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Social Behavior and Impairments in Social Cognition Following Traumatic Brain Injury

  • Michelle May (a1), Maarten Milders (a2), Bruce Downey (a3), Maggie Whyte (a3), Vanessa Higgins (a4), Zuzana Wojcik (a3), Sophie Amin (a5) and Suzanne O’Rourke (a6)...

Abstract

Objectives: The negative effect of changes in social behavior following traumatic brain injury (TBI) are known, but much less is known about the neuropsychological impairments that may underlie and predict these changes. The current study investigated possible associations between post-injury behavior and neuropsychological competencies of emotion recognition, understanding intentions, and response selection, that have been proposed as important for social functioning. Methods: Forty participants with TBI and 32 matched healthy participants completed a battery of tests assessing the three functions of interest. In addition, self- and proxy reports of pre- and post-injury behavior, mood, and community integration were collected. Results: The TBI group performed significantly poorer than the comparison group on all tasks of emotion recognition, understanding intention, and on one task of response selection. Ratings of current behavior suggested significant changes in the TBI group relative to before the injury and showed significantly poorer community integration and interpersonal behavior than the comparison group. Of the three functions considered, emotion recognition was associated with both post-injury behavior and community integration and this association could not be fully explained by injury severity, time since injury, or education. Conclusions: The current study confirmed earlier findings of associations between emotion recognition and post-TBI behavior, providing partial evidence for models proposing emotion recognition as one of the pre-requisites for adequate social functioning. (JINS, 2017, 23, 400–411)

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Corresponding author

Correspondence and reprint requests to: Maarten Milders, Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, Netherlands. E-mail: m.v.milders@vu.nl

References

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Adolphs, R. (2009). The social brain: Neural basis of social knowledge. Annual Review of Psychology, 60, 693716.
Babbage, D., Yim, J., Zupan, B., Neumann, D., Tomita, M., & Willer, B. (2011). Meta-analysis of facial affect recognition difficulties after traumatic brain injury. Neuropsychology, 25, 277285.
Ben-David, B.M., Nguyen, L.L., & van Lieshout, P.H. (2011). Stroop effects in persons with traumatic brain injury: Selective attention, speed of processing, or color-naming? A meta-analysis. Journal of the International Neuropsychological Society, 17, 354363.
Benedictus, M., Spikman, J., & van der Naalt, J. (2010). Cognitive and behavioural impairment in traumatic brain injury related to outcome and return to work. Archives of Physical and Medical Rehabilitation, 91, 14361441.
Bennett, P.C., Ong, B., & Ponsford, J. (2005). Assessment of executive dysfunction following traumatic brain injury: Comparison of the BADS with other clinical neuropsychological measures. Journal of the International Neuropsychological Society, 11, 606613.
Benton, A.L., Sivan, A.B., Hamsher, K., Varney, N.R., & Spreen, O. (1994). Contributions to neuropsychological assessment. New York: Oxford University Press.
Bibby, H., & McDonald, S. (2005). Theory of mind after traumatic brain injury. Neuropsychologia, 43, 99114.
Bivona, U., Riccio, A., Ciurli, P., Carlesimo, G., Delle Donne, V., Pizzonia, E., Caltagirone, C., … Costa, A. (2014). Low self-awareness of individuals with severe traumatic brain injury can lead to reduced ability to take another person’s perspective. The Journal of Head Trauma Rehabilitation, 29, 157171.
Bornhofen, C., & McDonald, S. (2008). Treating deficits in emotion perception following traumatic brain injury. Neuropsychological Rehabilitation, 18, 2224.
Brooks, N., Campsie, L., Symington, C., Beattie, A., & McKinlay, W. (1986). The five year outcome of severe blunt head injury: A relative’s view. Journal of Neurology, Neurosurgery, and Psychiatry, 49, 764770.
Calder, A., Young, A., Rowland, A., Perrett, D., Hodges, J., & Etcoff, N. (1996). Facial emotion recognition after bilateral amygdala damage: Differentially severe impairment of fear. Cognitive Neuropsychology, 13, 699745.
Cannon, B.J. (2000). A comparison of self- and other-rated forms of the neuropsychology behaviour and affect profile in a traumatic brain injury population. Archives of Clinical Neuropsychology, 15, 327334.
Channon, S., Pellijeff, A., & Rule, A. (2005). Social cognition after head injury: Sarcasm and theory of mind. Brain and Language, 93, 123134.
Chaytor, N., & Schmitter-Edgecombe, M. (2007). Fractionation of the dysexecutive syndrome in a heterogeneous neurological sample: Comparing the dysexecutive questionnaire and the brock adaptive functioning questionnaire. Brain Injury, 21, 615621.
Corcoran, R., Mercer, G., & Frith, C.D. (1995). Schizophrenia, symptomatology and social inference: Investigating “theory of mind” in people with schizophrenia. Schizophrenia Research, 17, 517.
Corrigan, P. (1997). The social perceptual deficits of schizophrenia. Psychiatry, 60, 309326.
Croker, V., & McDonald, S. (2005). Recognition of emotion from facial expression following traumatic brain injury. Brain Injury, 19, 787799.
Dahlberg, C., Hawley, L., Morey, C., Newman, J., Cusick, C., & Harrison-Felix, C. (2006). Social communication skills in persons with post-acute traumatic brain injury: Three perspectives. Brain Injury, 20, 425435.
Dijkers, M. (1997). Measuring the long-term outcomes of traumatic brain injury: A review of the Community Integration Questionnaire. The Journal of Head Trauma Rehabilitation, 12, 7491.
Ekman, P., & Friesen, W. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologists Press.
Eslinger, P.J., Moore, P., Anderson, C., & Grossman, M. (2011). Social cognition, executive functioning and neuroimaging correlates of empathic deficits in frontotemporal dementia. The Journal of Neuropsychiatry and Clinical Neurosciences, 23, 7482.
Geraci, A., Surian, L., Ferraro, M., & Cantagallo, A. (2010). Theory of mind in patients with ventromedial or dorsolateral prefrontal lesions following traumatic brain injury. Brain Injury, 24, 978987.
Golan, O., Baron-Cohen, S., & Hill, J. (2006). The Cambridge Mindreading (CAM) Face-Voice Battery: Testing complex emotion recognition in adults with and without Asperger syndrome. Journal of Autism and Developmental Disorders, 36, 169183.
Golden, C.J. (1978). The Stroop colour and word test: A manual for clinical and experimental uses. Chicago: Stoelting Co.
Goodglass, H., & Kaplan, E. (1983). Boston Diagnostic Aphasia Examination. Media, PA: Williams & Wilkins.
Gregory, C., Lough, S., Stone, V., Erzinclioglu, S., Martin, L., Baron-Cohen, S., & Hodges, J. (2002). Theory of mind in patients with frontal variant frontotemporal dementia and Alzheimer’s disease: Theoretical and practical implication. Brain, 125, 752764.
Hanks, R., Temkin, N., Machamer, J., & Dikmen, S. (1999). Emotional and behavioral adjustment after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 80, 991999.
Hannay, H.J., Howieson, D.B., Loring, D.W., Fischer, J.S., & Lezak, M.D. (2004). Neuropathology for neuropsychologists. In M. D. Lezak, D. B. Howieson & D. W. Loring (Eds.), Neuropsychological assessment. Oxford, UK: Oxford University Press. p. 160.
Havet-Thomassin, V., Allain, P., Etcharry-Bouyx, F., & Le Gall, D. (2006). What about theory of mind after severe brain injury? Brain Injury, 20, 8391.
Henry, J., Cowan, D., Leeb, T., & Sachdev, S. (2015). Recent trends in testing social cognition. Current Opinion Psychiatry, 28, 133140.
Herrmann, C. (1997). International experiences with the hospital anxiety and depression scale: A review of validation data and clinical results. Journal of Psychosomatic Research, 2, 1741.
Ietswaart, M., Milders, M., Crawford, J.R., Currie, D., & Scott, C.L. (2008). Longitudinal aspects of emotion recognition in patients with traumatic brain injury. Neuropsychologia, 46, 148159.
Katsifaraki, M., & Wood, R. (2014). The impact of alexithymia on burnout amongst relatives of people who suffer from traumatic brain injury. Brain Injury, 28, 13891395.
Kelley, E., Sullivan, C., Loughlin, J., Hutson, L., Dahdah, N., Long, M., & Poole, J. (2014). Self-awareness and neurobehavioral outcomes, 5 years or more after moderate to severe brain injury. The Journal of Head Trauma Rehabilitation, 29, 147152.
Kendall, E., & Terry, D. (1996). Psychosocial adjustment following closed head injury: A model for understanding individual differences and predicting outcome. Neuropsychological Rehabilitation, 6, 101132.
Knox, L., & Douglas, J. (2009). Long-term ability to interpret facial expression after traumatic brain injury and its relation to social integration. Brain and Cognition, 69, 442449.
Koskinen, S. (1998). Quality of life 10 years after a very severe traumatic brain injury (TBI): The perspective of the injured and the closest relative. Brain Injury, 12, 631648.
Kosty, J., Stein, A., & Sherman, C. (2013). Measuring outcome after severe TBI. Neurological Research, 35, 277284.
Lezak, M.D., & O’Brien, K.P. (1988). Longitudinal study of emotional, social, and physical changes after traumatic brain injury. Journal of Learning Disabilities, 21, 456463.
Mah, L.W.Y., Arnold, M.C., & Grafman, J. (2005). Deficits in social knowledge following damage to ventromedial prefrontal cortex. The Journal of Neuropsychiatry and Clinical Neurosciences, 17, 6674.
Mathias, J.L., & Coats, J.L. (1999). Emotional and cognitive sequelae to mild traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 21, 200215.
McDonald, S. (2013). Impairments in social cognition following severe traumatic brain injury. Journal of the International Neuropsychological Society, 19, 231246.
McDonald, S., Fisher, A., & Flanagan, S. (2015). When diplomacy fails: Difficulty understanding hints following severe traumatic brain injury. Aphasiology, doi: 10.1080/02687038.2015.1070948
McLellan, T., & Mckinlay, A. (2013). Sensitivity to emotion, empathy and theory of mind: Adult performance following childhood TBI. Brain Injury, 27, 10321037.
Milders, M., Fuchs, S., & Crawford, J.R. (2003). Neuropsychological impairments and changes in emotional and social behavior following severe traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 25, 157172.
Milders, M., Ietswaart, M., Crawford, J.R., & Currie, D. (2006). Impairments in ‘theory of mind’ shortly after traumatic brain injury and at one-year follow-up. Neuropsychology, 20, 400408.
Milders, M., Ietswaart, M., Crawford, J.R., & Currie, D. (2008). Social behaviour following traumatic brain injury and its association with emotion recognition, understanding of intentions, and cognitive flexibility. Journal of the International Neuropsychological Society, 14, 318326.
Muller, F., Simion, A., Reviriego, E., Galera, C., Mazaux, J., Barat, M., & Joseph, P. (2010). Exploring theory of mind after severe traumatic brain injury. Cortex, 46, 10881099.
Nelson, L., Drebing, C., Satz, P., & Uchiyama, C.L. (1998). Personality change in head trauma: A validity study of the Neuropsychology Behaviour and Affect Profile. Archives of Clinical Neuropsychology, 13, 549560.
Neumann, D., Babbage, D., Zupan, B., & Willer, B. (2014). A randomized controlled trial of emotion recognition training after traumatic brain injury. Journal of Head Trauma Rehabilitation, 30, E12E23.
Norris, G., & Tate, R.L. (2000). The Behavioural Assessment of the Dysexecutive Syndrome (BADS): Ecological, concurrent and construct validity. Neuropsychological Rehabilitation, 10, 3345.
Ochsner, K. (2008). The Social-Emotional Processing Stream: Five core constructs and their translational potential for schizophrenia and beyond. Biological Psychiatry, 64, 4861.
Oddy, M., Coughlan, T., Tyerman, A., & Jenkins, D. (1985). Social adjustment after closed head injury: A further follow-up seven years after injury. Journal of Neurology, Neurosurgery, and Psychiatry, 48, 564568.
Osborne-Crowley, K., & McDonald, S. (2016). Hyposmia, not emotion perception, is associated with psychosocial outcome after severe traumatic brain injury. Neuropsychology, 30, 820829.
Osborne-Crowley, K., McDonald, S., & Rushby, J. (2016). Role of reversal learning impairment in social disinhibition following severe traumatic brain injury. Journal of the International Neuropsychological Society, 22, 303313.
Ownsworth, T., & McKenna, K. (2004). Investigation of factors related to employment outcome following traumatic brain injury: A critical review and conceptual model. Disability and Rehabilitation, 26, 765784.
O’Sullivan, M., & Guilford, J.P. (1976). Four factor test of social intelligence: Manual of instructions and interpretations. Orange, CA: Seridan Psychological Services.
Parente, J.K., DeCesare, A., & Parente, R. (1990). Spouses who stayed. Cognitive Rehabilitation, 8, 2225.
Prigatano, G. (1992). Personality disturbances associated with traumatic brain injury. Journal of Consulting and Clinical Psychology, 60, 360368.
Reid-Arndt, S., Nehl, C., & Hinkebein, J. (2007). The Frontal Systems Behaviour Scale (FrSBe) as a predictor of community integration following a traumatic brain injury. Brain Injury, 21, 13611369.
Reitan, R.M. (1958). Validity of the Trail Making Test as an indication of organic brain damage. Perceptual Motor Skills, 8, 271276.
Rolls, E., Hornak, J., Wade, D., & McGrath, J. (1994). Emotion-related learning in patients with social and emotional changes associated with frontal lobe damage. Journal of Neurology, Neurosurgery, and Psychiatry, 57, 15181524.
Salter, K., Foley, N., Jutai, J., Bayley, M., & Teasell, R. (2008). Assessment of community integration following traumatic brain injury. Brain Injury, 22, 820835.
Shany-Ur, T., & Rankin, K. (2011). Personality and social cognition in neurodegenerative disease. Current Opinion in Neurology, 24, 550555.
Spikman, J., Timmerman, M., Milders, M., Veenstra, W., & van der Naalt, J. (2012). Social cognition impairments in relation to general cognitive deficits, injury severity and prefrontal lesions in traumatic brain injury patients. Journal of Neurotrauma, 29, 101111.
Spikman, J.M., Milders, M.V., Visser-Keizer, A.C., Westerhof-Evers, H.J., Herben-Dekker, M., & van der Naalt, J. (2013). Deficits in facial emotion recognition indicate behavioral changes and impaired self-awareness after moderate to severe traumatic brain injury. PLoS One, 8, 17.
Stone, V.E., Baron-Cohen, S., & Knight, R.T. (1998). Frontal lobe contributions to theory of mind. Journal of Cognitive Neuroscience, 10, 640656.
Struchen, M.A., Clark, A.N., Sander, A.M., Mills, M.R., Evans, G., & Kurtz, D. (2008). Relation of executive functioning and social communication measures to functional outcomes following traumatic brain injury. NeuroRehabilitaion, 23, 185198.
Struchen, M., Pappadis, M., Sander, A., Burrows, C., & Myszka, K. (2011). Examining the contribution of social communication abilities and affective/behavioral functioning to social integration outcomes for adults with traumatic brain injury. J Head Trauma Rehabilitation, 26, 3042.
Tate, R.L. (1999). Executive dysfunction and characterological changes after traumatic brain injury: Two sides of the same coin? Cortex, 35, 3955.
Ubukata, S., Tanemure, R., Yoshizumi, M., Sugihara, G., Murai, T., & Ueda, K. (2014). Social cognition and its relationship to functional outcomes in patients with sustained acquired brain injury. Neuropsychiatric Disease and Treatment, 10, 20612068.
Vilkki, J., Ahola, K., Holst, P., Ohman, J., Servo, A., & Heiskanen, O. (1994). Prediction of psychosocial recovery after head injury with cognitive test and neurobehavioral ratings. Journal of Clinical and Experimental Neuropsychology, 16, 325338.
Vollm, B.A., Taylor, A.N.W., Richandson, P., Corcoran, R., Stirling, J., McKie, S., & Elliot, R. (2006). Neuronal correlates of theory of mind and empathy: A functional magnetic resonance imaging study in a nonverbal task. Neuroimage, 29, 9098.
Wechsler, D., Wycherley, R., Benjamin, L., Crawford, J., & Mockler, D. (1998). Manual for the Wechsler Adult Intelligence Scale (3rd ed.). London: Psychological Corporation.
Wessa, M., Houenou, J., Paillere-Martinot, M.L., Berthoz, S., Artiges, E., Lebooyer, M., & Marinot, J.L. (2007). Fronto-striatal overactivation in euthymic bipolar patients during an emotional go/nogo task. The American Journal of Psychiatry, 164, 638646.
Williams, C., & Wood, R. (2010). Impairment in the recognition of emotion across different media following traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 32, 113122.
Williams, C., & Wood, R.L. (2013). The impact of alexithymia on relationship quality and satisfaction following traumatic brain injury. Journal of Head Trauma Rehabilitation, 28, E21E30.
Willer, B., Ottenbacher, K.J., & Coad, M.L. (1994). The Community Integration Questionnaire: A comparative examination. American Journal of Physical Medicine and Rehabilitation, 73, 103111.
Wilson, B., Alderman, N., Burgess, P., Emslie, H., & Evans, J. (1996). Behavioural Assessment of the Dysexecutive Syndrome. Bury St. Edmunds, UK: Thames Valley Test Company.
Wood, R.L. (2001). Understanding neurobehavioural disability. In R.L. Wood & T.M. McMillan (Eds.), Neurobehavioural disability and social handicap following traumatic brain injury (pp. 328). Hove: Psychology Press Ltd.
Wood, R., & Rutterford, N. (2006). Demographic and cognitive predictors of long-term psychosocial outcome following traumatic brain injury. Journal of the International Neuropsychological Society, 12, 350358.
Wood, R., & Yurdakul, L. (1997). Change in relationship status following traumatic brain injury. Brain Injury, 11, 491501.
Wood, R., & Williams, C. (2008). Inability to empathize following traumatic brain injury. Journal of the International Neuropsychological Society, 14, 289296.
Zigmond, A., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.
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Journal of the International Neuropsychological Society
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