1. Mentalization (theory of mind) and autism
Domina Petric, MD

2. Mentalization and theory of mind
Mentalization mainly concerns the reflection of affective mental states.
Theory of mind focuses on epistemic states such as beliefs, intentions and persuasions.

3. Autism
Autism spectrum disorders (ASDs) include:
autism
Asperger's syndrome
pervasive development disorder not otherwise specified (PDD-NOS)
Those are neurodevelopmental conditions characterized by core deficits in social communication skills evident before the age of three years.

4. Interpersonal relationships
one's own state of mind
state of mind of others
Interpersonal relationships involve effective assessment of:

5. The assessment of one´s own state of mind includes:
motivational processes that appraise the value to the self of rewards or punishments as potential consequences of specific social situations
real or prospective

6. The assessment of others´ state of mind includes:
mentalizing processes that establish a representation of others' thoughts, desires, goals and beliefs (theory of mind)

7. The specialized mentalizing-related network involves:
temporoparietal junction (TPJ)
superior temporal sulcus (STS)
temporal pole (TP)
medial prefrontal cortex (MPFC)

8. Temporoparietal junction

9. Superior temporal sulcus

10. Temporal pole

11. Stimlab.org

12. Explicit off-line mentalizing tasks
tasks where participants are explicitly instructed to retrospectively explain the state of mind of other people

13. Implicit on-line mentalizing tasks
tasks where participants are not instructed to be involved in thinking about the others during an on-going interaction
mentalizing happens in real-time and potentially affects the behavior of the participant him/herself
Assaf M, Hyatt CJ, Wong CG, et al. Mentalizing and motivation neural function during social interactions in autism
spectrum disorders. NeuroImage : Clinical. 2013;3: doi: /j.nicl

14. The reward-related motivation network includes:
cortical–basal ganglia circuit
nucleus accumbens
orbitofronal cortex
midbrain dopaminergic neurons

15. The reward-related motivation network
This network is involved in the anticipation and response to both primary and secondary rewards. 

16. Nucleus accumbens

17. Orbitofrontal cortex

18. Autism spectrum disorders
The mentalizing development and reasoning is impaired in individuals with ASDs.
Diminished reward valence of social stimuli (faces) leads to reduced attention to these stimuli.
The result is abnormal reward processing and deficits in the social interactions and learning. 

19. Autism
People with autism have difficulty understanding goals and intentions of others.
Two theories try to explain this: mentalizing theory and the broken mirror theory.

20. Mentalising theory
Only mentalizing network is abnormal.
At least basic processing in the mirror system is normal.
Many children and adults with autism have particular difficulties with false belief tasks (Maxi´s chocolate task).
Failure of implicit mentalizing may be the core difficulty in autism (Frith, 2012).
Implicit mentalizing develops over the first two years of life at the same time that autism emerges.
Mentalizing remains impaired in high functioning adults with autism.

21. It is a cause of poor mentalizing.
Broken mirror theory
Developmental failure of the mirror system is the primary social difficulty in autism.
It is a cause of poor mentalizing.
Deficits in understanding the kinematic and goal features of an action would lead to further difficulties in understanding emotions and mental states.

22. The mirror neuron system
Mirror neurons are defined as single cells which respond when an individual performs an action and observes an equivalent action.
The mirror system seems to match observed actions onto the observer´s own motor system.
This system allows action comprehension and imitation from the inside (Rizzolatti, Giacomo, Sinigaglia, 2010).

23. Literature
Assaf M, Hyatt CJ, Wong CG, et al. Mentalizing and motivation neural function during social interactions in autism spectrum disorders. NeuroImage : Clinical. 2013;3: doi: /j.nicl
Wikimedia.org
Stimlab.org
Hamilton A. Marsh L. Two systems for action comprehension in autism: mirroring and mentalizing