Dissociation between 'theory of mind' and executive functions in a patientwith early left amygdala damage

There have been recent suggestions that the amygdala may be involved in the development or mediation of 'theory of mind'. We report a patient, B,M,, w ith early or congenital left amygdala damage who, by adulthood, had receive d the psychiatric diagnoses of schizophrenia and Asperger's syndrome. We co nducted a series of experimental investigations to determine B,M,'s cogniti ve functioning, In line with his diagnoses, B,M, was found to be severely i mpaired in his ability to represent mental states. Following this, we condu cted a second series of studies to determine B,M,'s executive functioning. In the literature, there have been frequent claims that theory of mind is m ediated by general executive functioning. B,M, showed no indication of exec utive function impairment, passing 16 tests assessing his ability to inhibi t dominant responses, create and maintain goal-related behaviours, and temp orally sequence behaviour. The findings are discussed with reference to mod els regarding the role of the amygdala in the development of theory of mind and the degree of dissociation between theory of mind and executive functi oning. We conclude that theory of mind is not simply a function of more gen eral executive functions, and that executive functions can develop and func tion on-line, independently of theory of mind. Moreover, we conclude that t he amygdala may play some role in the development of the circuitry mediatin g theory of mind.