OTSurveyAutism research : official journal of the International Society for Autism Research2025

Theory of Mind Mediates the Association Between Autistic Traits and Social Isolation in Middle-Aged and Older Adults.

Gloria Hei Man Lo, Clemie Dale, Francesca Happé and 1 others

PMID 40183363

WHAT IT FOUND

Middle-aged and older adults with more autistic traits reported less social connection.

Poorer theory-of-mind task performance partly accounted for this association, and it accounted for the whole association when depression and anxiety symptoms were considered.

Key findings

01Lower social connectedness was associated with higher autistic traits and poorer theory-of-mind task performance.

02Theory-of-mind performance partially mediated the association between autistic traits and social connectedness.

03When depression and anxiety symptoms were controlled, theory-of-mind performance accounted for the entire association between autistic traits and social connectedness.

STILL TO COME

How it was doneWhat they foundWhat it means for OTs

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What it does not show

The final sample was 111 participants, slightly below the estimated sample size of 123 needed for 80% statistical power. Many complete responses were excluded as suspicious, so some real participants may have been removed and some fake participants may have remained. The study used online convenience sampling and self-report, and older adults who take part in research may be healthier or less socially isolated than those who do not. The study was cross-sectional, so it cannot show that autistic traits or theory-of-mind performance caused social isolation. The theory-of-mind tasks used cartoons and triangles, not real people in everyday social situations. The study did not ask whether participants had previously received social skills training. The analysis plan was not pre-registered.

Declared interests

The authors declared no conflicts of interest. The paper lists non-U.S. government research support.

The easy way to misread this

Do not conclude that improving theory-of-mind ability will reduce social isolation. The study was cross-sectional and did not test an intervention, so it cannot show cause.

Read it on PubMed →