Allain Philippe, Hamon Martin, Saoût Virginie, Verny Christophe, Dinomais Mickaël, Besnard Jeremy
Laboratoire de Psychologie des Pays de la Loire (EA 4638), University of Angers, Angers, France.
Department of Neurology, Angers University Hospital, Angers, France.
Front Neurol. 2020 Jan 22;10:1367. doi: 10.3389/fneur.2019.01367. eCollection 2019.
In view of the recent literature, the negative impact of traumatic brain injury (TBI) on social cognition remains a debated issue. On one hand, a considerable number of studies reported significant impairments in emotion recognition, empathy, moral reasoning, social problem solving, and mentalizing or theory of mind (ToM) abilities in patients with TBI. On the other hand, the ecological validity of social cognition tasks is still a matter of concern and debate for clinicians and researchers. The objectives of the present study were 2-fold: (1) to assess social cognition in TBI with an ecological performance-based test which focuses on ToM ability, and (2) to study the relationship between performances on this task and behavioral disorders. To this end, 47 patients with moderate to severe TBI in the chronic stage were assessed with a ToM task, the Movie for the Assessment of Social Cognition (MASC), a film displaying social interactions in natural settings and asking for an evaluation of the emotions, thoughts, and intentions of the characters. Behavioral disorders were assessed with the Behavioral Dysexecutive Syndrome Inventory (BDSI), a structured interview of an informant in assessing changes compared with previous behavior in 12 domains. Patients were significantly less accurate in mental state attribution than a demographically matched group of 38 healthy control subjects. Significant others of patients also reported more behavioral executive problems than controls' relatives on most of the domains of the BDSI. In addition, social cognition performance in the MASC was significantly correlated with behavioral dysexecutive problems rated by proxies on the BDSI. This study is the first to find association between impairments in mentalizing abilities in the MASC and behavioral impairments in patients with TBI, confirming the added value of this ecological task and that the recognition of social signals is a key element for adequate behavioral functioning.
鉴于近期的文献，创伤性脑损伤（TBI）对社会认知的负面影响仍是一个有争议的问题。一方面，大量研究报告称，TBI患者在情绪识别、同理心、道德推理、社会问题解决以及心理化或心理理论（ToM）能力方面存在显著损害。另一方面，社会认知任务的生态效度仍是临床医生和研究人员关注和争论的问题。本研究的目的有两个：（1）使用一项基于生态表现的测试来评估TBI患者的社会认知，该测试侧重于ToM能力；（2）研究该任务的表现与行为障碍之间的关系。为此，对47名慢性期中度至重度TBI患者进行了一项ToM任务评估，即社会认知评估电影（MASC），这是一部展示自然场景中社会互动并要求对角色的情绪、想法和意图进行评估的电影。使用行为执行功能障碍综合征量表（BDSI）评估行为障碍，这是一种由信息提供者进行的结构化访谈，用于评估与之前在12个领域的行为相比的变化。与38名年龄、性别匹配的健康对照受试者相比，患者在心理状态归因方面的准确性显著较低。患者的重要他人在BDSI的大多数领域也比对照组亲属报告了更多的行为执行问题。此外，MASC中的社会认知表现与BDSI上代理人评定的行为执行功能障碍问题显著相关。本研究首次发现MASC中的心理化能力损害与TBI患者的行为损害之间存在关联，证实了这项生态任务的附加价值，以及对社会信号的识别是适当行为功能的关键要素。
