits in cognitive but not affective empathy
(Dziobek et al., 2008; Rogers, Dziobek, Hassenstab,
Wolf, & Convit, 2007), whilst one study found
decits in both (Shamay-Tsoory, Tomer, Yaniv, &
Aharon-Peretz, 2002). In general, impaired empa-
thy, measured by self-report, provides an every-
day validation of impaired ToM as measured
in lab-based tasks. Therefore, the second aim of
the present study was to investigate the relation-
ship between abilities on TASIT as an ecologi-
cal measure of ToM and self-reported empathy
in high-functioning adults with ASDs, using two
well-established measures of empathy known to dif-
ferentiate between cognitive and affective empathy.
In summary, the aim of the present study was
to investigate performance on TASIT, an ecologi-
cally valid test of ToM, in high-functioning adults
with ASDs who have normal IQ and language abil-
ities. It was hypothesized that the ASDgroup would
show: (a) intact comprehension of straightforward
(sincere) interactions; (b) impaired ability to under-
stand indirect interactions involving sarcasm or
deception; (c) specic impairments for questions
requiring comprehension of the speakers beliefs,
intentions, and meaning in the indirect scenarios.
In addition, it was hypothesized that self-reported
empathy would be associated with poor advanced
ToM performance. Specically, questions probing
understanding of cognitive ToM (i.e., beliefs, inten-
tions, meaning) on the indirect scenarios would
be associated with self-reported cognitive empa-
thy, while questions that pertained specically to
understanding feelings would be associated with
self-reported affective empathy.
METHOD
Participants
Forty high-functioning adults with ASDs and
37 nonclinical control individuals were recruited
from a range of locations across Australia, via
advertisements, support groups, clinicians, Aspect
(Autism Spectrum Australia),
2
and undergradu-
ate university populations. Individuals were reim-
bursed for their time or received course credit for
participation. Participants gave written informed
consent in accordance with the University of New
South Wales Human Research Ethics Committee
(UNSW HREC).
All individuals in the clinical group met
Diagnostic and Statistical Manual of Mental
DisordersFourth Edition, Text Revision (DSM
IVTR; APA, 2000) diagnostic criteria for an
ASD, as assessed by experienced clinicians inde-
pendent of the present study. These clinicians (e.g.,
clinical psychologists, neuropsychologists, psychia-
trists) administered standardized clinical interviews
such as the ADIR (Autism Diagnostic Interview
Revised; Lord, Rutter, & Le Couteur, 1994)
and ADOSG (Autism Diagnostic Observation
ScheduleGeneric; Lord, Rutter, DiLavore, &
Risi, 1999); however, the information from these
reports was not typically made available to the
researchers. As such, the Autism Quotient (AQ;
32; Baron-Cohen, Wheelwright, Skinner, et al.,
2001) and/or Ritvo Autism Aspergers Diagnostic
2
Australias largest not-for-prot provider of services related
to ASDs, including access to information, support groups, blogs,
research participation, and relevant media releases.
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658 MATHERSUL, MCDONALD, RUSHBY
Scale (RAADS; 77; Ritvo et al., 2008) were used
to support diagnosis. The AQ has been shown to
produce good testretest reliability (r = .70) and
good internal consistency (Cronbachs =.63.77;
Baron-Cohen, Wheelwright, Skinner, et al., 2001).
The RAADS has been shown to produce reliable
clinical discrimination (97100% sensitivity, 100%
specicity), high testretest reliability (r = .99), and
good internal consistency (Cronbachs =.65.92;
Ritvo et al., 2011; Ritvo et al., 2008). Exclusion cri-
teria were a self-reported personal history of physi-
cal brain injury or a neurological or developmental
disorder (other than an ASD in the clinical group).
In addition, control participants were excluded if
they had a score above the recommended clinical
cutoff on the AQ and/or RAADS. Four control
participants were subsequently excluded. The nal
sample consisted of 40 high-functioning adults with
ASDs (aged 1873 years; 31 males) and 33 nonclini-
cal control individuals (aged 1872 years; 24 males).
Measures
The Awareness of Social Inference Test
(TASIT)
The Awareness of Social Inference Test (TASIT;
McDonald et al., 2002) uses video vignettes depict-
ing conversational exchanges to assess basic emo-
tion recognition, as well as the ability to under-
stand more subtle emotions and conversational
inferences. It has three parts. Part 1 assesses basic
emotion perception while Parts 2 and 3 assess com-
prehension of more complex emotions and theory
of mind. Parts 2 and 3 were used in this study. Part
2 (Social InferenceMinimal; SIM) of TASIT con-
sists of 15 video vignettes, each lasting 1560 s and
each comprising an ambiguous exchange between
two people. For example, in one vignette, a man
informs his colleague that he is no longer able
to cover her class, and she responds: Thats OK,
I know youre busy. Dont worry about it, its not
like I have anything else I have to do anyway.
These conversational exchanges are enacted to be
either: (a) sincerethat is, the literal meaning of
the dialogue is sincerely meant, and the emotion of
the speaker is consistent with that; or (b) indirect,
where the literal meaning of the dialogue is contra-
dicted by the demeanor of the speaker (in the above
example, the woman speaker is clearly annoyed),
thereby compelling viewers to derive inferences as
to the true meaning of the exchange (i.e., that the
speaker is being sarcastic). In both cases, the dia-
logue is ambiguous, and the meaning can only be
accurately interpreted by attending to the context,
including facial expression, vocal intonation, and
gestures. The indirect exchanges consist of either
simple sarcasm where the verbal content is logical
but ambiguous, as in the above example, or para-
doxical sarcasm where the exchange logically makes
no sense unless it is understood as sarcastic (e.g., a
man says to his friend who is sitting, reading the
paper: Still hard at it I see to which his friend
replies Yeah, I am having a break). Past research
has demonstrated similar performance across each
type, so for the purposes of this study, they were
combined to form one sarcasm measure (Kipps
et al., 2009; McDonald et al., 2006).
Part 3 (Social InferenceEnriched; SIE) con-
sists of 16 vignettes, all of which are indirect. These
depict either (a) sarcasm, where the main speaker
makes an untrue statement that is meant to imply
the opposite, or (b) lies/deception, in which the
main speaker is speaking untruthfully but wants to
be believed in order to be sympathetic or diplo-
matic. Unlike Part 2, in Part 3 viewers are pro-
vided with additional information in the form of a
prologue/epilogue or else a visual edit (e.g., a cam-
era shot of a childs unnished meal on the plate)
that reveals what the speakers know about the true
state of affairs. For example, one vignette involves
a woman talking to her corpulent partner about his
waistline. This is preceded by a prologue in which
she condes to a third party that her partner has
put on weight. Following this she enters the dress-
ing room and responds to her partners question
Do you think I have put on weight? by remarking
No! You are as slim as ever!. In the sarcastic ver-
sion of this, she clearly intends to amplify the true
state of affairs to her partner, whereas in the decep-
tion condition she attempts to conceal or minimize
the truth. Accurate interpretation of the meaning of
the exchanges in Part 3 requires reference to these
enriched contextual cues, knowledge regarding
who was privileged to the true facts of the situation,
and comprehension of the same type of paralin-
guistic cues (facial expression, vocal intonation,
gesture) as provided in Part 2.
In both Parts 2 and 3, participant responses are
quantied by pausing the video at the end of each
clip and asking four yes/no questions. For each
vignette, the four probes measure four facets of
mental judgment: (a) the feeling probe assesses
complex, subtle aspects of emotion (e.g., sympathy,
irritation, disapproval)for example, in the class-
roomexample above, the probe was: Is she annoyed
with him?; (b) the thinking probe taps under-
standing of the speakers thoughts (beliefs, knowl-
edge), otherwise known as rst-order ToMfor
example, Does she believe hes too busy to take the
class?; (c) the doing (intending) probe requires a
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THEORY OF MIND & EMPATHY IN HIGH-FUNCTIONING ASDS 659
judgment about what one speaker is intending to do
to another persons thoughtsthat is, second-order
ToM (McDonald et al., 2003)for example, Is
she trying to make him feel OK about cancelling?;
(d) the saying/meaning probe taps understand-
ing of the pragmatic meaningthat is, whether the
speaker wants the literal or nonliteral meaning of
their message to be believedfor example, Is she
trying to say she that hes causing a big problem [by
cancelling]?. This pragmatic meaning is primar-
ily determined by what the speaker intends by his
or her remark (McDonald & Flanagan, 2004) and
is, therefore, also a measure of second-order ToM
abilities.
TASIT has a playing time of approximately
35 min and an administration viewing time of
6075 min. Practice items are provided for all parts.
The vignettes are presented in a xed order, ran-
domized between condition types. Part 2 has an
overall total score (maximum = 60), plus subto-
tals for each scene condition (sincere versus sar-
casm; each maximum = 20) and type of question
(feel, think, do, say; each maximum = 15). Part
3 has an overall total score (maximum = 64), plus
subtotals for each scene condition (sarcasm versus
deception; maximum = 32) and type of question
(feel, think, do, say; maximum = 16). TASIT has
been shown to have good testretest reliability (r =
.74.88). Convergent validity of TASIT has been
demonstrated via its correlation with traditional
text-based measures of second-order ToM (r =
.68) and emotion perception (r = .45; McDonald
et al., 2006). Construct validity has been estab-
lished by demonstration that TASIT is sensitive to
clinical disorders that are known to disrupt social
cognition, including the traumatic brain injury pop-
ulation (McDonald & Flanagan, 2004; McDonald
et al., 2003; McDonald & Saunders, 2005) and
more recently in schizophrenia (Chung et al., 2011;
Kern et al., 2009; Sparks et al., 2010) and fron-
totemporal dementia (Kipps et al., 2009; Rankin
et al., 2009). Finally TASIT is predictive of real-
world function, indicating good ecological validity
(McDonald et al., 2004).
All participants in the present study completed
Parts 2 and 3, designed to assess ToM and the abil-
ity to comprehend nonliteral expressions. For the
purposes of the present study, accurate comprehen-
sion of sincere interactions was proposed to rely
on simple ToM judgments. While comprehension
of all vignettes, including the sincere exchanges,
was assessed by probes tapping comprehension of
the speakers feelings, thoughts, intentions, and
meaning, in the sincere vignettes these sources of
information were convergent and therefore not dif-
cult. In contrast, accurate comprehension of the
exchanges involving indirect/nonliteral meaning
(i.e., sarcasm and deception) required the amalga-
mation of contradictory information, such as a lit-
eral meaning at odds with the speakers demeanor.
Participants needed to make sense of these remarks
by weighing up this conicting evidence in order to
judge the speakers intentions, thoughts, and feel-
ings. Thus, the counterfactual, indirect vignettes
required more complex ToM abilities.
Wechsler Abbreviated Scale of Intelligence
The Wechsler Abbreviated Scale of Intelligence
(WASI) is a brief, standardized measure of gen-
eral intellectual functioning that demonstrates good
reliability and validity (Wechsler, 1999). All par-
ticipants were administered the two-subtest format
(Vocabulary and Matrix Reasoning), allowing for
a measure of full-scale IQ (FSIQ). In adults, the
WASI two-subtest FSIQ correlates .87 with the
Wechsler Adult Intelligence Scale (WAIS; Wechsler,
1997) FSIQ (Strauss, Sherman, & Spreen, 2006),
Administration and scoring were completed by a
trained clinician (intern clinical psychologist).
Interpersonal Reactivity Index (IRI)
The Interpersonal Reactivity Index (IRI; Davis,
1980, 1983) is a 28-item self-report questionnaire
designed to assess both cognitive and affective
empathy. Responses are made on a 5-point Likert
scale ranging from 0 (does not describe me well)
to 4 (describes me very well). The IRI consists
of four 7-item subscales: Perspective Taking (PT;
the ability to imagine the cognitive viewpoint of
others); Fantasy (FS; the tendency to emotion-
ally identify with ctional characters in novels
and movies); Empathic Concern (EC; the capac-
ity to form an emotional response, e.g., warmth,
compassion, concern, to the emotional state of
another person); and Personal Distress (PD; the
extent to which one forms a self-centered emotional
responsefear, discomfort, distressto anothers
misfortunes). All four subscales demonstrate good
internal (.71.77) and good testretest (.62.71) reli-
abilities (Davis, 1980). The PT and EC subscales
are considered the strongest representations of cog-
nitive and affective empathy, respectively (Davis,
1983), and as such were the measures employed in
the present study.
Empathy Quotient (EQ)
The Empathy Quotient (EQ; Baron-Cohen
& Wheelwright, 2004) is a 60-item self-report
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660 MATHERSUL, MCDONALD, RUSHBY
questionnaire consisting of 40 empathy items and
20 ller items, to distract participants from the
focus on empathy. Responses are made on a 4-point
Likert scale ranging from strongly agree to strongly
disagree. The EQ allows for a measure of over-
all empathy, as well as the separation of affective
empathy (emotional reactivity; EQER) and cog-
nitive empathy (EQCE; 11 items each; Lawrence,
Shaw, Baker, Baron-Cohen, &David, 2004; Muncer
& Ling, 2006). Both the total EQ (Cronbachs
= .852) and the two subscales (Cronbachs =
.76.84) have been shown to demonstrate good
internal consistency (Muncer & Ling, 2006). The
total EQ also has high testretest reliability (r =.97;
Baron-Cohen & Wheelwright, 2004).
Procedure
On the day of testing, an overview of the procedure
was provided, and informed consent and diagnostic
information were obtained. Subsequently, partici-
pants completed the EQ and IRI, and the WASI
and TASIT
3
were administered. Participants were
allowed breaks as desired and unlimited time to
respond to the TASIT questions (though scenes
were only viewed once). Due to time constraints
and/or location, the TASIT DVD was mailed to
four participants, and the vocabulary subtest of
the WASI was conducted via phone/Skype for two
participants.
4
Analyses
In order to test the specic hypotheses, the follow-
ing analyses of variance (ANOVAs) were conducted
using a mixed between-groups and repeated mea-
sures design: (a) 2 (group: ASD vs. control) 2
(Part 2 scene: sincere vs. sarcasm) 4 (question: do
vs. say vs. think vs. feel) and (b) 2 (group: ASD vs.
3
Given the suggestion that reward incentives may improve
task performance (Kohls, Peltzer, Herpertz-Dahlmann, &
Konrad, 2009), an additional aim of the present study was to
investigate the inuence of monetary reward on ToM perfor-
mance in ASDs. However, as there were no signicant main
effects of monetary reward or signicant Group Monetary
Reward interaction effects for any of the analyses, data were col-
lapsed across conditions, and no further investigations into the
effects of monetary reward were investigated. These null effects
may have been due to the relatively small amount of potential
reward (up to an additional $12.50 across the entire task).
4
Analyses were run separately both with and without these
participants. There were no signicant differences in the direc-
tion or signicance of effects, and so these participants were
retained in the nal analyses in order to preserve power and the
high number of clinical participants.
control) 2 (Part 3 scene: sarcasm vs. deception)
4 (question: do vs. say vs. think vs. feel). Planned
a priori contrasts compared the measures within
each contrast. Partial eta-squared (
2
p
) values are
reported as a measure of effect size. Greenhouse
Geisser corrections were used for all ANOVAs with
greater than 1 degree of freedom.
Simultaneous regression analyses were con-
ducted to determine which question probes for the
indirect scenes in TASIT Part 2 and Part 3 were
uniquely related to cognitive or affective empa-
thy. As outlined in the introduction, cognitive and
affective empathy are proposed to be related to per-
spective taking and emotion perception (cognitive
and affective ToM, respectively; Blair, 2008; Davis,
1980, 1983; Rankin et al., 2005; Shamay-Tsoory &
Aharon-Peretz, 2007; Shamay-Tsoory et al., 2003).
Therefore, it is predicted that the TASIT ques-
tions probing understanding of cognitive ToM (i.e.,
beliefs, intentions, meaning) on the indirect scenar-
ios would be associated with self-reported cognitive
empathy, while questions that pertained speci-
cally to understanding feelings would be associated
with self-reported affective empathy. Factor analy-
ses were rst conducted to produce summary scores
of cognitive empathy (IRIPT and EQCE) and
affective empathy (IRIEC and EQER). R
2
val-
ues are used as a measure of variance explained.
Bivariate correlations were conducted to determine
the direction of effects.
RESULTS
Demographic and clinical group
characteristics
There were no signicant differences between
groups on age, F(1, 72) = 1.3, p = .260, gender
ratio (
2
= 0.222, p = .638), years of education,
F(1, 72) =2.8, p =.098, or full-scale IQ, F(1, 72) =
0.4, p = .844 (Table 1). Age, education and IQ were
not signicantly correlated to total TASIT scores,
and nor did they inuence group differences when
entered as covariates. Consequently these demo-
graphic variables were not controlled for in this
study.
Conrming diagnostic group, the ASD group
was signicantly higher on the AQ, F(1, 72) =
103.4, p < .001, and RAADS, F(1, 72) = 94.7, p <
.001. They were also signicantly lower on all empa-
thy measures: IRIPT, F(1, 72) = 25.1, p < .001;
IRIEC, F(1, 72) = 4.6, p = .035; EQ, F(1, 72) =
58.7, p < .001; EQCE, F(1, 72) = 75.5, p < .001;
and EQER, F(1, 72) = 13.1, p = .001 (Table 1).
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THEORY OF MIND & EMPATHY IN HIGH-FUNCTIONING ASDS 661
TABLE 1
Group demographics
Measure ASD Control
N (M:F) 40 (31: 9) 33 (24: 9)
Age (years) 37.2 (16.2) 41.7 (17.2)
Years of education 15.1 (2.4) 16.1 (2.2)
FSIQ-2 113.6 (15.6) 114.5 (21.9)
AQ 32.5 (7.5)

15.4 (5.8)
RAADS 126.4 (43.6)

37.9 (26.8)
IRIPT 12.6 (4.9)

18.8 (5.3)
IRIEC 17.2 (6.7)

20.2 (4.1)
EQ 21.6 (10.7)

42.7 (11.9)
EQCE 4.1 (4.0)

12.9 (4.4)
EQER 6.6 (4.4)

10.5 (4.6)
Notes. Means; standard deviations in parentheses. ASD =
autism spectrum disorder; M:F = male-to-female ratio; FSIQ-
2 = Full Scale Intelligence Quotient, 2-subtest version;
AQ = Autism Quotient; RAADS = Ritvo Autism Aspergers
Diagnostic Scale; IRIPT = Interpersonal Reactivity Index
Perspective Taking; IRIEC = Interpersonal Reactivity Index
Empathic Concern; EQ = Empathy Quotient; EQCE =
Empathy QuotientCognitive Empathy; EQER = Empathy
QuotientEmotional Reactivity.

p < .05.

p < .01.

p < .001.
TASIT Part 2: Sincere versus sarcasm
There was a signicant main effect of group for
TASIT Part 2, F(1, 70) = 7.4, p = .008,
2
p
=
.098; the ASD group had signicantly poorer per-
formance than the controls, regardless of scene type
(Figure 1). There was also a signicant main effect
of scene for TASIT Part 2, F(1, 70) = 12.6, p =
.001,
2
p
= .156; all participants had better perfor-
mance for the sarcastic than the sincere interactions
(Figure 1). There were no signicant interaction
effects. Because of our a priori hypothesis that
sincere exchanges would be understood without
difculty, post hoc analyses were conducted and
revealed that the ASD group performed equally as
10
11
12
13
14
15
16
17
18
19
20
ASD Control
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Sincere
Sarcasm
Figure 1. Mean accuracy on The Awareness of Social Inference
Test (TASIT) Part 2 (sincere vs. sarcasm; maximum = 20) for
high-functioning autism spectrum disorder (ASD) and control
participants. Error bars represent standard errors.
well as the control group on the sincere interactions
(p =.367) but had signicantly poorer performance
for the sarcastic interactions (p = .005; Figure 1).
The lack of a signicant interaction effect may be
due to issues of power.
TASIT Part 3: Sarcasm versus deception
There was a signicant main effect of group for
TASIT Part 3, F(1, 70) = 15.6, p < .001,
2
p
=
.187; the ASD group had signicantly poorer per-
formance than the controls, regardless of scene type
(Figure 2). There were no signicant main effects
of scene or signicant group by scene interaction
effects. As can be seen in Figure 2, the ASD group
tended to be poorer at understanding deception
than sarcasm, though this effect was not signicant,
F(1, 39) = 2.9, p = .095,
2
p
= .074.
There was a signicant group by question inter-
action effect, F(3, 213) = 3.2, p = .029,
2
p
=
.045. Overall, the ASD group was signicantly
poorer than the control group at answering think,
F(1, 70) = 5.8, p = .018,
2
p
= .079, do,
F(1, 70) = 9.7, p = .003,
2
p
= .125, and say,
F(1, 70) =21.7, p <.001,
2
p
=.242, but not feel,
F(1, 70) = 3.0, p = .086,
2
p
= .043 (Figure 3).
There was no signicant group by scene by question
interaction effect.
Empathy and ToM
Factor analyses of EQCE and IRIPT resulted
in a single cognitive empathy factor (eigenvalue
1.601), which explained 80.1% of the variance.
Factor analyses of EQER and IRIEC resulted
in a single affective empathy factor (eigenvalue
1.637), which explained 81.9% of the variance.
20
21
22
23
24
25
26
27
28
29
30
31
32
ASD Control
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Sarcasm
Deception
Figure 2. Mean accuracy on The Awareness of Social Inference
Test (TASIT) Part 3 (sarcasm vs. deception; maximum= 32) for
high-functioning autism spectrum disorder (ASD) and control
participants. Error bars represent standard errors.
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662 MATHERSUL, MCDONALD, RUSHBY
10
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14
15
16
ASD Control
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Feel
Think
Do
Say
Figure 3. Mean accuracy for each question type (feel vs. think
vs. do vs. say) for The Awareness of Social Inference Test
(TASIT) Part 3 (maximum = 16) for high-functioning autism
spectrum disorder (ASD) and control participants. Error bars
represent standard errors.
In order to test the hypothesis that ability to
answer questions about thoughts, intentions, and
meaning in the indirect speech scenarios would
be specically related to cognitive empathy, the
four response probes for TASIT Part 2 (sarcasm)
and Part 3 were entered into simultaneous regres-
sions as independent variables, along with group
membership. As Part 3 is enriched with additional
contextual information (and is therefore potentially
tapping different aspects of ToM), Parts 2 and
3 were entered into two separate regressions. The
cognitive empathy score was entered as the depen-
dent variable. The model for Part 2 (sarcasm) was
signicant [adjusted R
2
= .518, F(5, 65) = 15.0,
p < .001]. The signicant independent contributors
to cognitive empathy were the think probe ( =
.449, t =2.4, p =.020) and group ( =.643, t =7.1,
p <.001). Similarly for Part 3, the model was signif-
icant [adjusted R
2
=.485, F(5, 65) =13.4, p <.001].
The independent contributors to cognitive empathy
were the do ( = .256, t = 2.0, p = .052) and
say probes ( = .304, t = 2.1, p = .040) and
group ( = .740, t = 7.0, p < .001).
Similar regressions were conducted using
affective empathy as the dependent variable to
test the hypothesis that ability to answer questions
about feelings would be specically related to
affective empathy. According to these models [Part
2: adjusted R
2
= .168, F(5, 65) = 3.6, p = .006;
Part 3: adjusted R
2
= .105, F(5, 65) = 2.5, p =
.037], group was the only signicant independent
contributor to affective empathy for both TASIT
Part 2 ( = .314, t = 2.6, p = .011) and Part 3 ( =
.377, t = 2.7, p = .008).
DISCUSSION
While there are a range of studies that have exam-
ined social cognitive abilities in high-functioning
adults with ASDs, this is the rst study to uti-
lize an ecologically valid measure that approxi-
mates everyday social interactions. TASIT is an
audiovisual measure designed to assess the abil-
ity to infer beliefs, intentions, and emotions in
social interactions displaying both sincere inter-
actions and nonliteral statements of sarcasm and
lies/deception. The specic aim of the present study
was to compare simple and advanced ToM in high-
functioning adults with ASDs. Furthermore, given
the suggestion that advanced ToM may be differ-
entially related to cognitive and affective empa-
thy, it was predicted that empathy would explain
group differences in ToM. As predicted, the high-
functioning adults with ASDs were capable of
making simple ToM judgments that underpin sin-
cere interactions.
5
However, they were signicantly
impaired at understanding nonliteral expressions
(sarcasm and deception) that required advanced
ToM in order to know that someone might say
something opposite to what they intend (sarcasm)
or believe (lie). Furthermore, the responses to the
probes for Part 3 suggested the ASD group had par-
ticular decits in comprehending ToM questions
about both beliefs and intentions as well as the
(intended) meaning of the indirect remarks. The
regression analyses revealed that understanding the
beliefs, intentions, and meaning of the indirect
remarks, as well as group membership, were related
to cognitive empathy. On the other hand, the only
unique predictor of affective empathy was group
membership.
These ndings were not due to global cognitive
decits, as groups were matched on both FSIQ
and years of education. The nding that ASDs are
associated with decits in sarcasm in audiovisual
presentations replicates earlier work using written
tasks (Happ, 1994; Jolliffe & Baron-Cohen, 1999;
Kaland et al., 2005), although such decits have not
always been found (Roeyers et al., 2001; Shamay-
Tsoory et al., 2002). These inconsistencies in the
literature may be due in part to the high degree
of variability in performance and ability across
ASDs. The poor ecological validity of written tasks
to accurately reect real-world performance is an
5
While the overall main effect in both the ASD and control
group of poorer comprehension for sincere versus sarcastic inter-
actions appears counterintuitive, it is consistent with the norms
for TASIT (McDonald et al., 2006; McDonald & Flanagan,
2004; McDonald et al., 2004). Possible reasons for this effect
may be that the sarcastic interactions are more obvious than
the sincere, or that the presence of sarcastic interactions primes
individuals to (mis)interpret the sincere interactions as sarcastic.
Importantly though, there were no group differences in compre-
hension of sincere interactions, highlighting specic decits in
comprehension of nonliteral expressions in ASDs.
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THEORY OF MIND & EMPATHY IN HIGH-FUNCTIONING ASDS 663
additional important factor. Sarcasm by nature is
associated with paralinguistic cues (facial expres-
sion, vocal intonation, gestures) that might facil-
itate comprehension. In order to understand a
sarcastic remark, listeners need to accurately infer
what the speaker knows and to accurately infer
their intentions (i.e., that they mean the opposite of
what they say and intend for the listener to compre-
hend their real meaning; McDonald, 1999). Given
that TASIT involves audiovisual representations of
social interactions, it is arguably more ecologically
valid than written forms of sarcastic interactions.
Generally, there is a paucity of empirical stud-
ies investigating recognition and comprehension of
deception (white lies) in ASDs. Those that exist
have largely relied on written tasks with poor
ecological validity (e.g., Happ, 1994; Jolliffe &
Baron-Cohen, 1999; Kaland et al., 2005) or have
focused on deception in the form of tricking or
in the context of a competition (e.g., Baron-Cohen,
1992; Reinecke, Newman, Kurtz, Ryan, & Hemmes,
1997). However, one recent study revealed that
high-functioning children with ASDs are capable
of spontaneously telling both antisocial lies (deny-
ing they had peeked at a toy when told not to)
and white lies (pretending to like an undesirable
prize), though they are signicantly less convincing
at telling antisocial lies (Li, Kelley, Evans, & Lee,
2011). Taken together with the present ndings, it is
possible that individuals with ASDs are capable of
spontaneously lying in order to protect themselves;
however, they lack sufcient abilities to compre-
hend the use of lies in order to protect others. This
is an interesting and complex area of research that
warrants further investigation.
The question probes generally support the pro-
posal that high-functioning adults with ASDs
demonstrate particular decits in second-order or
advanced ToM abilities. In TASIT Part 3, where all
vignettes entail a nonliteral sarcastic or deceptive
remark, the ASD group demonstrated signicant
decits in comprehending the thoughts, intentions,
and meaning of the speakers. In general, the nd-
ing that Part 3 was particularly difcult for the
ASD group is interesting as it differs from Part 2 in
two important ways. First, none of the exchanges
are literally true. In every case, the listeners need
to make a judgment about what precise mean-
ings are inferred, given the counterfactual nature of
the remark. Secondly, it includes a visual or ver-
bal edit that provides information as to the true
state of affairs and explicit information as to what
each speaker knows about the situation. This sug-
gests that for individuals with ASDs, the problem
is not so much knowing the content of what peo-
ple think/believe, but understanding that there are
a variety of ways in which they might use that
information when communicating (i.e., that they
might minimize the impact of that knowledge (lie)
to be kind or protect themselves, or exaggerate it
(be sarcastic) to make the other person uncomfort-
able). It has been proposed that judging a speakers
intentions may involve additional cognitive abilities
other than those required for ToM, such as more
general deductive reasoning or inference-making
skills (McDonald & Flanagan, 2004). Given that
advanced (second-order) ToM is associated with
executive function (e.g., Carlson & Moses, 2001;
Carlson, Moses, & Hix, 1998; Perner, Lang, &
Kloo, 2002; Talwar & Lee, 2008), this is a potential
underlying mechanism that is worth investigating in
future research.
The present study found decits in both cog-
nitive and affective empathy in high-functioning
individuals with ASDs. This is consistent with one
previous study (Shamay-Tsoory et al., 2002), but
inconsistent with two others demonstrating intact
affective empathy (Dziobek et al., 2008; Rogers
et al., 2007). This inconsistency may again be due
to the high degree of variability in performance and
ability across ASDs. Furthermore, closer examina-
tion of the questionnaire results from the study by
Dziobek and colleagues (2008) reveals a trend (p =
.051) towards signicant decits in affective empa-
thy. Thus, statistical power may be an alternative
explanation, given that the present study has more
than twice as many participants as that of Dziobek
and colleagues.
The regression analyses conrmed the hypothesis
that cognitive empathy is related to advanced ToM.
More specically, cognitive empathy was related
to comprehension of the speakers thoughts in the
indirect scenarios in Part 2. This suggests that when
there are only paralinguistic cues (facial expres-
sion, vocal intonation, gestures), available viewers
relied upon similar skills to those required for cog-
nitive empathy in order to accurately infer what the
speaker believes. The lack of association between
cognitive empathy and comprehension of intentions
and meanings in Part 2 would suggest that these lat-
ter judgments pivoted upon this initial understand-
ing of speaker beliefs and did not, in themselves,
represent independent abilities. Part 3 represented a
different type of scenario where explicit information
was provided as to what the speakers believed, thus
minimizing any need to infer this. Consistent with
this, in Part 3, the regressions suggested that scores
on the think probes were not associated with cog-
nitive empathy, whilst the probes assessing ability
to accurately infer intentions and meaning were.
Thus, even when viewers knew what the speakers
thought, further ToM judgments were required in
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664 MATHERSUL, MCDONALD, RUSHBY
order to determine how they were going to use that
knowledge (e.g., to ridicule, sympathize, etc.), and it
was these judgments that were related to cognitive
empathy. Finally, that group was also a signicant
predictor of cognitive empathy suggests that the
difculties individuals with ASDs have with cogni-
tive empathy cannot be explained entirely by their
difculties on ToM (at least on TASIT).
According to the regression analyses, affective
empathy is not related to advanced ToM on TASIT.
First, this suggests that TASITmay be a better mea-
sure of cognitive than affective empathy. Secondly,
it suggests that affective ToMthat is, recognition
of how someone feels in response to the words
and/or actions of another personmay be a dif-
ferent concept to affective empathy. Indeed, it has
been proposed that affective empathy involves emo-
tional responsivity (Decety, 2010; Rankin et al.,
2005), which is not necessarily the same as an
ability to infer anothers emotional state. This is
important given that group was a signicant pre-
dictor of affective empathy. That is, the present
study not only found that individuals with ASDs
are impaired on affective empathy but not the
ability to infer emotions, but it also found that
these abilities are independent of each other. This
is consistent with our previous work demonstrat-
ing decits in emotional responsivity in ASDs (as
measured by psychophysiological measures such as
facial mimicry and autonomic arousal) but intact
ability to rate affective scenes on valence and
arousal (Mathersul, McDonald, & Rushby, 2013a)
or to judge the trustworthiness of another person
(Mathersul, McDonald, & Rushby, 2013b).
Limitations
It should be noted that TASIT has a forced-
choice response format that is not directly rep-
resentative of real-world situations. However, this
is a difculty inherent in quantitative research in
general. Furthermore, TASIT demonstrates signif-
icant correlations with social problem solving and
emotion recognition (McDonald et al., 2006) and
is predictive of real-world difculties with social
interactions (McDonald et al., 2004). Nevertheless,
future research might investigate freely generated
responses to video vignettes depicting conversa-
tional exchanges, in order to build on the ecological
validity of TASIT.
All individuals in the ASD group were assessed
by experienced clinicians independent of the
present study and met DSMIVTR (APA,
2000) diagnostic criteria for an ASD. However,
information from standardized clinical interviews
such as the ADI (Autism Diagnostic Interview) and
ADOS (Autism Diagnostic Observation Schedule)
were not available to the present study. While
this is a potential limitation, the self-report ques-
tionnaires used to support diagnosis demonstrate
reliable clinical discrimination.
Implications
These results have implications for neural sys-
tems known to underlie ToM and social cogni-
tion more generally. For example, brain injury
(McDonald & Flanagan, 2004; McDonald et al.,
2003) and dementia (Kipps et al., 2009) studies
have demonstrated the importance of the PFC,
OFC, amygdala, insula, and temporal pole in the
comprehension of sarcasm on TASIT. Other lesion
and functional imaging studies have conrmed the
role of the amygdala (Olson, Plotzker, & Ezzyat,
2007) and PFC (Amodio & Frith, 2006; Shamay-
Tsoory, Tomer, & Aharon-Peretz, 2005), as well
as the ACC (Uchiyama et al., 2006), in sarcasm
comprehension on written tasks. Similarly, decep-
tion and lying appear to rely on the PFC and
ACC (Langleben et al., 2002; Spence et al., 2001;
Spence et al., 2004). Numerous studies have also
shown these structures to be functionally atypical
in individuals with ASDs, particularly the amygdala
(Ashwin, Baron-Cohen, Wheelwright, ORiordan,
& Bullmore, 2007; Baron-Cohen, Ring, et al., 1999;
Critchley et al., 2000; Di Martino et al., 2009;
Pierce, Muller, Ambrose, Allen, & Courchesne,
2001), OFC (Ashwin et al., 2007; Loveland,
Steinberg, Pearson, Mansour, & Reddoch, 2008),
medial PFC (Di Martino et al., 2009; Loveland
et al., 2008; Ohnishi et al., 2000; Wang, Lee,
Sigman, & Dapretto, 2007), ACC (Ashwin et al.,
2007; Dichter & Belger, 2007; Di Martino et al.,
2009; Hall, Szechtman, & Nahmias, 2003; Ohnishi
et al., 2000), and insula (Critchley et al., 2000; Di
Martino et al., 2009; Silani et al., 2008). Therefore,
the present study provides further support for atyp-
ical function of these structures in ASDs, which
may be a potential underlying mechanism for their
advanced ToM decits, including poor comprehen-
sion of sarcasm and lies/deception.
Original manuscript received 5 November 2012
Revised manuscript accepted 24 May 2013
First published online 21 June 2013
REFERENCES
Adolphs, R. (1999). Social cognition and the human
brain. Trends in Cognitive Sciences, 3, 469479. doi:10.
1016/S1364-6613%2899%2901399-6
D
o
w
n
l
o
a
d
e
d

b
y

[
B
i
b
l
i
o
t
h
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e

D
e

L
'
u
n
i
v
e
r
s
i
t
e
]

a
t

1
6
:
0
3

0
3

J
a
n
u
a
r
y

2
0
1
4

THEORY OF MIND & EMPATHY IN HIGH-FUNCTIONING ASDS 665
Adolphs, R. (2001). The neurobiology of social cogni-
tion. Current Opinion in Neurobiology, 11, 231239.
doi:10.1016/S0959-4388%2800%2900202-6
American Psychiatric Association. (2000). Diagnostic and
statistical manual of mental disorders (4th ed., text
rev.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic
and statistical manual of mental disorders (5th ed.).
Arlington, VA: American Psychiatric Publishing.
Amodio, D. M., & Frith, C. D. (2006). Meeting of
minds: The medial frontal cortex and social cog-
nition. Nature Reviews Neuroscience, 7, 268277.
doi:10.1038/nrn1884
Ashwin, C., Baron-Cohen, S., Wheelwright, S.,
ORiordan, M., & Bullmore, E. T. (2007). Differential
activation of the amygdala and the social brain
during fearful face-processing in Asperger syn-
drome. Neuropsychologia, 45, 214. doi:10.1016/j.
neuropsychologia.2006.04.014
Baron-Cohen, S. (1988). Social and pragmatic decits
in autism: Cognitive or affective? Journal of Autism
& Developmental Disorders, 18, 379402. doi:10.1007/
BF02212194
Baron-Cohen, S. (1989). The autistic childs theory
of mind: A case of specic developmental delay.
Journal of Child Psychology and Psychiatry and
Allied Disciplines, 30, 285297. doi:10.1111/j.1469-
7610.1989.tb00241.x
Baron-Cohen, S. (1991). The theory of mind decit
in autism: How specic is it? British Journal of
Developmental Psychology, 9, 301314. doi:10.1111/j.
2044-835X.1991.tb00879.x
Baron-Cohen, S. (1992). Out of sight or out of mind?
Another look at deception in autism. Journal of Child
Psychology and Psychiatry and Allied Disciplines, 33,
11411155. doi:10.1111/j.1469-7610.1992.tb00934.x
Baron-Cohen, S., Jolliffe, T., Mortimore, C., &
Robertson, M. (1997). Another advanced test of
theory of mind: Evidence from very high func-
tioning adults with autism or Asperger syndrome.
Journal of Child Psychology and Psychiatry and Allied
Disciplines, 38, 813822. doi:10.1111/j.1469-7610.
1997.tb01599.x
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). Does
the autistic child have a theory of mind? Cognition,
21, 3746. doi:10.1037/1089-2680.12.4.329
Baron-Cohen, S., ORiordan, M., Stone, V., Jones, R., &
Plaisted, K. (1999). Recognition of faux pas by nor-
mally developing children and children with Asperger
syndrome or high-functioning autism. Journal of
Autism & Developmental Disorders, 29, 407418.
doi:10.1023/A:1023035012436
Baron-Cohen, S., Ring, H. A., Wheelwright, S.,
Bullmore, E. T., Brammer, M. J., Simmons, A.,
& Williams, S. C. (1999). Social intelligence in the
normal and autistic brain: An fMRI study. European
Journal of Neuroscience, 11, 18911898. doi:10.1046/
j.1460-9568.1999.00621.x
Baron-Cohen, S., & Wheelwright, S. (2004). The
empathy quotient: An investigation of adults with
Asperger syndrome or high functioning autism,
and normal sex differences. Journal of Autism &
Developmental Disorders, 34, 163175. doi:10.1023/B:
JADD.0000022607.19833.00
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., &
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
and Allied Disciplines, 42, 241251. doi:10.1111/1469-
7610.00715
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin,
J., & Clubley, E. (2001). The autism-spectrum quo-
tient (AQ): Evidence from Asperger syndrome/high-
functioning autism, males and females, scientists and
mathematicians. Journal of Autism & Developmental
Disorders, 31, 517.
Blair, R. J. R. (2008). Fine cuts of empathy and the amyg-
dala: Dissociable decits in psychopathy and autism.
The Quarterly Journal of Experimental Psychology, 61,
157170. doi:10.1080/17470210701508855
Brent, E., Rios, P., Happ, F., & Charman, T. (2004).
Performance of children with autism spectrum dis-
order on advanced theory of mind tasks. Autism, 8,
283299. doi:10.1177/1362361304045217
Carlson, S. M., & Moses, L. J. (2001). Individual dif-
ferences in inhibitory control and childrens theory
of mind. Child Development, 72, 10321053. doi:10.
1016/j.cogdev.2007.08.002
Carlson, S. M., Moses, L. J., & Hix, H. R. (1998).
The role of inhibitory processes in young childrens
difculties with deception and false belief. Child
Development, 69, 672691. doi:10.2307/1132197
Castelli, F., Frith, C., Happ, F., & Frith, U. (2002).
Autism, Asperger syndrome and brain mechanisms
for the attribution of mental states to animated
shapes. Brain, 125, 18391849. doi:10.1093/brain/
awf189
Castelli, F., Happ, F., Frith, U., & Frith, C. (2000).
Movement and mind: A functional imaging study
of perception and interpretation of complex inten-
tional movement patterns. NeuroImage, 12, 314325.
doi:10.1006/nimg.2000.0612
Chung, Y. S., Mathews, J. R., & Barch, D. M.
(2011). The effect of context processing on different
aspects of social cognition in schizophrenia. Schizo-
phrenia Bulletin, 37, 10481056. doi:10.1093/schbul/
sbq012
Couture, S. M., Penn, D. L., Losh, M., Adolphs, R.,
Hurley, R., & Piven, J. (2010). Comparison of social
cognitive functioning in schizophrenia and high func-
tioning autism: More convergence than divergence.
Psychological Medicine, 40, 569579. doi:10.1017/
S003329170999078X
Craig, J. S., Hatton, C., Craig, F. B., & Bentall, R. P.
(2004). Persecutory beliefs, attributions and theory
of mind: Comparison of patients with paranoid
delusions, Aspergers syndrome and healthy con-
trols. Schizophrenia Research, 69, 2933. doi:10.1016/
S0920-9964(03)00154-3
Critchley, H. D., Daly, E. M., Bullmore, E. T., Williams,
S. C., van Amelsvoort, T., Robertson, D. M., . . .
Murphy, D. G. (2000). The functional neuroanatomy
of social behaviour: Changes in cerebral blood ow
when people with autistic disorder process facial
expressions. Brain, 123, 22032212. doi:10.1093/
brain/123.11.2203
Davis, M. H. (1980). A multidimensional approach to
individual differences in empathy. JSAS Catalog of
Selected Documents in Psychology, 10, 85.
Davis, M. H. (1983). Measuring individual differences in
empathy: Evidence for a multidimensional approach.
Journal of Personality and Social Psychology, 44,
113126. doi:10.1037/0022-3514.44.1.113
D
o
w
n
l
o
a
d
e
d

b
y

[
B
i
b
l
i
o
t
h
e
q
u
e

D
e

L
'
u
n
i
v
e
r
s
i
t
e
]

a
t

1
6
:
0
3

0
3

J
a
n
u
a
r
y

2
0
1
4

666 MATHERSUL, MCDONALD, RUSHBY
Decety, J. (2010). The neurodevelopment of empathy in
humans. Developmental Neuroscience, 32, 257267.
doi:10.1159/000317771
Dichter, G. S., & Belger, A. (2007). Social stimuli inter-
fere with cognitive control in autism. NeuroImage, 35,
12191230. doi:10.1016/j.neuroimage.2006.12.038
Di Martino, A., Ross, K., Uddin, L. Q., Sklar,
A. B., Castellanos, F. X., & Milham, M. P. (2009).
Functional brain correlates of social and nonsocial
processes in autism spectrum disorders: An activa-
tion likelihood estimation meta-analysis. Biological
Psychiatry, 65, 6374. doi:10.1016/j.biopsych.2008.
09.022
Dziobek, I., Rogers, K., Fleck, S., Bahnemann, M.,
Heekeren, H. R., Wolf, O. T., & Convit, A. (2008).
Dissociation of cognitive and emotional empa-
thy in adults with Asperger syndrome using the
Multifaceted Empathy Test (MET). Journal of Autism
& Developmental Disorders, 38, 464473. doi:10.1007/
s10803-007-0486-x
Frith, U. (1989). Autism: Explaining the enigma. Oxford:
Blackwell.
Hall, G. B. C., Szechtman, H., & Nahmias, C. (2003).
Enhanced salience and emotion recognition in autism:
A PET study. American Journal of Psychiatry, 160,
14391441. doi:10.1176/appi.ajp.160.8.1439
Happ, F. G. (1994). An advanced test of theory of
mind: Understanding of story characters thoughts
and feelings by able autistic, mentally handicapped,
and normal children and adults. Journal of Autism
& Developmental Disorders, 24, 129154. doi:10.1007/
BF02172093
Heberlein, A. S., Adolphs, R., Tranel, D., & Damasio,
H. (2004). Cortical regions for judgments of emo-
tions and personality traits from point-light walk-
ers. Journal of Cognitive Neuroscience, 16, 11431158.
doi:10.1162/0898929041920423
Hubert, B., Wicker, B., Moore, D. G., Monfardini,
E., Duverger, H., Da Fonseca, D., & Deruelle, C.
(2007). Brief report: Recognition of emotional and
non-emotional biological motion in individuals with
autistic spectrum disorders. Journal of Autism &
Developmental Disorders, 37, 13861392. doi:10.1007/
s10803-006-0275-y
Jarrold, C., Butler, D. W., Cottington, E. M., & Jimenez,
F. (2000). Linking theory of mind and central coher-
ence bias in autism and in the general population.
Developmental Psychology, 36, 126138. doi:10.1037/
0012-1649.36.1.126
Johnston, L., Miles, L., & McKinlay, A. (2007). A
critical review of the Eyes Test as a measure of
socialcognitive impairment. Australian Journal of
Psychology, 1, 17. doi:10.1080/00049530701449521
Jolliffe, T., & Baron-Cohen, S. (1999). The Strange
Stories Test: A replication with high-functioning
adults with autism or Asperger syndrome. Journal
of Autism & Developmental Disorders, 29, 395406.
doi:10.1023/A:1023082928366
Kaland, N., Mller-Nielsen, A., Smith, L., Mortensen,
E. L., Callesen, K., & Gottlieb, D. (2005). The Strange
Stories test: A replication study of children and ado-
lescents with Asperger syndrome. European Child &
Adolescent Psychiatry, 14, 7382. doi:10.1007/s00787-
005-0434-2
Kern, R. S., Green, M. F., Fiske, A. P., Kee, K. S.,
Lee, J., Sergi, M. J., . . . Nuechterlein, K. H. (2009).
Theory of mind decits for processing counterfactual
information in persons with chronic schizophrenia.
Psychological Medicine, 39, 645654. doi:10.1017/
S0033291708003966
Kipps, C. M., Nestor, P. J., Acosta-Cabronero, J., Arnold,
R., & Hodges, J. R. (2009). Understanding social
dysfunction in the behavioural variant of frontotem-
poral dementia: The role of emotion and sarcasm
processing. Brain, 132, 592603. doi:10.1093/brain/
awn314
Kohls, G., Peltzer, J., Herpertz-Dahlmann, B., & Konrad,
K. (2009). Differential effects of social and non-
social reward on response inhibition in children
and adolescents. Developmental Science, 12, 614625.
doi:10.1111/j.1467-7687.2009.00816.x
Langleben, D. D., Schroeder, L., Maldjian, J. A., Gur,
R. C., McDonald, S., Ragland, J. D., . . . Childress,
A. R. (2002). Brain activity during simulated decep-
tion: An event-related functional magnetic resonance
study. NeuroImage, 15, 727732. doi:10.1006/nimg.
2001.1003
Lawrence, E. J., Shaw, P., Baker, D., Baron-Cohen,
S., & David, A. S. (2004). Measuring empathy:
Reliability and validity of the Empathy Quotient.
Psychological Medicine, 34, 911919. doi:10.1017/
S0033291703001624
Li, A. S., Kelley, E. A., Evans, A. D., & Lee, K.
(2011). Exploring the ability to deceive in children
with autism spectrum disorders. Journal of Autism &
Developmental Disorders, 41, 185195. doi:10.1007/
s10803-010-1045-4
Lord, C., Rutter, M., DiLavore, P. C., & Risi, S.
(1999). Autism Diagnostic Observation Schedule
Generic (ADOS-G). Los Angeles, CA: Western
Psychological Services.
Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism
Diagnostic InterviewRevised: A revised version of a
diagnostic interview for caregivers of individuals with
possible pervasive developmental disorders. Journal
of Autism and Developmental Disorders, 24, 659685.
doi:10.1007/BF02172145
Loveland, K. A., Steinberg, J. L., Pearson, D. A.,
Mansour, R., & Reddoch, S. (2008). Judgments of
auditory-visual affective congruence in adolescents
with and without autism: A pilot study of a new task
using fMRI. Perceptual & Motor Skills, 107, 557575.
doi:10.2466/pms.107.2.557-575
Mathersul, D., McDonald, S., & Rushby, J. A. (2013a).
Automatic facial responses to affective stimuli in
high-functioning adults with autism spectrum disor-
der. Physiology & Behavior, 109, 1422. doi:10.1016/j.
physbeh.2012.10.008
Mathersul, D., McDonald, S., & Rushby, J. A.
(2013b). Psychophysiological correlates of social
judgement in high-functioning adults with autism
spectrum disorder. International Journal of Psycho-
physiology, 87, 8894. doi:10.1016/j.ijpsycho.2012.
11.005
McDonald, S. (1999). Exploring the process of infer-
ence generation in sarcasm: A review of normal and
clinical studies. Brain and Language, 68, 486506.
doi:10.1006/brln.1999.2124
McDonald, S., Bornhofen, C., Shum, D., Long, E.,
Saunders, C., & Neulinger, K. (2006). Reliability
and validity of The Awareness of Social Inference
Test (TASIT): A clinical test of social percep-
tion. Disability & Rehabilitation, 28, 15291542.
doi:10.1080/09638280600646185
D
o
w
n
l
o
a
d
e
d

b
y

[
B
i
b
l
i
o
t
h
e
q
u
e

D
e

L
'
u
n
i
v
e
r
s
i
t
e
]

a
t

1
6
:
0
3

0
3

J
a
n
u
a
r
y

2
0
1
4

THEORY OF MIND & EMPATHY IN HIGH-FUNCTIONING ASDS 667
McDonald, S., & Flanagan, S. (2004). Social percep-
tion decits after traumatic brain injury: Interaction
between emotion recognition, mentalizing ability, and
social communication. Neuropsychology, 18, 572579.
doi:10.1037/0894-4105.18.3.572
McDonald, S., Flanagan, S., Martin, I., & Saunders, C.
(2004). The ecological validity of TASIT: A test of
social perception. Neuropsychological Rehabilitation,
14, 285302. doi:10.1080/09602010343000237
McDonald, S., Flanagan, S., & Rollins, J. (2002). The
Awareness of Social Inference Test. Sydney: Harcourt
Assessment.
McDonald, S., Flanagan, S., Rollins, J., & Kinch,
J. (2003). TASIT: A new clinical tool for assess-
ing social perception after traumatic brain injury.
Journal of Head Trauma Rehabilitation, 18, 219238.
doi:10.1097/00001199-200305000-00001
McDonald, S., & Saunders, J. C. (2005). Differential
impairment in recognition of emotion across dif-
ferent media in people with severe traumatic
brain injury. Journal of the International Neuro-
psychological Society, 11, 392399. doi:10.10170
S1355617705050447
Muncer, S. J., & Ling, J. (2006). Psychometric analysis
of the Empathy Quotient (EQ) scale. Personality and
Individual Differences, 40, 11111119. doi:10.1016/j.
paid.2005.09.020
Ohnishi, T., Matsuda, H., Hashimoto, T., Kunihiro,
T., Nishikawa, M., Uema, T., & Sasaki, M. (2000).
Abnormal regional cerebral blood ow in childhood
autism. Brain, 123, 18381844. doi:10.1093/brain/
123.9.1838
Olson, I. R., Plotzker, A., & Ezzyat, Y. (2007). The enig-
matic temporal pole: A review of ndings on social
and emotional processing. Brain, 130, 17181731.
doi:10.1093/brain/awm052
Perner, J., Lang, B., & Kloo, D. (2002). Theory of
mind and self-control: More than a common prob-
lem of inhibition. Child Development, 73, 752767.
doi:10.1111/1467-8624.00436
Perner, J., & Wimmer, H. (1985). John thinks that Mary
thinks that . . .: Attribution of second-order beliefs
by 5- to 10-year-old children. Journal of Experimental
Child Psychology, 39, 437471. doi:10.1016/0022-
0965(85)90051-7
Philip, R. C., Dauvermann, M. R., Whalley, H. C.,
Baynham, K., Lawrie, S. M., & Staneld, A. C.
(2012). A systematic review and meta-analysis of
the fMRI investigation of autism spectrum disorders.
Neuroscience and Biobehavioral Reviews, 36, 901942.
doi:10.1016/j.neubiorev.2011.10.008
Phillips, M. L., Drevets, W. C., Rauch, S. L., & Lane, R.
(2003). Neurobiology of emotion perception: I. The
neural basis of normal emotion perception. Biological
Psychiatry, 54, 504514. doi:10.1016/S0006-3223(03)
00168-9
Pierce, K., Muller, R. A., Ambrose, J., Allen, G., &
Courchesne, E. (2001). Face processing occurs out-
side the fusiform face area in autism: Evidence from
functional MRI. Brain, 124, 20592073. doi:10.1093/
brain/124.10.2059
Pilowsky, T., Yirmiya, N., Arbelle, S., &Mozes, T. (2000).
Theory of mind abilities of children with schizophre-
nia, children with autism, and normally develop-
ing children. Schizophrenia Research, 42, 145155.
doi:10.1016/S0920-9964(99)00101-2
Rankin, K. P., Kramer, J. H., & Miller, B. L.
(2005). Patterns of cognitive and emotional empa-
thy in frontotemporal lobar degeneration. Cognitive &
Behavioral Neurology, 18, 2836. doi:10.1097/01.wnn.
0000152225.05377.ab
Rankin, K. P., Salazar, A., Gorno-Tempini, M. L.,
Sollberger, M., Wilson, S. M., Pavlic, D., . . . Miller,
B. L. (2009). Detecting sarcasm from paralinguis-
tic cues: Anatomic and cognitive correlates in neu-
rodegenerative disease. NeuroImage, 47, 20052015.
doi:10.1016/j.neuroimage.2009.05.077
Reinecke, D. R., Newman, B., Kurtz, A. L., Ryan, C. S.,
& Hemmes, N. S. (1997). Teaching deception skills in
a game-play context to three adolescents with autism.
Journal of Autism & Developmental Disorders, 27,
127137. doi:10.1023/A:1025835706522
Ritvo, R. A., Ritvo, E. R., Guthrie, D., Ritvo, M. J.,
Hufnagel, D. H., McMahon, W., . . . Eloff, J. (2011).
The Ritvo Autism Asperger Diagnostic ScaleRevised
(RAADSR): A scale to assist the diagnosis of autism
spectrum disorder in adults: An international val-
idation study. Journal of Autism & Developmental
Disorders, 41, 10761089. doi:10.1007/s10803-010-
1133-5
Ritvo, R. A., Ritvo, E. R., Guthrie, D., Yuwiler, A.,
Ritvo, M. J., & Weisbender, L. (2008). A scale to
assist the diagnosis of autism and Aspergers dis-
order in adults (RAADS): A pilot study. Journal
of Autism & Developmental Disorders, 38, 213223.
doi:10.1007/s10803-007-0380-6
Roeyers, H., Buysse, A., Ponnet, K., & Pichal, B. (2001).
Advancing advanced mind-reading tests: Empathic
accuracy in adults with a pervasive developmental
disorder. Journal of Child Psychology & Psychiatry
& Allied Disciplines, 42, 271278. doi:10.1111/1469-
7610.00718
Rogers, K., Dziobek, I., Hassenstab, J., Wolf, O. T.,
& Convit, A. (2007). Who cares? Revisiting empa-
thy in Asperger syndrome. Journal of Autism &
Developmental Disorders, 37, 709715. doi:10.1007/
s10803-006-0197-8
Shamay-Tsoory, S. G., & Aharon-Peretz, J. (2007).
Dissociable prefrontal networks for cognitive
and affective theory of mind: A lesion study.
Neuropsychologia, 45, 30543067. doi:10.1016/j.
neuropsychologia.2007.05.021
Shamay-Tsoory, S. G., Tomer, R., & Aharon-Peretz,
J. (2005). The neuroanatomical basis of understand-
ing sarcasm and its relationship to social cognition.
Neuropsychology, 19, 288300. doi:10.1037/0894-
4105.19.3.288
Shamay-Tsoory, S. G., Tomer, R., Berger, B. D.,
& Aharon-Peretz, J. (2003). Characterization of
empathy decits following prefrontal brain damage:
The role of the right ventromedial prefontal cor-
tex. Journal of Cognitive Neuroscience, 15, 324337.
doi:10.1162/089892903321593063
Shamay-Tsoory, S. G., Tomer, R., Yaniv, S., & Aharon-
Peretz, J. (2002). Empathy decits in Asperger syn-
drome: A cognitive prole. Neurocase, 8, 245252.
Silani, G., Bird, G., Brindley, R., Singer, T., Frith, C.,
& Frith, U. (2008). Levels of emotional awareness
and autism: An fMRI study. Social Neuroscience, 3,
97112. doi:10.1080/17470910701577020
Sparks, A., McDonald, S., Lino, B., ODonnell, M., &
Green, M. J. (2010). Social cognition, empathy and
D
o
w
n
l
o
a
d
e
d

b
y

[
B
i
b
l
i
o
t
h
e
q
u
e

D
e

L
'
u
n
i
v
e
r
s
i
t
e
]

a
t

1
6
:
0
3

0
3

J
a
n
u
a
r
y

2
0
1
4

668 MATHERSUL, MCDONALD, RUSHBY
functional outcome in schizophrenia. Schizophrenia
Research, 122, 172178. doi:10.1016/j.schres.2010.
06.011
Spek, A. A., Scholte, E. M., & van Berckelaer-
Onnes, I. A. (2010). Theory of mind in adults with
HFA and Asperger syndrome. Journal of Autism &
Developmental Disorders, 40, 280289. doi:10.1007/
s10803-009-0860-y
Spence, S. A., Farrow, T. F. D., Herford, A. E.,
Wilkinson, I. D., Zheng, Y., & Woodruff, P. W. (2001).
Behavioural and functional anatomical correlates of
deception in humans. Neuroreport, 12, 28492853.
doi:10.1097/00001756-200109170-00019
Spence, S. A., Hunter, M. D., Farrow, T. F. D., Green,
R. D., Leung, D. H., Hughes, C. J., & Ganesan,
V. (2004). A cognitive neurobiological account of
deception: Evidence from functional neuroimaging.
Philosophical Transactions of the Royal Society of
LondonSeries B: Biological Sciences, 359, 17551762.
doi:10.1098/rstb.2004.1555
Strauss, E., Sherman, E. M., & Spreen, O. (2006). A com-
pendium of neuropsychological tests: Administration,
norms, and commentary (3rd ed.). New York, NY:
Oxford University Press.
Talwar, V., & Lee, K. (2008). Social and cognitive cor-
relates of childrens lying behavior. Child Develop-
ment, 79, 866881. doi:10.1111/j.1467-8624.2008.
01164.x
Uchiyama, H., Seki, A., Kageyama, H., Saito, D.
N., Koeda, T., Ohno, K., & Sadato, N. (2006).
Neural substrates of sarcasm: A functional magnetic-
resonance imaging study. Brain Research, 1124,
100110. doi:10.1016/j.brainres.2006.09.088
Wang, A. T., Lee, S. S., Sigman, M., & Dapretto, M.
(2007). Reading affect in the face and voice: Neural
correlates of interpreting communicative intent in
children and adolescents with autism spectrum dis-
orders. Archives of General Psychiatry, 64, 698708.
doi:10.1001/archpsyc.64.6.698
Wechsler, D. (1997). Wechsler Adult Intelligence Scale
(3rd ed.). San Antonio, TX: The Psychological
Corporation.
Wechsler, D. (1999). Wechsler Abbreviated Scale of
Intelligence. San Antonio, TX: The Psychological
Corporation.
Wimmer, H., & Perner, J. (1983). Beliefs about
beliefs: Representation and constraining function of
wrong beliefs in young childrens understanding of
deception. Cognition, 13, 103128. doi:10.1016/0010-
0277(83)90004-5
Yirmiya, N., Erel, O., Shaked, M., & Solomonica-
Levi, D. (1998). Meta-analyses comparing theory of
mind abilities of individuals with autism, individu-
als with mental retardation, and normally develop-
ing individuals. Psychological Bulletin, 124, 283307.
doi:10.1037/0033-2909.124.3.283
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