Theory of mind following traumatic brain injury: the role of emotion recognition and executive dysfunction.

A number of studies have now documented that traumatic brain injury (TBI) is associated with deficits in the recognition of basic emotions, the capacity to infer mental states of others (theory of mind), as well as executive functioning. However, no study to date has investigated the relationship between these three constructs in the context of TBI. In the current study TBI participants (N=16) were compared with demographically matched healthy controls (N=17). It was found that TBI participants' recognition of basic emotions, as well as their capacity for mental state attribution, was significantly reduced relative to controls. Performance on both of these measures was strongly correlated in the healthy control, but not in the TBI sample. In contrast, in the TBI (but not the control) sample, theory of mind was substantially correlated with performance on phonemic fluency, a measure of executive functioning considered to impose particular demands upon cognitive flexibility and self-regulation. These results are consistent with other evidence indicating that deficits in some aspects of executive functioning may at least partially underlie deficits in social cognition following TBI, and thus help explain the prevalence of social dysfunction in TBI.