Social behavior following traumatic brain injury and its association with emotion recognition, understanding of intentions, and cognitive flexibility

Although the adverse consequences of changes in social behavior following traumatic brain injury (TBI) are well documented, relatively little is known about possible underlying neuropsychological deficits. Following a model originally developed for social behavior deficits in schizophrenia, we investigated whether impairments in emotion recognition, understanding of other people's intentions ("theory of mind"), and cognitive flexibility soon after first TBI or 1 year later were associated with self and proxy ratings of behavior following TBI. Each of the three functions was assessed with two separate tests, and ratings of behavior were collected on three questionnaires. Patients with TBI (n = 33) were impaired in emotion recognition, "theory of mind," and cognitive flexibility compared with matched orthopedic controls (n = 34). Proxy ratings showed increases in behavioral problems 1 year following injury in the TBI group but not in the control group. However, test performance was not associated with questionnaire data. Severity of the impairments in emotion recognition, understanding intention, and flexibility were unrelated to the severity of behavioral problems following TBI. These findings failed to confirm the used model for social behavior deficits and may cast doubt on the alleged link between deficits in emotion recognition or theory of mind and social functioning

Attentional cueing: Fearful body postures capture attention with saccades

Arash Sahraie According to theories of attention and emotion, threat-related stimuli (e.g., negative facial expressions) capture and hold attention. Despite these theories, previous examination of attentional cueing by threat showed no enhanced capture at brief durations. One explanation for the absence of attentional capture effects may be related to the sensitivity of the manual response measure employed. Here we extended beyond facial expressions and investigated the time course of orienting attention towards fearful body postures in the exogenous cueing task. Cue duration (20, 40, 60, or 100 ms), orientation (upright or inverted), and response mode (saccadic eye movement or manual keypress) were manipulated across three experiments. In the saccade mode, both enhanced attentional capture and impaired disengagement from fearful bodies were evident and limited to rapid cue durations (20 and 40 ms), suggesting that saccadic cueing effects emerge rapidly and are short lived. In the manual mode, fearful bodies impacted only upon the disengagement component of attention at 100 ms, suggesting that manual cueing effects emerge over longer periods of time. No cueing modulation was found for inverted presentation, suggesting that valence, not low-level image confounds, was responsible for the cueing effects. Importantly, saccades could reveal threat biases at brief cue durations consistent with current theories of emotion and attention

Improving access to a multi-component intervention for caregivers and people with dementia

Acknowledgements We thank staff and volunteers from Voluntary Service Aberdeen, Forget Me Not Club, NHS Grampian, Alzheimer’s Scotland, Quarrier’s Carer Support, and Aberdeenshire Council who participated as trainers, and Zahid Quayyum at the Health Economics Research Unit of the University of Aberdeen who contributed to the economic analysis. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Aberdeenshire Change Fund (Study 1), NHS Grampian Carers Information Strategy and Alzheimer Scotland (Study 2).Peer reviewedPostprin

Increased neural response to social rejection in major depression

Background: Being a part of community is critical for survival and individuals with major depressive disorder (MDD) have a greater sensitivity to interpersonal stress that makes them vulnerable to future episodes. Social rejection is a critical risk factor for depression and it is said to increase interpersonal stress and thereby impairing social functioning. It is therefore critical to understand the neural correlates of social rejection in MDD. Methods: To this end, we scanned 15 medicated MDD and 17 healthy individuals during a modified cyberball passing game, where participants were exposed to increasing levels of social exclusion. Neural responses to increasing social exclusion were investigated and compared between groups. Results: We showed that compared to controls, MDD individuals exhibited greater amygdala, insula, and ventrolateral prefrontal cortex activation to increasing social exclusion and this correlated negatively with hedonic tone and self-esteem scores across all participants. Conclusions: These preliminary results support the hypothesis that depression is associated with hyperactive response to social rejection. These findings highlight the importance of studying social interactions in depression, as they often lead to social withdrawal and isolation

Deficits in Facial Emotion Recognition Indicate Behavioral Changes and Impaired Self-Awareness after Moderate to Severe Traumatic Brain Injury

Traumatic brain injury (TBI) is a leading cause of disability, specifically among younger adults. Behavioral changes are common after moderate to severe TBI and have adverse consequences for social and vocational functioning. It is hypothesized that deficits in social cognition, including facial affect recognition, might underlie these behavioral changes. Measurement of behavioral deficits is complicated, because the rating scales used rely on subjective judgement, often lack specificity and many patients provide unrealistically positive reports of their functioning due to impaired self-awareness. Accordingly, it is important to find performance based tests that allow objective and early identification of these problems. In the present study 51 moderate to severe TBI patients in the sub-acute and chronic stage were assessed with a test for emotion recognition (FEEST) and a questionnaire for behavioral problems (DEX) with a self and proxy rated version. Patients performed worse on the total score and on the negative emotion subscores of the FEEST than a matched group of 31 healthy controls. Patients also exhibited significantly more behavioral problems on both the DEX self and proxy rated version, but proxy ratings revealed more severe problems. No significant correlation was found between FEEST scores and DEX self ratings. However, impaired emotion recognition in the patients, and in particular of Sadness and Anger, was significantly correlated with behavioral problems as rated by proxies and with impaired self-awareness. This is the first study to find these associations, strengthening the proposed recognition of social signals as a condition for adequate social functioning. Hence, deficits in emotion recognition can be conceived as markers for behavioral problems and lack of insight in TBI patients. This finding is also of clinical importance since, unlike behavioral problems, emotion recognition can be objectively measured early after injury, allowing for early detection and treatment of these problems

Social behavior and impairments in social cognition following traumatic brain injury

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- A nd proxy reports of pre- A nd 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

Abnormal neural responses to social exclusion in schizophrenia

Social exclusion is an influential concept in politics, mental health and social psychology. Studies on healthy subjects have implicated the medial prefrontal cortex (mPFC), a region involved in emotional and social information processing, in neural responses to social exclusion. Impairments in social interactions are common in schizophrenia and are associated with reduced quality of life. Core symptoms such as delusions usually have a social content. However little is known about the neural underpinnings of social abnormalities. The aim of this study was to investigate the neural substrates of social exclusion in schizophrenia. Patients with schizophrenia and healthy controls underwent fMRI while participating in a popular social exclusion paradigm. This task involves passing a 'ball' between the participant and two cartoon representations of other subjects. The extent of social exclusion (ball not being passed to the participant) was parametrically varied throughout the task. Replicating previous findings, increasing social exclusion activated the mPFC in controls. In contrast, patients with schizophrenia failed to modulate mPFC responses with increasing exclusion. Furthermore, the blunted response to exclusion correlated with increased severity of positive symptoms. These data support the hypothesis that the neural response to social exclusion differs in schizophrenia, highlighting the mPFC as a potential substrate of impaired social interactions

Relationship between social cognition and social behaviour following traumatic brain injury

Objective: To present an overview of studies that investigated associations between social cognition functions (social cue perception, empathy, understanding intentions) and social behaviour or social outcome following traumatic brain injury (TBI). Methods: The literature search was conducted in the Medline, PsycInfo, Cochrane Library and Web of Science databases. Main criteria for selection were that the participants were adult persons with TBI, social cognition as well as social behaviour or social outcome post-TBI was assessed and correlations between social cognition and social behaviour or outcome were reported. Average correlations were calculated based on weighted summation of the correlations from the individual studies. Results: Of the 511 publications identified in the search, 13 were selected. Ten of these assessed emotion recognition, six assessed understanding of intentions and two assessed empathy. Average correlations between social cognition performance and post-injury social behaviour or outcome were significant for each of the three social cognition functions; poorer performance was associated with poorer outcome. Effect sizes varied from small to moderate (understanding intentions) to moderate (emotion recognition) to large (empathy). Conclusions: The associations were in line with models of social cognition and proposals that impairments in social cognition may underlie social behaviour difficulties and poor social outcome following TBI