---
title: "Chapter 7. Social Cognition and Its Difficulties"
book: "Why Minds Break: An Evolutionary and Developmental Programme for Psychopathology"
author: Ian Pitchford
url: https://evidencepress.org/why-minds-break/chapter-7/
---

# Chapter 7. Social Cognition and Its Difficulties

Using autism, psychosis and the impostor delusion, the chapter shows why a task result, a proposed mental process and a real-life difficulty each need separate evidence.

The chapter opens with the Sally-Anne experiment of 1985, in which Simon Baron-Cohen, Alan Leslie and Uta Frith found that most autistic children tested pointed to where a moved marble actually was, not where its owner believed it to be. The authors read this as a failure of theory of mind. The chapter treats that reading as a leap across three distinct things: an answer on a task, a claim about an underlying mechanism, and the difficulties a child meets at school or with friends. Later work, including Francesca Happé's pooled analysis, shows that false-belief performance depends heavily on language and on how samples are matched, and that differences also appear in intellectual disability and schizophrenia. Claims of very early belief tracking in infants have a mixed replication record.

It then asks what the autism category now contains. Recorded prevalence has climbed, but a Danish register study traced much of the rise to changed diagnostic rules and counting practices. Del Giudice's evolutionary account proposes several overlapping routes, not a single adaptation. Damian Milton's double empathy idea, that misunderstanding runs both ways, prompted transmission-chain experiments; the disadvantage first reported for mixed autistic and non-autistic chains did not hold up in a 2025 registered replication. The extreme male brain theory is circular unless the "male brain" is measured independently, and its proposed hormonal mechanism has had inconsistent support. A meta-analysis testing predictive-processing accounts of autism found a small-to-moderate average difference, with wide unexplained variation between studies.

For psychosis, the chapter accepts that early development contributes to schizophrenia without implying one lesion or one timetable. Mentalising scores are markedly lower on average but relate only weakly to delusions. Reduced dampening of self-produced sensation, seen in Frith's tickling and force-matching work, replicates at group level yet shows little link to hallucinations. A 2026 meta-analysis found no overall difference in perceptual priors. The diametric hypothesis, placing autism and psychosis at opposite poles, has mixed evidence, since genetic liability for the two overlaps.

The Capgras delusion, in which a loved one seems replaced by an impostor, offers a narrower test. Small studies found faces recognised without the usual skin-conductance response. Max Coltheart's two-factor theory adds a failure of belief evaluation; one-factor and predictive accounts, including Philip Corlett's, dispute that, and both sides claim a 2017 lesion-network result. For Cotard delusion, the belief that one is dead, case surveys weigh against an account based on a complete loss of feeling.

The final sections outline research able to tie performance to process, using tasks checked for equal meaning across groups, models shown to be distinguishable, and prospective designs. A task difference, a candidate process and an everyday difficulty each deserve a separate record and separate evidence.

## Questions the chapter asks

- Does failing a false-belief test show that autistic people lack an understanding of other minds?
- Do autism and schizophrenia share a mechanism, or sit at opposite ends of one?
- Why does someone with Capgras delusion recognise a parent's face yet believe the parent is an impostor?

This is a summary of the chapter, written for this site; it is not an extract from the book. Coming soon from Amazon in Kindle, paperback and hardback editions.

*Why Minds Break* and these summaries are © 2026 Ian Pitchford, all rights reserved. The cover drawing is by Santiago Ramón y Cajal (1915), public domain.