Role of social cognition in post‐traumatic stress disorder: A review and meta‐analysis

Abstract

Social functioning is a key component of recovery after a potentially traumatic experience, and the buffering role of the social support in trauma resilience and recovery has been very well documented. Factors contributing to resilience and recovery are notable because although most people will experience a traumatic event during their lifetimes, only 6% to 10% are diagnosed with post-traumatic stress disorder (PTSD). The relationship between an individual and their social environment is determined both by the quality of the social environment itself, and by the individual's perception and understanding of information conveyed by the other people around them. However, little research has considered the contribution of these internal social cognitive processes to PTSD risk or resilience. The current review draws on the existing literature on social cognitive functioning in trauma exposure and PTSD, identifying key questions and themes for future research. We utilized a meta-analytic approach to assess the evidence for alterations in social cognition in PTSD, finding a consistent large deficit in social cognitive performance in PTSD groups relative to trauma-exposed and healthy controls. We then reviewed the literature on the interaction of genes and the social environment, supporting the hypothesis that social cognitive deficits are a preexisting risk factor for PTSD. Finally, we reviewed relevant neuroimaging findings, which suggest that alterations in social cognition affect the perception of threat cues in PTSD. Overall, research on social cognition and PTSD is still emerging, but existing findings suggest this is an important and understudied area for the understanding of PTSD.

Social cognition in post‐traumatic stress disorder: A systematic review

“…The present review highlighted the difficulty of studying social cognition, owing to the heterogeneity of the data. A recent meta‐analysis conducted by Stevens and Jovanovic evidenced social cognitions deficits in PTSD patients (Stevens & Jovanovic, ). Author also noted the extreme heterogeneity of studies.…”

“…Regarding the variability induced by type of trauma and sex, we believe that trauma involving another human being (i.e., interpersonal) further impairs social cognition. In Stevens and Jovanovic meta‐analysis (Stevens & Jovanovic, ), the effect size by type of trauma revealed that interpersonal trauma provoked more damages in social cognition than a natural disaster for instance. As they included childhood trauma in their analysis, complex PTSD patients may have biased result (atypical social cognition development, re‐victimization as it is evoked in their review).…”

Latent cause inference during extinction learning in trauma-exposed individuals with and without PTSD

“…Participants completed a demographic questionnaire where they provided information about their age, gender, race/ethnicity, and highest level of educational achievement. All participants also completed the Medical Outcomes Survey brief Social Support questionnaire (MOS-SS; Sherbourne & Stewart, 1991) -a measure of perceived social support -which was included in the analysis as social support has previously been shown to play a vital role in resilience to psychopathology following trauma (Fritz et al, 2018;Stevens & Jovanovic, 2019). A subset of individuals (N=24) completed the Cogstate battery, a set of computerised tests probing general executive function that have been shown to be sensitive to mild cognitive impairment (Maruff et al, 2009).…”

Neuroimaging resilience to trauma: convergent evidence and challenges for future research

“…One further study found evidence that greater maternal support attenuated the relationship between childhood adversity and neural responses to fearful emotional faces in the anterior cingulate cortex, insula, nucleus accumbens, and frontal pole (Wymbs et al, 2020). Importantly, higher levels of social cognitive function (ability to infer the thoughts of others and navigate the social world) may help foster adaptive outcomes following trauma, by conferring the ability to recruit and maintain these important social support structures (Stevens and Jovanovic, 2019;Lepore and Kliewer, 2019). However, to date, very few studies have examined role of neural activity related to social cognition in resilience following trauma exposure.…”