We have developed criteria for scoring patients’ cartoon interpretations. The scale extends from 0-5 for first order belief cartoons and 0-6 for second order belief cartoons.
6: Complete and appropriate, identifies the second-order belief/mental state of the character
5: Complete and appropriate, identifies the first-order belief/mental state of one or more characters.
4: Complete and appropriate, identifies the mental state of one or more characters but (a) delayed (longer than 5 seconds required for response initiation), (b) may contain self corrections, or false starts but eventually gets to the correct response, or (c) may include some tangential comments and/or personalization.
3: Provides a mental state term relevant to the cartoon but inaccurate (i.e. wrong mental state, mental state of self rather than the character/wrong character) identification of the mental state.
2: Mention of oddness, incongruity of elements.
1: Interpretation has some clear elements of understanding the incongruous nature of the critical elements of the cartoon, may describe the physical details in the picture, does not identify the mental state of the character(s)
0: No response. I don’t know. Completely off topic comments unrelated/personalized association, tangential to cartoon.
The scale can be used reliably (independent inter-rater reliability reached 90%, based on 100% of the pilot subject responses during this pilot training).