Social behavior following traumatic brain injury and its association with emotion recognition, understanding of intentions, and cognitive flexibility

Maarten Milders, Magdalena Ietswaart, John R. Crawford, David Currie

Research output: Contribution to journalArticle

121 Citations (Scopus)


Although the adverse consequences of changes in social behavior following traumatic brain injury (TBI) are well documented, relatively little is known about possible underlying neuropsychological deficits. Following a model originally developed for social behavior deficits in schizophrenia, we investigated whether impairments in emotion recognition, understanding of other people's intentions ("theory of mind"), and cognitive flexibility soon after first TBI or 1 year later were associated with self and proxy ratings of behavior following TBI. Each of the three functions was assessed with two separate tests, and ratings of behavior were collected oil three questionnaires. Patients with TBI (n = 33) were impaired in emotion recognition, "theory of mind." and cognitive flexibility compared with matched orthopedic controls (n = 341). Proxy ratings showed increases in behavioral problems I year following injury in the TBI group but not in the control group. However, test performance was not associated with questionnaire data. Severity of the impairments in emotion recognition. understanding intention. and flexibility were unrelated to the severity of behavioral problems following TBI. These findings failed to confirm the Used model for social behavior deficits and may cast doubt on the alleged link between deficits in emotion recognition or theory of mind and social functioning.

Original languageEnglish
Pages (from-to)318-326
Number of pages9
JournalJournal of the International Neuropsychological Society
Issue number2
Early online date18 Feb 2008
Publication statusPublished - Mar 2008


  • traumatic brain injury
  • social behavior
  • emotion recognition
  • theory of mind
  • cognitive flexibility
  • follow-up
  • closed-head injury
  • psychosocial adjustment
  • ecological validity
  • executive function
  • facial expression
  • self-awareness
  • mind
  • deficits
  • impairments
  • personality

Cite this