Abstract
Disturbances in social cognitive processes such as the ability to infer others' mental states importantly contribute to social and functional impairments in psychiatric disorders. Yet, despite established social, emotional, and cognitive problems, the role of social cognition in obsessive-compulsive disorder is largely overlooked. The current review provides a first comprehensive overview of social (neuro)cognitive disturbances in adult patients with obsessive-compulsive disorder. Results of our review indicate various social cognitive alterations. Patients with obsessive-compulsive disorder show deficits in the recognition of affective social cues, specifically facial expressions of disgust, and more general deficits in theory of mind/mentalizing. Additionally, patients show heightened affective reactions and altered neural responding to emotions of self and others, as well as poor emotion regulation skills, which may contribute to poor social functioning of patients. However, the discrepancies in findings and scarcity of studies make it difficult to draw firm conclusions with regard to the specificity of social cognitive disturbances. The review offers directions for future research and highlights the need to investigate obsessive-compulsive disorder from an interactive social neurocognitive perspective in addition to the prevalent passive spectator perspective to advance our understanding of this intricate and burdensome disorder.
Highlights
Almost all psychiatric disorders are characterized by disturbances in the ability to have successful and meaningful interactions with others
Yap et al (135) found that Obsessive-compulsive disorder (OCD) patients scored significantly higher than controls on all Difficulties in Emotion Regulation Scale (DERS) subscales, and group differences remained significant after correcting for depression and anxiety on all scales except for the lack of emotional awareness and emotional clarity scales. These findings indicate that patients with OCD have difficulties regulating their emotions, expressed in the tendency to show a nonacceptance of emotions, experienced difficulties in goal-directed behavior and impulse control when distressed, and the use of maladaptive regulation strategies
The current review demonstrated that on a more intrapersonal level, patients with OCD are characterized by heightened emotional and neural reactivity as well as by problems in emotion regulation, which may directly contribute to the development and maintenance of obsessions and compulsions [see, e.g., (111)], but which may importantly hinder the enjoyment of social relations and contribute to maladaptive social behavior
Summary
Almost all psychiatric disorders are characterized by disturbances in the ability to have successful and meaningful interactions with others. Social cognition is a broad term that includes a wide variety of interrelated cognitive processes that enable successful and adaptive behavior in a social context [e.g., (2, 3)] It includes, among other things, the ability to recognize social cues such as facial emotions, the ability to understand others' mental states [known as theory of mind (ToM) or mentalizing], the ability to share the experiences and emotions of others, as well as the capacity to regulate one's emotional responses to others (4). Among other things, the ability to recognize social cues such as facial emotions, the ability to understand others' mental states [known as theory of mind (ToM) or mentalizing], the ability to share the experiences and emotions of others, as well as the capacity to regulate one's emotional responses to others (4) Disturbances in these social cognitive abilities are important predictors of social and functional impairments in psychiatric disorders [e.g., (5)].
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