Learning from the minds of others: A review of social cognition treatments and their relevance to traumatic brain injury

Abstract

Social cognition is widely regarded as an essential skill with which to understand the social world. Despite this, the role that social cognition plays in outcome, and whether deficits are remediable after traumatic brain injury (TBI), are not yet well known. The current review examines the construct of social cognition and presents a conceptual biopsychosocial model with which to understand the social cognitive process. This is related to the literature on social cognitive deficits in TBI and we discuss relevant treatment developments to date within this population. We then review social cognition treatment programmes researched in other clinical populations in order to advise and inform approaches for those living with TBI. Whilst treatments have focused on emotion perception skills in the TBI literature, programmes developed for other clinical populations have had broader targets, focusing on Theory of Mind skills and/or modifying interpretational cognitive biases. Moreover, they have largely proven to be efficacious. Programmes that are contextualised, collaborative, and experiential seem optimal in enabling generalisation relevant to individuals' everyday social lives. We argue that there is therefore scope to improve the evidence-based social cognitive treatment options available for those with TBI, taking into account specific adaptations necessary for this population.

Sex and Gender Differences in Emotion Recognition and Theory of Mind After TBI: A Narrative Review and Directions for Future Research

“…Differences generally are small (e.g., accounting for <10% of variance in scores) and are mostly for threat-related affective displays. Analysis of 14,000 samples of written and spoken language showed that women also used more emotion words (e.g., happy, certainty, nervous, and hate) than men, and fewer swear words (31), although again effect sizes were small [i.e., [10][11][12][13][14][15][16][17][18][19][20][21][22].…”

“…The review focuses on two aspects of social cognition that have been studied in TBI: recognition of emotions from facial affect; and Theory of Mind (ToM), the ability to attribute mental states to oneself and others, and use that information to make predictions about others' actions (9). We chose these two aspects of social cognition because they have been linked to broader social outcomes like quality of life and social reintegration, both conceptually (10)(11)(12), and empirically (13)(14)(15)(16)(17)(18)(19)(20). We consider data from typical adults and adults with TBI, in the broader context of common stereotypes about social skills and behaviors in men vs. women.…”

Ostracism and physiological arousal following traumatic brain injury

“…Investigating the associations between physiological variables including heart rate changes and the likelihood of response will yield insights relevant to the development and implementation of targeted treatment approaches to autonomic deficits in adults after a brain injury. Whilst there is now enough evidence to support routine clinical assessment of social cognition (though there is evidence to suggest this is not happening [62]), more research is needed to establish evidence for social skills interventions in this field [63].…”

Interpretation of non‐verbal cues by people with and without TBI: understanding relationship intentions

“…A more recent review of social cognition treatments and TBI (Cassel et al . ) highlights the paucity of interventions for social cognition, and summarizes that those that do exist primarily use stimuli consisting of pictures, videos and role‐play. The authors suggest that social cognition interventions for other populations may be used to inform treatments for people with TBI, and more naturalistic and experiential interventions could transfer better to real‐life contexts.…”

“…Ylvisaker et al (2005) summarized research findings about behavioural and social interaction interventions for people with TBI and suggested that interventions should focus on situational training; that is, practicing the skill in the situation that requires it, and cautioned against social skills groups that may train discrete skills out of context. A more recent review of social cognition treatments and TBI (Cassel et al 2016) highlights the paucity of interventions for social cognition, and summarizes that those that do exist primarily use stimuli consisting of pictures, videos and role-play. The authors suggest that social cognition interventions for other populations may be used to inform treatments for people with TBI, and more naturalistic and experiential interventions could transfer better to real-life contexts.…”