1 Psychology and human development1.10 Social psychology

1.10.1.3 Theory of mind and autism

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Written by Resident Doctor Committee · Published

New in the 2027 syllabus

The College added this topic for exams from January 2027.

What theory of mind means

Theory of mind is understanding that another person can have beliefs, intentions or knowledge that differ from your own, and from reality.

Working out what is in someone else's mind is called mentalising. It has two parts:

  • Cognitive mentalising: understanding what someone believes or intends.

  • Affective mentalising: understanding how someone feels.

False-belief tasks

In the Sally-Anne task, an object is moved while Sally is away. The participant is asked where Sally will search for it. To give the original location, they must hold in mind Sally's belief, which is now out of date.

Two control questions rule out other reasons for failing:

  • Memory question: has the participant forgotten the story?

  • Reality question: do they know where the object actually is?

Performance also depends on language, attention and executive control (the mental skills that organise and regulate thinking and behaviour). So one wrong answer is not a specific diagnostic test.

A schematic false-belief task. Sally searches where she last saw the ball, although the observer knows it has moved. Memory, language and task comprehension also affect performance; this is not a diagnostic test for autism. Original illustration drawn in Python for MRCPsychiatrist; see images/ATTRIBUTION.md

Autism spectrum conditions

The original theory-of-mind account proposed that difficulty inferring other people's mental states contributes to autistic differences in social communication.

The picture varies a great deal:

  • Autistic people can pass false-belief tasks. Reasoning about beliefs explicitly may differ from the rapid interpretation of others needed in everyday interaction.

  • Mentalising and emotional concern are separate. Difficulty working out what someone believes does not mean the person lacks care or empathy.

  • Communication difficulties can arise between people with different expectations and styles. Assessment looks at both the individual and the interaction.

Revision material for the MRCPsych examinations. Not clinical guidance, and not for use in patient care.