Social cognitive deficits following stroke

Abstract

Social cognition refers broadly to the cognitive processes used to encode and decode social information and consists of four key domains: theory of mind, social perception, affective empathy, and social behaviour. Social cognitive deficits are a key predictor of important functional outcomes as they fundamentally disrupt the ability to form and sustain strong interpersonal relationships thereby potentially leading to social isolation, a critical risk factor for morbidity and mortality. Although people who have suffered a stroke are one of the many clinical groups at increased risk of social cognitive impairment, important questions remain about the nature and magnitude of these difficulties. The overarching aim of the present thesis was therefore to enhance current understanding of social cognitive deficits following stroke. This was achieved in two parts. Firstly, via a comprehensive meta-analysis (Chapter 2) of 58 datasets involving 2567 participants (937 with stroke, 1630 non-clinical controls). Results from this meta-analysis revealed significant stroke related deficits for three of the four social cognitive domains (theory of mind, social perception, and social behaviour), with these deficits robust across both left and right lateralized lesions, as well as social cognitive assessments that differed in their broader cognitive demands and their modality of presentation. The second core part of the thesis involved an extensive empirical study (Chapter 3) addressing limitations of the broader literature identified by the meta-analysis. Seventy participants (35 people who had suffered a first-time stroke and 35 demographically-matched controls) completed a comprehensive social cognitive test battery, background neuropsychological tests and measures related to quality of life. Key results indicated that while affective empathy remained intact following stroke, again there was evidence of significant stroke-related impairment for all three other social cognitive domains. The theoretical and practical implications of these findings are discussed.