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ORIGINALRESEARCHARTICLE published:24January2013 doi:10.3389/fpsyg.2012.00588 Imagining other people’s experiences in a person with impaired episodic memory: the role of personal familiarity JenniferS.Rabin1*,NicoleCarson1,AsafGilboa2,3,4,DonaldT.Stuss2,3,5,6,7 andR.ShaynaRosenbaum1,2 1DepartmentofPsychology,YorkUniversity,Toronto,ON,Canada 2RotmanResearchInstitute,BaycrestHospital,Toronto,ON,Canada 3DepartmentofPsychology,UniversityofToronto,Toronto,ON,Canada 4TheHeartandStrokeFoundation,CentreforStrokeRecovery,Toronto,ON,Canada 5OntarioBrainInstitute,Toronto,ON,Canada 6DivisionofNeurology,DepartmentofMedicine,UniversityofToronto,Toronto,ON,Canada 7RehabilitationSciences,UniversityofToronto,Toronto,ON,Canada Editedby: Difficultiesrememberingone’sownexperiencesviaepisodicmemorymayaffecttheability R.NathanSpreng,CornellUniversity, toimagineotherpeople’sexperiencesduringtheoryofmind(ToM).Previousworkshows USA that the same set of brain regions recruited during tests of episodic memory and future Reviewedby: imaginingarealsoengagedduringstandardlaboratorytestsofToM.However,hippocampal SimoneG.Shamay-Tsoory,University ofHaifa,Israel amnesicpatientswhoshowdeficitsinpastandfuturethinking,showintactperformance JanelleBeadle,UniversityofIowa, onToMtests,whichinvolveunknownpeopleorfictionalcharacters.Herewepresentdata USA fromadevelopmentalamnesicperson(H.C.)andagroupofdemographicallymatchedcon- *Correspondence: trols,whoweretestedonanaturalistictestofToMthatinvolveddescribingotherpeople’s JenniferS.Rabin,Departmentof experiences in response to photos of personally familiar others (“pToM” condition) and Psychology,YorkUniversity,4700 KeeleStreet,Toronto,ON,Canada unfamiliar others (“ToM” condition).We also included a condition that involved recollect- M3J1P3. ing past experiences in response to personal photos (“EM” condition). Narratives were e-mail:[email protected] scoredusinganadaptedAutobiographicalInterviewscoringprocedure.Duetothevisually rich stimuli, internal details were further classified as either descriptive (i.e., details that describethevisualcontentofthephoto)orelaborative(i.e.,detailsthatgobeyondwhat is visually depicted in the photo). Relative to controls, H.C. generated significantly fewer elaborativedetailsinresponsetothepToMandEMphotosandanequivalentnumberof elaborativedetailsinresponsetotheToMphotos.Thesedataconvergewithpreviousneu- roimaging results showing that the brain regions underlying pToM and episodic memory overlaptoagreaterextentthanthosesupportingToM.Takentogether,theseresultssug- gestthatdetailedepisodicrepresentationssupportedbythehippocampusmaybepivotal forimaginingtheexperiencesofpersonallyfamiliar,butnotunfamiliar,others. Keywords:episodicmemory,theoryofmind,hippocampus,amnesia,socialcognition INTRODUCTION toimagineone’sownpersonalfuture.Amnesicindividualswith Amnesia following damage to the hippocampus has been char- hippocampaldamagewhoareunabletorecollectpasteventsalso acterized by impaired episodic memory for personally experi- have difficulty imagining themselves in future events (Tulving, encedevents.However,thereisgrowingevidencethatother,non- 1985;Kleinetal.,2002;Rosenbaumetal.,2005;Andelmanetal., mnemonic processes may be compromised in amnesia as well. 2010). Consistent with this finding, neuroimaging studies have Thesefindingshaveledresearcherstosuggestabroaderrolefor revealed that both abilities recruit a similar set of brain regions thehippocampusandepisodicmemorythatgoesbeyondrecall- thatincludethehippocampusandadjacentmedialtemporallobe ingpastpersonalexperiences.Muchofthisworkhasfocusedon (MTL)regionsaswellasmedialfrontal,medialparietal,andlateral theideathatepisodicmemoryisnecessaryforimaginingpossible temporal cortex (Okuda et al.,2003;Addis et al.,2007;Szpunar future scenarios (Tulving,1985; Klein et al.,2002; Okuda et al., etal.,2007).Someofthesestudieshaveincludedacontrolcondi- 2003; Rosenbaum et al.,2005;Addis et al.,2007; Szpunar et al., tion in which participants are asked to imagine the experiences 2007;Andelmanetal.,2010),whereasmuchlessattentionhasbeen of an “average” person or a famous person, which appears to paidtotherolethatepisodicmemoryplaysinsocialbehavior.In engage regions within the MTL as well,albeit to a lesser extent thecurrentstudy,weexaminedif,andunderwhatconditions,the (Szpunaretal.,2007;seealsoGilboaetal.,2004).However,itmay abilitytorememberandimagineone’sownexperiencesservesa be the case that episodic memory and associated MTL function socialfunctioninfacilitatingtheabilitytoimagineotherpeople’s play an important role in imagining other people’s experiences, experiences. assuggestedbyqualitativereviewsandmeta-analysesoftheneu- Animpressivebodyofresearchhasshownthatepisodicmem- roimagingliterature.Thesestudiesshowthatthesamesetofbrain ory,supportedbythehippocampus,iscloselyrelatedtotheability regions activated during tests of episodic memory and future www.frontiersin.org January2013|Volume3|Article588|1 Rabinetal. Episodicmemoryandimaginingothers’experiences imagining are also engaged during standard tests of theory of similartotheselfandwhentheeventhadoccurredinthepartici- mind (ToM; Buckner and Carroll,2007; Hassabis and Maguire, pant’sownlife.Takentogether,thesestudiessuggestthatepisodic 2007;Sprengetal.,2009). memorymayserveasocialroleinimaginingotherpeople’sexpe- In addition to an overlapping set of brain regions, episodic riences,but only when intimacy or closeness exists between the memory, future imagining, and ToM emerge close in time in participantandtheperceivedother. ontogenetic development (Perner and Ruffman, 1995; Atance Inthecurrentstudy,wetesttheideathatepisodicmemoryis and O’Neil, 2001; Perner et al., 2007) and tend to be impaired necessaryforimaginingeventsfromtheperspectiveofpersonally in patients with schizophrenia (Corcoran and Frith, 2003; knownothers.Onewaytoaddressthisquestionistoassesswhether D’Argembeau et al., 2008) and high functioning autism and apersonwithhippocampalamnesiaandimpairedepisodicmem- Asperger’ssyndrome(Adleretal.,2010;LindandBowler,2010). oryisabletoimagineeventsexperiencedbywell-knownothers, Thesefindingslendsupporttoaninfluentialtheoreticalperspec- includingreconstructingothers’thoughtsandfeelings.Here,we tivethatindividualsdrawonpastexperiencesviaepisodicmemory testH.C.,auniqueyoungwomanwithnormalintellectualfunc- tosimulatefuturepersonalexperiencesandtoimagineotherpeo- tiondespiteimpaireddevelopmentofherepisodicmemorydueto ple’sexperiencesduringToM(Gordon,1986;Goldman,1992;Cor- selectivehippocampaldamage1weekafterbirth(Vargha-Khadem coran,2000,2001;GallagherandFrith,2003;BucknerandCarroll, etal.,2003;Rosenbaumetal.,2011;seealsoKwanetal.,2010;Hur- 2007; Schacter and Addis, 2007; Spreng and Mar, 2012). How- leyetal.,2011).Importantly,aswasthecasefortheadult-onset ever,work with hippocampal amnesic patients shows preserved hippocampal amnesic cases described above, we recently found performanceonstandardtestsofToMdespiteimpairedepisodic that H.C.’s performance on a wide range of standard ToM tests memory and future imagining (Rosenbaum et al., 2007; Rabin was indistinguishable from that of controls (Rabin et al.,2012). etal.,2012).StandardToMtestsincludedinthesestudiesranged WebelievethatherpreservedToMperformanceisduetoreliance frompredictingacharacter’sfalsebelief (Stoneetal.,1998)and onhersemanticmemoryandgeneralknowledgeabilities,which identifyingafauxpas(Stoneetal.,1998)basedonnarratives,to remainrelativelyintact(Rabinetal.,2012).Inthecurrentstudywe inferringothers’thoughtsandemotionsbasedonviewingtheeye employedanaturalistictestof ToMthatinvolveddescribingthe regionoffaces(Baron-Cohenetal.,2001).Theamnesicpatients’ experiences of other people in response to photos of personally successful performance on these tests may have been achieved known others (i.e., relatives and close friends; “pToM” condi- via semantic memory, which remains relatively intact in these tion)andunknownothers(“ToM”condition)engaginginspecific patients(Rosenbaumetal.,2007).Thismightincluderelianceon events.Wealsoincludedaconditionthatinvolvedrecollectingpast social knowledge of the average person’s thoughts,feelings,and experiencesinresponsetopersonalphotos(“EM”condition).This intentionsindifferentcircumstances(Lieberman,2012). naturalistic task was selected because it is less constrained than More recent neuroimaging studies have directly compared moststandardtestsofToMandthereforebettercapturesToMas episodicmemorywithToMinthesameindividualsusingmore itoccursineverydaylife.FindingsofimpairedpToMthatparal- naturalisticstimuli(Rabinetal.,2010;SprengandGrady,2010;St. lelH.C.’sepisodicmemorydeficitwouldsuggestthatpToMrelies Jacquesetal.,2011;seealsoGilboaetal.,2004;Szpunaretal.,2007). on episodic memory or that a common process mediates both Thesestudiesrevealedthatrelativetorecallingpastepisodes,imag- abilities. Alternatively, it may be the case that intact aspects of iningtheexperiencesof otherpeopleelicitedlessactivitywithin H.C.’s semantic memory are sufficient to support mental state MTL and midline regions. However,the“other”targets in these inferences involving pToM and ToM,and therefore H.C. would studieswerenotintimatelyknownbyparticipants(i.e.,strangers showintactperformanceonbothtasks,similartoherperformance or public figures). It is possible that when the target person is onstandardToMtests. personally known,shared past experiences can influence partic- ipants’current social processing. Indeed, knowing someone for MATERIALSANDMETHODS a long period of time and observing that person’s behavior in PARTICIPANTS different situations provides a rich source of information from H.C.isaright-handedwomanwhowas20yearsoldatthetime whichonecandrawwhenimagininghis/hermentalstatesinspe- of testing. A second testing session was performed when H.C. cificsituations.Consistentwiththisidea,RabinandRosenbaum was 23years old for reliability purposes. She was born prema- (2012) recently showed that imagining the experiences of per- turelyandsufferedhypoxicdamage,whichledtoreducedbilateral sonally familiar versus unfamiliar others preferentially engaged hippocampal volume by approximately 50% relative to healthy regionsknowntosupportepisodicmemory,suggestingastrategy controls (Vargha-Khadem et al., 2003; Hurley et al., 2011; see ofrelyingonpastpersonalexperienceswhenthetargetpersonis Rosenbaumetal.,2011foradetailedneuropsychologicalprofile). personallyknown.Inanotherstudy,Krienenetal.(2010)focused H.C.’scompromisedbilateralhippocampaldevelopmentappears exclusivelyonmidlinefrontalregionsandfoundgreateranterior tohaveprecludednormaldevelopmentofherepisodicmemory. medialprefrontalcortexandrostralanteriorcingulatecortexactiv- Her impairment affects her personal and public event memory ityforjudgmentsrelatingtoparticipants’friendsversusstrangers. more than her personal and general semantic memory (Rosen- Infact,participantsinthatstudyindicatedthattheyreliedonaspe- baumetal.,2011),whichisconsistentwithotherdevelopmental cificmemoryoranecdotesignificantlymoreoftenforjudgments amnesic cases (Gadian et al.,2000). H.C. successfully graduated relatingtofriendsthanstrangers.Perryetal.(2011)showedthat fromamainstreamhighschoolandcompleted1yearoftechnical hippocampalactivityduringjudgmentsofothers’emotionalstates college.At the time of the first testing session,she was enrolled was specific to conditions in which the protagonist was deemed inapost-secondaryculinaryprogrambutwithdrewafter1year. FrontiersinPsychology|Cognition January2013|Volume3|Article588|2 Rabinetal. Episodicmemoryandimaginingothers’experiences H.C.hasformedanormalnumberofcloserelationships(David- inasmuchdetailaspossible.Theyweretoldtofocusonwhatthey sonetal.,2012,thisissue)andwasengagedtobemarriedatthe werethinkingandfeelingatthetime. secondtimeoftesting. Following the presentation of each photo, participants rated H.C.’s performance on all measures was compared with that the events they imagined/recollected on a number of dimen- of 18 right-handed,healthy women with no reported history of sions. Three ratings scales were presented after each photo. The neurological or psychiatric illness (mean age=19.4, SD=1.3; firstratingscaledifferedforthepToM/ToMandEMevents.The meaneducation=13.3,SD=1.1).Allparticipantsgaveinformed pToMandToMeventswereratedforlikenesstoanactualmem- written consent in accordance with the ethics review boards ory (1=exactly like a memory ... 4=nothing like a memory), atYork University and Baycrest. Participants received monetary whereas the EM events were rated on the extent to which the compensationfortheirtime. events were recollected (1=don’t know event;2=familiar with event;3=rememberevent;Gardineretal.,1998;Tulving,1985). STIMULI Participantswereinstructedtoselect“remember”iftheeventwas We employed a novel, naturalistic test of ToM that involved specific to a time and place and they could re-experience it, to describing others’ thoughts and feelings in response to photos select“familiarwithevent”iftheeventwasfamiliartothem,but of personally familiar others (“pToM”condition) and unfamil- theycouldnotrecallanyspecificcontextualorotherexperiential iar others (“ToM” condition) engaging in specific events. We detailsassociatedwiththeevent,andtoselect“don’tknowevent” also included a condition that involved recollecting past experi- iftheywereunabletorecallanyaspectoftheevent.Thenexttwo encesinresponsetopersonalphotos(“EM”condition;Rabinand ratingsscaleswereemployedforallconditions.Onescaleassessed Rosenbaum,2012). theamountof detailgeneratedforeachevent(1=notvivid... ThepToMconditioninvolvingpersonallyknownotherscon- 4=veryvivid)andtheotherscaleassessedthespatialcoherenceof sistedof 15photosdepictingspecificeventsthathadbeenexpe- eachevent(contiguousnessofthespatialcontext:1=fragmented rienced by family members and close friends but not by the scenes...4=continuousscene;Hassabisetal.,2007;notreported participant him/herself. The ToM condition involving unfamil- inthecurrentstudy). iarothersconsistedof 15photosdepictingstrangersengagedin Prior to the scan, a short training session was provided to specificevents.TheEMconditionconsistedof15personalfamily ensure that participants fully understood the task instructions. photos of events that took place within the past 1–5years. H.C. The photos used in the training session were not used during and13ofthe18controlparticipantsappearedineachEMphoto thescan. tohelpverifythattheparticipantpersonallyexperiencedtheevent. Immediately following the scan,participants took part in an Analysesconfirmedthatthepresenceorabsenceofthecontrolpar- interview in which they viewed the same photos that had been ticipantsintheEMphotosdidnotaffectthebehavioralresults(i.e., presentedinthescanner.Participantswereaskedtothinkbackto averagenumberof internaldetailsdidnotdiffer,t(16)=−0.47, theeventstheygeneratedinthescannerandtorateeacheventon p=0.64). The pToM and EM photos were collected by a rela- thesamethreescalesthatwerepresentedinthescanner.Thepho- tiveorclosefriendof eachparticipant,whereastheToMphotos toswiththehighestvividnessratings(approximatelytwo-thirds were collected by the experimenter. Themes were similar across of all photos) were selected for a semi-structured interview in the three conditions (e.g., birthday party, picnic, vacation) and which participants described the events as they had been imag- includedbothindoorandoutdoorscenes.Allphotoswereresized ined/recollectedinthescanner.1Highvividnessratingsweretaken andconvertedtograyscale. tosuggestthatparticipantswereindeedimaginingorrecollecting theevents.Therewasnotimelimitforparticipantstodescribethe TASK events, and participants continued with their descriptions until H.C.andthecontrolparticipantswerescannedwithfMRIwhile they came to a natural ending point. The examiner then pro- performingthefamilyphotostask(fMRIdatanotreportedhere). videdasingle,standardizedprobetoelicitadditionaldetails(e.g., Stimuli were presented in blocks and each block contained five “Canyoutellmeanythingelse?”).Theeventswererecordedand photosfromoneofthethreeconditions.Therewerethreeblocks transcribedforscoring. foreachcondition(foratotalofnineblocks)andthesewerepre- Controlparticipantsweretestedonthefamilyphotosparadigm sented in pseudorandom order.At the beginning of each block, once whereas H.C. was tested on the paradigm on two separate participantsviewedasetofinstructionsthatcorrespondedtoone occasions for reliability purposes. However, the EM events that of the three conditions (i.e., pToM, ToM, or EM). Each photo were included during H.C.’s first testing session were excluded waspresentedfor20sandwasfollowedbythreeratingscales(see because we subsequently learned that she frequently views and below). rehearsestheeventsdepictedinthesephotos. InthepToMandToMconditions,participantswerepresented withphotosofotherpeopleandaskedtogenerateanoveleventfor SCORING eachphotowhilefocusingonwhatonepersoninthephotomight NarrativeswerescoredusinganadaptedAutobiographicalInter- have been thinking and feeling at the time. In order to distin- view scoring procedure described by Levine et al. (2002). The guishimaginingfromremembering,participantswerespecifically instructednottodrawonpastexperienceswhengeneratingthese 1Duringsession2,H.C.wasinterviewedonallofthephotospresentedduringthe events.IntheEMcondition,participantswerepresentedwiththeir scanaswellaseightadditionalEMevents,whichwerenotpresentedinthescanner, ownphotosandaskedtorecollecttheeventdepictedineachphoto inordertoincreasepower. www.frontiersin.org January2013|Volume3|Article588|3 Rabinetal. Episodicmemoryandimaginingothers’experiences pToM, ToM, and EM events were first segmented into distinct 7pToMeventsand9ToMeventstotheanalyses.Insession2,H.C. details,whichwereclassifiedasinternal(includingevent-specific, contributed15pToMevents,12ToMevents,and18EMeventsto temporal, perceptual, spatial, and thought/emotion details) or theanalyses. external (i.e., semantic facts that were irrelevant to the central event,repetitions,and metacognitive statements). Given the use PHENOMENOLOGYOFTHEpToM,ToM,ANDEMEVENTS ofvisuallyrichphotosascues,wewantedtoensurethatpartici- We entered participants’ post-scan ratings into the analyses (as pants’performancewasnotinflatedduetomerelydescribingthe opposedtothewithin-scannerratings)asthesewerebelievedto detailsdepictedinthephotos.Therefore,internaldetailswerefur- better correspond with the events participants described during ther classified as either descriptive (i.e.,details that describe the thepost-scaninterview.Table2presentsparticipants’phenome- visual content of the photo) or elaborative (i.e., details that go nologicalratingsofthepToM,ToM,andEMevents.Intermsof beyond what is visually depicted in the photo; see Table 1 for vividness,H.C.ratedthepToMeventsinsession1aslessvividthan scoringcriteria). controls,t(17)=−2.68,p=0.02;therewasnodifferenceforthe Scoring of the narratives was conducted by a trained rater pToMeventsinsession2,t(17)=−0.73,p=0.48.Withrespectto who achieved high interrater reliability on the Autobiographi- theToMevents,vividnessdidnotdifferbetweenH.C.andcontrols calInterviewusingastandardsetofpreviouslyscoredmemories forsession1,t(17)=−0.97,p=0.34,orsession2,t(17)=−1.46, (see Levine et al., 2002). Interrater reliability was also calcu- p=0.16.FortheEMevents,H.C.’sratingsweresignificantlyless latedfortheelaborativeanddescriptivedetailsbasedoncriteria vividthanthatofcontrols,t(17)=−3.89,p=0.0006.Intermsof developed by JSR. Intraclass correlation analyses indicated high theratingsassessinglikenesstoanactualmemory,nosignificant agreementamongscorersforpToM(Cronbach’sα=0.994),ToM differencesemergedbetweenH.C.andcontrolsforthepToMand (Cronbach’sα=0.992),andEMevents(Cronbach’sα=0.994). ToMeventsinsession1orsession2[pToMsession1andsession2, Datawereanalyzedusingamodifiedt-testprocedure,which t(17)=−1.56,p=0.14,andt(17)=−0.38,p=0.70,respectively, comparestestscoresofasinglepatienttothatofasmallcontrol and ToM session 1 and session 2, t(17)=−0.58, p=0.57, and sample(CrawfordandHowell,1998).Two-tailedt-testswereused t(17)=−0.58,p=0.57,respectively].Finally,asexpected,H.C.’s tocompareH.C.’sperformancewiththatofcontrolsonthepToM ratingsrelatingtotherecollectionofEMeventsweresignificantly andToMconditions,whereasaone-tailedt-testwasusedforthe lowerthanthatofcontrols,t(17)=−9.73,p<0.00001. EMconditiongivenapriorihypothesesregardingH.C.’sepisodic memoryperformance. ADAPTEDAUTOBIOGRAPHICALINTERVIEW Given the use of visually rich photos as cues, we were most RESULTS interested in the elaborative details that participants generated. Asmentionedabove,H.C.wastestedontwoseparateoccasions. We analyzed the data in two ways. First,we compared the aver- Forcompleteness,wereportthedataseparatelyforthetwotesting age number of elaborative details H.C. and controls produced sessions. Each control participant contributed an average of 8.9 in response to each pToM,ToM,and EM event. These absolute pToMevents(SD=0.72),9.1ToMevents(SD=0.9),and9.3EM numbers, however, are confounded by participants’ total verbal events(SD=0.49)totheanalyses.Insession1,H.C.contributed output.Toovercomethisissue,wealsocalculatedtheproportion Table1|Classificationofdescriptiveversuselaborativedetails. Typeofdetail Descriptivedetails Elaborativedetails Action Anydetailreferringtoanactionthatisdepictedinthephoto Anydetaildescribinganactionthatisnotobviousfromthe (e.g.,sitting,walking,standing,posingforthephoto) photo Character Anydetailexplainingwhothepeopleareinthephoto(onlyfor Anydetaildescribingwhothepeopleareoranydetailthat thepToMandEMconditions) referstotherelationship(s)betweenthepeopledepictedinthe photo(onlyfortheToMcondition) Temporal N/A Anydetailreferringtoaspecifictimeperiod(e.g.,year,season, month,date,dayofweek) Perceptual Perceptualdetailsthataredepictedinthephoto(e.g.,big Perceptualdetailsthatarenotvisibleinthephoto crowdofpeople,candleseverywhere). Describingornaminganobject,monumentorstatuethatis depictedinthephoto(e.g.,StatueofLiberty) Emotion/thought Anydetaildescribingafacialexpression(e.g.,smiling, Anydetaildescribinganemotionormentalstate(e.g.,happy, frowning) sad,tired) Spatial/Place Anydetaildescribingalocation(e.g.,country,city,street, Anydetaildescribingalocation(e.g.,country,city,street, locationwithinaroom)thatcanbeinferredfrominformation locationwithinaroom)thatisnotapparentfrominformation presentedinthephoto(e.g.,sign) depictedinthephoto FrontiersinPsychology|Cognition January2013|Volume3|Article588|4 Rabinetal. Episodicmemoryandimaginingothers’experiences Table2|PhenomenologicalqualitiesofthegeneratedpToM,ToM,and knownothers,whichresembleshercompromisedabilitytorecall EMevents. pastexperiencesviaepisodicmemory.Theseimpairmentsstand incontrasttoherpreservedabilitytoimaginetheexperiencesof pToM ToM EM unknown others. This pattern of results held whether we ana- lyzed the average number of elaborative details (i.e.,details that Vividness go beyond what is visually depicted in the photo) or the pro- H.C.session1 2.1* 2.7 – portionofelaborative-to-total-internaldetailsinordertocontrol H.C.session2 2.9 2.5 2.8* forverbaloutput.Theseresultsbolsterthefindingthatdifferent Controls 3.2(0.4) 3.1(0.4) 3.6(0.2) neural and cognitive mechanisms support thinking about per- Remember/know sonallyknownversusunknownothersandthattheformermay H.C.session1 – – dependonprocessesmediatedbythehippocampusandepisodic H.C.session2 – – 2.6* memory. Controls – – 3.0(0.04) The idea that individuals rely on past personal experiences SimilartoaMemory to infer and simulate another’s mental state has been suggested H.C.session1 2.7 3.3 – by philosophers and cognitive neuroscientists alike (Corcoran, H.C.session2 3.3 3.3 – 2000,2001;GallagherandFrith,2003;BucknerandCarroll,2007; Controls 3.5(0.5) 3.6(0.5) – SprengandMar,2012).However,thecurrentfindingsindicatethat Standarddeviationsaregiveninparentheses;pToM,personaltheoryofmind; reliance on past personal experiences may be pivotal only when ToM,theoryofmind;EM,episodicmemory;*p<0.05. imagining the experiences of personally known others. Indeed, knowing an individual for a long period of time and observ- ofelaborative-to-totalinternaldetails,whichprovidesanindexof ing that person’s behavior in different situations provides a rich theweightgiventodescriptiveversuselaborativedetails. source of information from which one can draw when imagin- The mean number of elaborative details produced by par- ing his/her mental states in various situations. Consistent with ticipants in response to each pToM, ToM, and EM event is thisinterpretation,Krienenetal.(2010)showedthatparticipants presented in Figure 12. In response to the pToM events, H.C. reported that they relied on a specific memory or anecdote sig- producedsignificantlyfewerelaborativedetailsthancontrolsdur- nificantlymoreoftenwhenmakingjudgmentsrelatingtofriends ing session 1, t(17)=−3.1, p=0.007, and there was a trend relativetostrangers.Inanotherstudy,Ciaramellietal.(submitted) toward impaired performance during session 2, t(17)=−1.8, found that participants’level of empathy for a familiar charac- p=0.08. In terms of the ToM events, no significant group dif- terwasmodulatedbytheretrievalofpreviousepisodesinvolving ferenceemergedforsession1,t(17)=−1.6,p=0.13,orsession thatcharacter.Furthermore,usingthesamefamilyphotospara- 2, t(17)=−0.98, p=0.34. With respect to the EM events, as digmemployedinthecurrentstudy,we(RabinandRosenbaum, expected, H.C. produced significantly fewer elaborative details 2012)showedthatthepatternofneuralactivitysupportingpToM thancontrols,t(17)=−1.78,p=0.0473. sharesmoreincommonwithepisodicmemorythanwithToM. The mean proportion of elaborative-to-total-internal details Notably,thegreatestdegreeofneuraloverlapbetweenpToMand producedbyparticipantsinresponsetoeachpToM,ToM,andEM episodicmemorywasobservedwithinmidlineregions,including event is presented in Figure2.Analyses revealed that H.C. pro- thehippocampusandrelatedMTLstructures,regionstraditionally ducedalowerproportionof elaborativedetails(andthereforea associatedwiththerecollectionofpastevents. greaternumberofdescriptivedetails)thancontrolsinresponseto Reliance on past personal experiences to infer familiar oth- thepToMeventsduringbothsession1,t(17)=−7.0,p<0.00001 ers’mental states may occur with or without one’s intention or and session 2, t(17)=−4.99, p=0.0001. In contrast, H.C. and awareness. There is accumulating evidence that episodic mem- controlsproducedanequivalentproportionofelaborativedetails orysupportedbythehippocampuscanrapidlyandautomatically inresponsetotheToMeventsduringbothsession1,t(17)=0.77, influenceperformanceonnon-mnemonictasks(Westmacottand p=0.45,andsession2,t(17)=−0.32,p=0.75.Consistentwith Moscovitch,2003;Westmacottetal.,2004;Moscovitch,2008;Ryan our predictions, H.C. generated a lower proportion of elabora- etal.,2008;Greenbergetal.,2009;SheldonandMoscovitch,2010). tive details relative to controls in response to the EM events, GobbiniandHaxby(2007)suggestthatthemereperceptionofa t(17)=−2.57,p=0.01. familiar individual is associated with the spontaneous retrieval ofpersonalknowledgeaboutthatindividual(i.e.,personaltraits, DISCUSSION attitudes, biographical facts, and episodic memories), which in H.C.,adevelopmentalamnesicpersonwithbilateralhippocampal turnmayhelptobetterunderstandandpredictwhatthefamil- damage,wasimpairedatimaginingtheexperiencesofpersonally iar other is thinking and/or feeling. These automatic processes mayhavebeenatplayinthecurrentstudygiventhatparticipants 2Duetothesmallnumberofelaborativedetailsproducedforeachevent,wewere wereinstructednottorefertopastepisodeswhengeneratingthe unabletomakemeaningfulcomparisonswhenthedetailswerefurtherdividedinto pToM and ToM events. It is possible that participants engaged theinternaldetailcategories(i.e.,event,place,time,perceptual,thought/emotion). ininhibitoryprocessestohelpovercometheprepotenttendency 3Wedidnotconfirmtheaccuracyofparticipants’reportedmemories.However, torelyonpastmemories.Alternatively,othermemoryregulation anecdotalevidenceprovidedbyH.C.’sfamilysuggeststhatshetendstofillinmem- processes, such as thought substitution (Benoit and Anderson, orygaps.Therefore,H.C.’sEMscoresarelikelyanoverestimateofherepisodic memorycapabilities. 2012)mayhavebeenemployed. www.frontiersin.org January2013|Volume3|Article588|5 Rabinetal. Episodicmemoryandimaginingothers’experiences FIGURE1|ThemeannumberofelaborativedetailsprovidedbyH.C.andcontrolsinresponsetoeachpToM,ToM,andEMevent,*p<0.08;**p<0.05. Errorbarsindicatestandarddeviations. FIGURE2|Themeanproportionofelaborative-to-total-numberofinternaldetailsprovidedbyH.C.andcontrolsinresponsetoeachpToM,ToM,and EMevent,*p<0.01;**p<0.0001.Errorbarsindicatestandarddeviations. AnotherpossibleexplanationforH.C.’scorrespondingimpair- (Addisetal.,2011;Fordetal.,2011),likelyduetothegreaterrela- mentinbothepisodicmemoryandpToMmayrelatetoadeficit tionalprocessingthatisrequiredfortheformer(Addisetal.,2011). in(re)constructingspecificepisodes.Evidencefromneuroimag- Severalresearchershavearguedthatindividualsaremorelikelyto ing studies suggests that imagining specific versus general past imaginecloseotherswithgreaterspecificityrelativetounknown andfutureeventselicitsgreateractivitywithinthehippocampus others. In contrast,unknown others are typically represented in FrontiersinPsychology|Cognition January2013|Volume3|Article588|6 Rabinetal. Episodicmemoryandimaginingothers’experiences more generic and abstract terms (Liviatan et al., 2008; Lieber- (Lieberman, 2012). Generic representations are likely based on man,2012).Thismaybebecausewepossessidiosyncratictheories routinesorschemasthatarealreadyboundtogetherandtherefore aboutcloseothers’personalitiesthatenableustorichlyimagine requireminimalrelationalprocessing.RecentfMRIfindingsfrom howwell-knownotherswouldrespondinvariousscenarios(see ourlaboratory(RabinandRosenbaum,2012),supportthisinter- Lieberman,2012). Therefore H.C.’s difficulty in generating spe- pretation. Using the same family photos paradigm, we recently cificdetailsmayaccountforherpoorperformanceontheepisodic showed that relative to pToM,ToM involving unfamiliar others memoryandpToMtasks. elicitedgreateractivityinlateralregionsknowntobeassociated ItmaybethecasethatforthepToMeventsH.C.attemptedto with accessing semantic knowledge (Martin and Chao, 2001). relyonastrategythatisoptimalforpeoplewhoareabletoconjure Taken together, these data further corroborate the notion that upcontextualandspecificdetailsratherthanrelyingonastrategy episodic memory may be needed for social cognition, but that thatwouldbeadvantageousforher.Likecontrols,H.C.mayhave itsrolemaybespecifictoimaginingtheexperiencesofpersonally beenengagingininhibitoryprocessesofpasteventswhengener- known,andnotunknown,others. atingthepToMandToMevents.However,becauseherepisodic Theuseofanopen-endedToMtaskallowedustogaininsight recollectionisimpaired,shemayhavegeneralizedthisinstruction into possible compensatory strategies that H.C. employed when topersonalsemanticinformation,whichwouldhavelikelyhelped takingtheperspectiveofanotherperson.WefoundthatH.C.gen- hertogenerateadditionaldetailsforthepToMevents.Itispossible eratedasignificantlygreaterproportionof descriptivedetailsin thatifshehadbeenprobedinamannerthatenabledhertodraw response to the pToM photos than did controls,suggesting that moreeffectivelyonherintactpersonalorsocialsemanticmemory, shereliedmoreheavilyonthevisualinformationdepictedinthe shemayhaveperformedbetteronthepToMtask.Indeed,different photostoimaginetheexperiencesofwell-knownothers.Thismay methodsofcuingcandifferentiallyaffecttaskperformance.H.C., haveincludedrelyingonthefamiliarother’sfacialexpression,body forinstance,wasimpairedatimaginingherselfinfutureepisodes language,and/ortherelativespatialrelationsbetweenpeople.This whenprovidedwithaspecificcueword(e.g.,“coffee”;Kwanetal., strategymayserveherwellinsocialsettingswhenexternalcues 2010)butshowedintactperformancewhenamoregeneraland are readily available but may fail when cues are absent or when non-specificcuewasprovided(e.g.,“Imaginesomethingyouwill situationsarecomplexandrequiretheintegrationofinformation bedoingthisweekend”;Hurleyetal.,2011;seealsoCooperetal., fromthepastandpresent. 2011). H.C.’s performance on the pToM condition was not at floor The corresponding deficit that emerged in episodic memory indicatingthatherabilitytoimaginetheexperiencesof person- andpToMisunlikelytobeduetoadeficitinnarrativeconstruc- allyfamiliarothersisnotobliterated.Infact,approximately50% tion,giventhatH.C.hadnodifficultyconstructingnarrativesin ofthedetailsshegeneratedinresponsetothepToMeventswere responsetotheToMevents.Thispatternof resultsisconsistent elaborative details (i.e., details that go beyond what is visually withthosefromarecentstudyshowingthattheabilitytogenerate depictedinthephoto).However,uponcloserexamination,even adetailednarrativeispreservedinadult-onsetamnesia(Raceetal., thequalitativenatureoftheelaborativedetailsshegenerateddif- 2011;butseeRosenbaumetal.,2009).Althoughthepatientsinthe feredfromthatofcontrols.Specifically,H.C.’sresponsestendedto studybyRaceandcolleaguesproducedimpoverisheddescriptions reflectmorebasicemotionalstatesthatcouldbeinferredfromthe of pastandfutureevents,theyshowedintactperformancewhen visualfeaturesof thephoto,suchas“they’rebothreallyexcited” asked to tell a story in response to pictures depicting fictional or“shelooksreallyhappy.”Incontrast,controlparticipantstypi- characters in various scenes. It is important to note that while callyprovidedmorecomplexmentalstateinferencessuchas“they theirparticipantswereinstructedtogenerateastoryratherthan were probably afraid but they are trying to look cool”and“her toreportwhatwasliterallydepictedinthepicture,toourknowl- motherwaspleasedthatherdaughterwashavingsomuchfun” edge,theauthorsdidnotexaminewhetherparticipantsadheredto (seeFigure3fornarrativesamples). thisinstruction.Inthecurrentstudy,whenexaminingtheextent H.C. generated a greater number of elaborative details in towhichparticipantsreliedonthevisualcontentofthephotosto response to the pToM and ToM events during session 2 relative generate details,we found thatapproximately half of the details to session 1. It is important to note, however, that the overall H.C.producedforthepToMeventsconsistedofdescriptivedetails pattern remained consistent across the two testing sessions in (vs.12.5%forcontrols).Thecurrentfindingshighlighttheimpor- that, in both cases, H.C. produced fewer elaborative details for tanceofexaminingdescriptiveversuselaborativedetailswhenrich the pToM versus ToM events. It is possible that the difference visualcuesareused. acrosstestingsessionsreflectsapracticeeffectresultingfromexpe- H.C.’s impairment in episodic memory and pToM contrasts riencewithnarrativegeneration.Althoughourtwotestingsessions withherpreservedabilitytoimaginetheexperiencesofunknown tookplace3yearsapart,H.C.participatedinseveralotherstud- othersduringToM.Thelatterfindingisconsistentwithherintact iesthatrequiredhertogeneratedetailednarrativesintheinterim performanceonawiderangeofstandardToMteststhatemploy (Kwanetal.,2010,2011;Hurleyetal.,2011).Infact,withinthese strangers or fictional characters as targets (Rabin et al., 2012; other studies, H.C. showed improved performance on tests of see also Rosenbaum et al., 2007). Imagining the experiences of futureimaginingacrosstestingsessions(Kwanetal.,2010;Hur- unfamiliar others may be achieved by relying on social seman- ley et al.,2011). A related explanation for H.C.’s inflated scores tic memory,which remains relatively intact in H.C. This might duringsession2isthatshemayhavelearnedtouseamoreeffec- include reliance on generic representations about how the aver- tive strategy that enabled her to generate a greater number of age person is expected to think and feel in a given situation details. www.frontiersin.org January2013|Volume3|Article588|7 Rabinetal. Episodicmemoryandimaginingothers’experiences FIGURE3|RepresentativesamplesofthepToM,ToM,andEMnarrativesprovidedbyH.C.andacontrolparticipant. Inthecurrentstudy,weattemptedtocontrolforvividnessby isunknown(RabinandRosenbaum,2012).Continuedresearch onlyincludingthepToM,ToM,andEMeventswiththehighest withH.C.andotheramnesicindividuals,particularlythosethat vividnessratingsinouranalyses.Nevertheless,analysesrevealed acquire damage later in life, is needed to better understand the thatH.C.ratedthepToMeventsinsession1andtheEMeventsin rolethatepisodicmemoryplaysinthisandotheraspectsofsocial session2aslessvividthancontrols.Inaddition,wecannotruleout cognition. thatotherfactors,suchaspersonalsignificance,differedbetween H.C.andcontrols. ACKNOWLEDGMENTS In conclusion, using an ecologically valid test of ToM, we This work was funded by a Sloan Research Fellowship,Ontario formallydocumentthatepisodicmemorysupportedbythehip- Ministry of Economic Development and Innovation Early pocampus may be pivotal for imagining the experiences of per- ResearcherAward,CanadianInstitutesofHealthResearch(CIHR) sonallyfamiliar,butnotunfamiliar,others.Thecurrentfindings NewInvestigatorAward,andCIHROperatingGranttoR.Shayna complementrecentfMRIdataandsuggestthatwhenimagining Rosenbaum (grant MOP 93535),and a CIHR Banting and Best other people’s experiences individuals are more likely to rely on Doctoral Award to Jennifer S. Rabin. Asaf Gilboa acknowledges episodic memory when the target person is personally familiar support from the Natural Sciences and Engineering Research and on general social semantic memory when the target person Council. REFERENCES Therelationshipbetweentheoryof Baron-Cohen,S.,Wheelwright,S.,Hill, Cooper, J. 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U.S.A. 104, experience to semantic memory: couldbeconstruedasapotentialcon- This article was submitted to Frontiers 642–647. evidence from Alzheimer’s disease, flictofinterest. inCognition,aspecialtyofFrontiersin Tulving,E.(1985).Memoryandcon- semantic dementia, and amnesia. Psychology. sciousness.Can.Psychol.26,1–12. Neuropsychologia42,25–48. Received:01September2012;accepted: Copyright©2013Rabin,Carson,Gilboa, Vargha-Khadem, F., Salmond, C. H., Westmacott, R., and Moscovitch, M. 12December2012;publishedonline:24 StussandRosenbaum.Thisisanopen- Watkins,K.E.,Friston,K.J.,Gadian, (2003).Thecontributionofautobi- January2013. accessarticledistributedundertheterms D. G., and Mishkin, M. (2003). ographicalsignificancetosemantic Citation: Rabin JS, Carson N, Gilboa of the Creative Commons Attribution Developmental amnesia: effect of memory.Mem.Cognit.31,761–774. A,StussDTandRosenbaumRS(2013) License,whichpermitsuse,distribution ageatinjury.Proc.Natl.Acad.Sci. Imagining other people’s experiences andreproductioninotherforums,pro- U.S.A.100,10055–11060. Conflict of Interest Statement: The in a person with impaired episodic vided the original authors and source Westmacott,R.,Black,S.E.,Freedman, authors declare that the research was memory: the role of personal famil- are credited and subject to any copy- M.,andMoscovitch,M.(2004).The conductedintheabsenceofanycom- iarity. Front. Psychology 3:588. doi: rightnoticesconcerninganythird-party contribution of autobiographical mercial or financial relationships that 10.3389/fpsyg.2012.00588 graphicsetc. FrontiersinPsychology|Cognition January2013|Volume3|Article588|10

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