A conceptual framework of cognitive-affective theory of mind: towards a precision identification of mental disorders

To explore the minds of others, which is traditionally referred to as Theory of Mind (ToM), is perhaps the most fundamental ability of humans as social beings. Impairments in ToM could lead to difficulties or even deficits in social interaction. The present study focuses on two core components of ToM, the ability to infer others’ beliefs and the ability to infer others’ emotions, which we refer to as cognitive and affective ToM respectively. Charting both typical and atypical trajectories underlying the cognitive-affective ToM promises to shed light on the precision identification of mental disorders, such as depressive disorders (DD) and autism spectrum disorder (ASD). However, most prior studies failed to capture the underlying processes involved in the cognitive-affective ToM in a fine-grained manner. To address this problem, we propose an innovative conceptual framework, referred to as visual theory of mind (V-ToM), by constructing visual scenes with emotional and cognitive meanings and by depicting explicitly a four-stage process of how humans make inferences about the beliefs and emotions of others. Through recording individuals’ eye movements while looking at the visual scenes, our model enables us to accurately measure each stage involved in the computation of cognitive-affective ToM, thereby allowing us to infer about potential difficulties that might occur in each stage. Our model is based on a large sample size (n > 700) and a novel audio-visual paradigm using visual scenes containing cognitive-emotional meanings. Here we report the obtained differential features among healthy controls, DD and ASD individuals that overcome the subjectivity of conventional questionnaire-based assessment, and therefore could serve as valuable references for mental health applications based on AI-aided digital medicine.