The effects of reading and watching fiction on the development of social cognition: a systematic review

Rezende, Júlia Ferreira; Shigaeff, Nadia

doi:10.1590/1980-5764-DN-2023-0066

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Dementia & Neuropsychologia

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View and Review • Dement. neuropsychol. 17 • 2023 • https://doi.org/10.1590/1980-5764-DN-2023-0066 copy

The effects of reading and watching fiction on the development of social cognition: a systematic review

Os efeitos da leitura e filmes de ficção no desenvolvimento da cognição social: uma revisão sistemática

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Social cognition is an umbrella term used to address the set of neurocognitive processes involved in effective social interaction, such as Theory of Mind and empathy, and is important for understanding of others’ intentions and actions and decision making. Narratives can serve as tools for learning social norms and understanding other people, as they involve mental simulations of social interactions. This review aimed to gather the results of current studies on the effects of reading and watching fiction movies on the development of social cognition. We included 16 publications, all of which were empirical studies. The results showed that, depending on individual factors, as well as on the specifics of the intervention, both reading and watching movies seem to influence the processes of development of social cognition, especially if associated with concomitant or subsequent activities, such as discussions. More research is needed to understand the specific details of this relationship.

Keywords:
Social Cognition; Theory of Mind; Empathy; Motion Pictures; Reading

Authors	Study type	Instruments	Participants	Intervention	Duration of intervention	Outcomes
Ahmadzadeh et al.²⁴24. Ahmadzadeh A, Esfahani MN, Ahmadzad-Asl M, Shalbafan M, Shariat SV. Does watching a movie improve empathy? A cluster randomized controlled trial. Can Med Educ J. 2019;10(4):e4-e12. PMID: 31807222.	Intervention	Jefferson Scale of Empathy-Health Professional Students	133 participants were distributed into four groups: A (n=42), B (n=23), C (n=22) and D (n=46)	A three-hour workshop (Group A); watching the movie “The Doctor” (Group B); watching the movie “The Doctor”, then, participating in a three-hour workshop the next day (Group C); control group with no intervention (Group D).	1 or 2 days, depending on the experimental group, and reassessment of empathy a month later	All of the three interventions had an immediate improving effect on empathy scores compared to the control group. One month later, only improvements on groups A and C remained significant.
Bal & Veltkamp²⁵25. Bal PM, Veltkamp M. How does fiction reading influence empathy? An experimental investigation on the role of emotional transportation. PLoS One. 2013;8(1):e55341. https://doi.org/10.1371/journal.pone.0055341 https://doi.org/10.1371/journal.pone.005...	Intervention	Emotional Transportation scale by Busselle and Bilandzic³⁹39. Busselle R, Bilandzic H. Fictionality and perceived realism in experiencing stories: A model of narrative comprehension and engagement. Commun Theory. 2008;18(2):255-80. https://doi.org/10.1111/j.1468-2885.2008.00322.x https://doi.org/10.1111/j.1468-2885.2008... Empathic concern scale by Davis (1980;1983) Narrative Understanding Scale Attentional Focus Scale	66 students in Study 1 (36 in the fiction condition and 30 in the control condition) 97 students in Study 2 (50 in the fiction condition and 47 in the control condition)	Participants in the experimental condition read a fictional narrative and participants in the control group read a nonfiction piece	Participants read the book and responded the measures both immediately after and a week after	Emotional transportation was positively related to the empathy scores measured after a week, but not right after the intervention
Collins et al.²⁸28. Collins KL, Zweber A, Irwin AN. Impact of a fictional reading intervention on empathy development in student pharmacists. Curr Pharm Teach Learn. 2017;9(3):498-503. https://doi.org/10.1016/j.cptl.2016.12.003 https://doi.org/10.1016/j.cptl.2016.12.0...	Intervention	Jefferson Scale of Empathy – Health Profession Students (JSE-HPS)	21 participants were distributed into an intervention (n=11) or control group (n=10)	Participants of the experimental group read short pieces of literary fiction over the course of 8 weeks. No action was required of the students in the control group.	Participants read short excerpts weekly over the course of eight weeks.	Results showed a statistically insignificant increase in the scores of participants in the intervention group.
Dias-Corrêa et al.³⁴34. Dias-Corrêa JP, Marturano EM, Rodrigues MC, Nahas AK. Efeito de um programa de histórias com abordagem sociocognitiva em crianças de educação infantil. Psicol Teor Pesqui. 2016;32(4):1-9. https://doi.org/10.1590/0102.3772e32429 https://doi.org/10.1590/0102.3772e32429...	Intervention	Avaliação Sociocognitiva de Respostas Infantis Pós Exploração Dialogada de Narrativa Textual^* Notes: in a free translation to English, “Sociocognitive assessment of children’s responses after dialogued exploration of textual narrative”; †in a free translation to English, “Questionnaire of Socially Skilled Responses, as reported by teachers”. Questionário de Respostas Socialmente Habilidosas Segundo Relato do Professor (QRSH-RP)^† Notes: in a free translation to English, “Sociocognitive assessment of children’s responses after dialogued exploration of textual narrative”; †in a free translation to English, “Questionnaire of Socially Skilled Responses, as reported by teachers”. Brazilian version of the Strengths and Difficulties Questionnaire (SDQ)	45 children distributed into two groups, which received the same intervention in two different years (2010 and 2011), group 1 (n=25) and group 2 (n=20)	Reading of storybooks with a focus on mental states and emotions	Two or three sessions of 50 minutes weekly, from August to November, with a total of 25 sessions	Gains in children’s social cognitive abilities and development of emotion, thought, intention and behavior comprehension of the characters in the stories were observed.
Mani et al.³⁶36. Mani SD, Chen NLP, Menon V, Babar MG. Stories and perspective taking: augmenting dental students’ understanding of patient care. Med Teach. 202143(sup1):S18-S24. https://doi.org/10.1080/0142159X.2019.1666206 https://doi.org/10.1080/0142159X.2019.16...	Intervention	-	11 third-year undergraduate dental students	After analysing literary texts, students participated in perspective-taking activities, and reflected on the effects of the study.	Three months	After content analysis, three main themes/learning points: facilitate empathy, stimulate self-awareness and motivate perceptive communication.
Gürcan et al.¹⁸18. Gürcan MB, Yildiz M, Patir K, Demir Y. The effects of narrative and movie therapy on the theory of mind and social functioning of patients with schizophrenia. Noro Psikiyatr Ars. 2021;58(2):108-14. https://doi.org/10.29399/npa.27291 https://doi.org/10.29399/npa.27291...	Intervention	The Positive and Negative Symptoms Scale (PANSS), Reading the Mind in the Eyes Test (RMET) Montreal Cognitive Assessment Scale (MoCA) Dokuz Eylül Theory of Mind Index (DEToMI) Social Functioning Assessment Scale (SFAS)	28 schizophrenia patients, medicated and clinically stable, distributed into two intervention groups: narrative therapy (n =14) and movie therapy (n = 14)	Narrative therapy or movie therapy	Once a week for 14 weeks	A significant difference was found between PANSS negative, DEToMI, SFAS and RMET pre- and post-intervention mean scores in both groups, but RMET and DEToMI scores were higher in the MT group.
Hojat et al.²⁶26. Hojat M, Axelrod D, Spandorfer J, Mangione S. Enhancing and sustaining empathy in medical students. Med Teach. 2013;35(12):996-1001. https://doi.org/10.3109/0142159X.2013.802300 https://doi.org/10.3109/0142159X.2013.80...	Intervention	Jefferson Scale of Empathy-Health (JSE)	248 medical students divided into experimental group (n=129) and control group (n=119)	Students in the experimental group were shown the movie clips and then asked to discuss positive and negative effects of it. Ten weeks later, the students in the experimental group were divided: half of them participated in a lecture about empathy, while the other half watched a different movie.	1 hour of presentation plus discussion, with a gap of ten weeks between phase 1 and phase 2	A significant increase in empathy was observed in the experimental group after phase one, but the improvement in empathy score was sustained after phase 2 only in the experimental group, which participated in the empathy lecture.
Kidd & Castano³¹31. Kidd DC, Castano E. Reading literary fiction improves theory of mind. Science. 2013;342(6156):377-80. https://doi.org/10.1126/science.1239918 https://doi.org/10.1126/science.1239918...	Intervention	False-belief tests as a measure of cognitive ToM Reading the Mind in the Eyes Test (RMET) Diagnostic Analysis of Nonverbal Accuracy 2 - Adult Faces test (DANVA2-AF) Yoni test, which measures both cognitive and affective ToM Author Recognition Test	86 participants in experiment 1 (randomly assigned to read literary fiction or nonfiction) 114 participants in experiment 2 (randomly assigned to read literary fiction or popular fiction) 69 participants in experiment 3 (randomly assigned to read literary fiction or popular fiction, using different texts from experiment 2) 72 participants in experiment 4 (randomly assigned to read literary fiction or popular fiction, using the same texts from experiment 3 with two additional texts for each condition)	Participants read short passages of either nonfiction, literary fiction or popular fiction.	Participants read the passages and were evaluated immediately after.	Literary fiction did increase ToM and results on the Author Recognition Test predicted RMET scores.
Klemenc-Ketis & Kersnik³⁷37. Klemenc-Ketis Z, Kersnik J. Using movies to teach professionalism to medical students. BMC Med Educ. 2011;11:60. https://doi.org/10.1186/1472-6920-11-60 https://doi.org/10.1186/1472-6920-11-60...	Intervention	-	11 fourth-year medical students	Students participated in an elective course about professionalism in medicine for 4 months, which included the screening of movies.	Four months	Students recognised communication, empathy, doctors’ personal interests and palliative care as dimensions of the movie, and reported that these dimensions were important aspects of the medical practice.
Panero et al.³⁰30. Panero ME, Weisberg DS, Black J, Goldstein TR, Barnes JL, Brownell H, et al. Does reading a single passage of literary fiction really improve theory of mind? An attempt at replication. J Pers Soc Psychol. 2016;111(5):e46-e54. https://doi.org/10.1037/pspa0000064 https://doi.org/10.1037/pspa0000064...	Intervention	Reading the Mind in the Eyes Test (RMET) Author Recognition Test (ART)	792 participants (distributed into four conditions: reading of literary fiction, nonfiction, popular fiction or no reading) Replication of Kidd and Castano’s³¹31. Kidd DC, Castano E. Reading literary fiction improves theory of mind. Science. 2013;342(6156):377-80. https://doi.org/10.1126/science.1239918 https://doi.org/10.1126/science.1239918... experiment	Participants read short passages of either nonfiction, literary fiction or popular fiction.	Participants read the passages and were evaluated immediately after.	Literary fiction had no significant effects on theory of mind, but results on the Author Recognition Test predicted RMET scores.
Peng et al.³³33. Peng X, Wu L, Xie X, Dai M, Wang D. Impact of virtual dementia tour on empathy level of nursing students: a quasi-experimental study. Int J Nurs Sci. 2020;7(3):258-61. https://doi.org/10.1016/j.ijnss.2020.06.010 https://doi.org/10.1016/j.ijnss.2020.06....	Intervention	Jefferson Scale of Empathy-Health Professional Students Semi-structured interview	45 second-year undergraduate nursing students	Participants watched a movie (“Still Alice”) and participated in a Virtual Dementia Tour (VTD).	The different steps of the intervention were performed in the course of three days	Participants’ empathy levels demonstrated significant overall improvements.
Pino & Mazza²¹21. Pino MC, Mazza M. The use of “literary fiction” to promote mentalizing ability. PLoS One. 2016;11(8):e0160254. https://doi.org/10.1371/journal.pone.0160254 https://doi.org/10.1371/journal.pone.016...	Intervention	Basic Empathy Scale - Cognitive Empathy Sub-scale (BES- CES) The Eyes Task (Revised “Reading the Mind in the Eye”) Interpersonal Reactivity Index cognitive sub-scales (IRI) Advanced Theory of Mind Task Attribution of Intentions Task Empathy Quotient Scale First and Second Order False Belief Test Multifaceted Empathy Test (MET) -Cognitive Empathy (CE) Faces Test Emotion Attribution Task Basic Empathy Scale-Affective Empathy Sub-scale (AES)	214 participants were distributed in the three experimental conditions (reading of literary fiction, nonfiction or science fiction).	Participants read literary fiction, nonfiction or science fiction books.	The time between the pre- and post-reading phases was 14 days, and the participants had one week to read the book.	Literary fiction facilitated changes indicative of improvement in mentalizing abilities.
Rodrigues et al.³²32. Rodrigues MC, Ribeiro NN, Cunha PC. Leitura mediada com enfoque sociocognitivo: avaliação de uma pesquisa-intervenção. Paidéia (Ribeirão Preto). 2012;22(53):393-402. https://doi.org/10.1590/S0103-863X2012000300011 https://doi.org/10.1590/S0103-863X201200...	Intervention	Avaliação sociocognitiva de respostas infantis pós-exploração dialogada de narrativa textual^* Notes: *in a free translation to English, “Sociocognitive assessment of children’s responses after dialogued exploration of textual narrative”; †in a free translation to English, “Questionnaire of Socially Skilled Responses, as reported by teachers”.	57 first-grade children of a public school in Minas Gerais	Reading of storybooks with a focus on mental states and emotions.	Teacher training lasted 20 hours, distributed into three months.	Increase in childrens’ attribution of mental states and significant improvement in social cognitive abilities scores after the intervention.
Samur et al.²⁹29. Samur D, Tops M, Koole SL. Does a single session of reading literary fiction prime mentalising performance? Four replication experiments of Kidd and Castano (2013). Cogn Emot. 2018;32(1):130-44. https://doi.org/10.1080/02699931.2017.1279591 https://doi.org/10.1080/02699931.2017.12...	Intervention	Reading the Mind in the Eyes Test (RMET) Author Recognition Test (ART) Bermond–Vorst Alexithymia Questionnaire Transportation Scale Osnabrück Life Stress Scale Adult Survey of Reading Attitudes	80 participants in experiment 1 (comparison between the effects of reading literary fiction and nonfiction on mentalizing) 80 participants in experiment 2 (comparison between the effects of reading literary fiction, nonfiction and popular fiction) 90 participants in experiment 3 (comparison between the effects of reading literary fiction, nonfiction, popular fiction and a control condition with no reading) 80 participants in experiment 4 (comparison between the effects of reading literary fiction, nonfiction, popular fiction and a control condition with no reading, using different texts from experiment 3)	Participants read short passages of either nonfiction, literary fiction or popular fiction.	Participants read the passages and were evaluated immediately after.	Higher RMET scores were observed on the literary fiction condition, but these findings were not statistically significant. Results on the Author Recognition Test predicted RMET scores.
Swami et al.³⁵35. Swami V, Zahari HS, Khatib NAM, Toh EKL, Barron D. Promoting inter-ethnic understanding and empathy using a round table cinema activity with malaysian malay and Chinese students. Integr Psychol Behav Sci. 2020;54(2):416-37. https://doi.org/10.1007/S12124-020-09514-7 https://doi.org/10.1007/S12124-020-09514...	Intervention	Scale of Ethnocultural Empathy	87 Malaysian citizens enrolled on undergraduate and postgraduate programs in three universities	Round Table Cinema Activity (RTCA)	Three different encounters, with two-week gaps in between	Participants’ ethnocultural empathy showed an increase following the intervention, and qualitative data analysis revealed a trend toward improvement in participants, driven by significant changes observed throughout the study.
Tompkins²⁷27. Tompkins V. Improving low-income preschoolers’ theory of mind: a training study. Cogn Dev. 2015;36:1-19. https://doi.org/10.1016/j.cogdev.2015.07.001 https://doi.org/10.1016/j.cogdev.2015.07...	Intervention	Social Skills Improvement System (SSIS) Rating Scales False belief tasks Peabody Picture Vocabulary Test - 4th edition Adaptation of the Head Start Family and Child Experiences Survey	73 low-income children distributed into experimental, storybook control group and non-treatment group (distribution of children was not specified).	Children in the experimental group participated in one-on-one book reading interactions, including questions about mental states, introduction and embedded statements and summary of false beliefs in the story. The storybook control group was read the same storybooks without statements, questions or summary. Non-treatment control group engaged in no interaction with the experimenter during the training phase.	Each child received 8 to 15 storybooks on separate days, approximately 3 books per week over 5 weeks.	Significant improvements were observed in the children’s false belief understanding, as well as statistically insignificant changes in the social competence of the experimental group.

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Correspondence: Nadia Shigaeff; Emaik: nadia.shigaeff@ufjf.br.