The relationship between social cognitive difficulties in the acute stages of stroke and later functional outcomes

Evidence for a multidimensional account of cognitive and affective theory of mind: A state-trace analysis

Theory of mind (ToM) has been argued to be a multidimensional construct, with ToM inferences depending on distinct processes across affective and cognitive ToM tasks and across first-order cognitive and second-order cognitive ToM tasks. Behavioural evidence for a multidimensional account has primarily depended on dissociations identified via analysis of variance, a statistical approach insufficient for assessing dimensionality. Instead, state-trace analysis (STA) is a more appropriate statistical technique to uncover dimensionality. The current study first applied STA to two summary datasets that had previously identified key dissociations between cognitive and affective ToM; these reanalyses did not support a multidimensional account of ToM. Next, STA was applied to a more detailed dataset to reveal whether ToM is based on multiple processes in a sample of 115 older adults aged 60-85 years (M = 68.5, SD = 5.92, 61.7% female) with higher or lower emotion perception ability. Participants made ToM judgements about different social exchanges (e.g., sarcasm or lying). STA results supported a multidimensional account of ToM across first-order cognitive, second-order cognitive, and affective ToM subdomains. These results lay a more rigorous foundation for subsequent studies to further examine the dimensionality of ToM and to apply formal modelling, progressing the field's understanding and measurement of the cognitive processes driving ToM judgements.

[The impact of the impairment of social cognitive functions in acute stage of stroke on its functional outcomes]

OBJECTIVE

To analyze the influence of the impairment of social cognitive functions (SCF) in acute phase of ischemic stroke (IS) on its functional outcomes in 6 months.

MATERIAL AND METHODS

One hundred patients with IS were included in the study. The assessment of social-demographic, clinical characteristics and SCF (theory of mind (ToM), affective empathy, social empathy) of the patients on the day 10 after stroke was conducted. Patients underwent standard laboratory tests of blood and urine. Functional outcomes in 6 months were recorded; score ≥3 on the modified Rankin scale (mRs) indicated unfavorable outcome. Multiple linear regression analysis was performed to identify independent predictors of functional outcomes of stroke in 6 months.

RESULTS

Patients with unfavorable outcomes in 6 months after stroke in acute phase had more severe neurological deficit, more prominent disability level, lower mobility, severer impairment of SCF and lower level of total protein in biochemical analysis of blood. The independent predictors of functional outcomes of IS in 6 months included severity of the impairment of SCF (namely, ToM) according to the Reading the Mind in the Eyes test and severity of functional impairment on admission assessed by mRs.

CONCLUSION

Changes of SCF, particularly of ToM, in the acute phase of IS are associated with its unfavorable functional outcomes in 6 months.

Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits

OBJECTIVE

Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia.

METHOD

Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity.

RESULTS

Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels.

CONCLUSIONS

We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.

Nursing and Allied Health Staff Perceptions and Experiences of a Volunteer Stroke Peer Support Program: A Qualitative Study

Purpose

Stroke brings about physical, cognitive, and psychosocial changes and, consequently, many stroke survivors feel underprepared for the transition from hospital to home. Nursing and allied health staff have a key role in stroke rehabilitation. Peer support programs have been found effective in supporting stroke survivors, alongside hospital staff caring for stroke patients, by providing experiential knowledge that staff are not able to provide.

Aim

This study explored the perceptions and experiences of nursing and allied health staff of a volunteer peer support program for stroke inpatients.

Methods

This study utilised a qualitative, evaluative case study design. This study was conducted at a public metropolitan hospital in Western Australia that had developed a stroke peer support program (SPSP) on a rehabilitation ward. A purposeful sample of nurses (n = 5) and multidisciplinary allied health staff (n = 5) were recruited from the ward where the SPSP was provided for stroke inpatients. Semi-structured, face-to-face interviews were conducted with staff participants. Verbatim transcripts from audio-recorded interviews were analysed using inductive thematic analysis.

Results

Nursing and allied health staff perceived the SPSP as valuable to stroke patients’ rehabilitation and beneficial to families, volunteer peers and staff. Four themes encapsulated the findings: awareness of and involvement in the program; recognising the benefits of the program; perceived enablers and barriers of the program and suggestions for the future of the program.

Conclusion

Nursing and allied health staff within multidisciplinary teams are cognisant of the psycho-emotional needs of stroke patients which staff are not fully able to meet. The study findings confirm volunteer peer support can provide valuable and fundamental adjunct support to address stroke patients’ unmet needs, as well as supporting staff to enhance stroke patient care.

Innate immunity impacts social-cognitive functioning in people with multiple sclerosis and healthy individuals: Implications for IL-1ra and urinary immune markers

Social-cognitive difficulties can negatively impact interpersonal communication, shared social experience, and meaningful relationships. This pilot investigation examined the relationship between social-cognitive functioning and inflammatory markers in people with multiple sclerosis (MS) and demographically-matched healthy individuals. Additionally, we compared the immune marker profile in serum and urine-matched samples. Social cognitive functioning was objectively assessed using The Awareness of Social Inference Test - Short (TASIT-S) and subjectively assessed using self-reports of abilities in emotion recognition, emotional empathy, and cognitive theory of mind. In people with MS and healthy individuals, there were moderate-to-large negative relationships between pro-inflammatory biomarkers (serum IL-1β, IL-17, TNF-α, IP-10, MIP-1α, and urine IP-10, MIP-1β) of the innate immune system and social-cognitive functioning. In MS, a higher serum concentration of the anti-inflammatory marker IL-1ra was associated with better social-cognitive functioning (i.e., self-reported emotional empathy and TASIT-S sarcasm detection performance). However, there were mixed findings for anti-inflammatory serum markers IL-4 and IL-10. Overall, our findings indicate a relationship between pro-inflammatory cytokines and social-cognitive abilities. Future studies may provide greater insight into biologically-derived inflammatory processes, sickness behaviour, and their connection with social cognition.

Problems with Social Cognition and Decision-Making in Huntington's Disease: Why Is it Important?

Huntington’s disease starts slowly and progresses over a 15–20 year period. Motor changes begin subtly, often going unnoticed by patients although they are typically visible to those close to them. At this point, it is the early non-motor problems of HD that arguably cause the most functional impairment. Approximately 65% of gene carriers will experience a reduction in their occupational level, and just under half will feel unable to manage their finances independently before a clinical diagnosis is made. Understanding what drives this impairment in activities of daily living is the key to helping people with HD to live more independently for longer, especially in early disease. Early cognitive decline is likely to play a contributory factor although few studies have looked directly at this relationship. Recently, it has been shown that along with the well documented dysexecutive syndrome seen in HD, changes in social cognition and decision-making are more common than previously thought. Furthermore, some of the early neuropathological and neurochemical changes seen in HD disrupt networks known to be involved in social functioning. In this review, we explore how HD changes the way individuals interact in a social world. Specifically, we summarise the literature on both classical and social decision-making (value-based decision-making in a social context) along with studies of theory of mind, empathy, alexithymia, and emotion recognition in HD. The literature specific to HD is discussed and supported by evidence from similar neurodegenerative disorders and healthy individuals to propose future directions and potential therapeutic avenues to be explored.