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

Although social cognitive difficulties are common following stroke, the extent to which such difficulties observed in the acute phase are related to long-term socioemotional outcomes remains poorly understood. To address this question empirically, 53 stroke patients completed a measure of Theory of Mind (The Reading the Mind in the Eyes Test) and a cognitive flexibility measure that has been related to social cognitive processes (a Reversal Learning Task) at hospital bedside. These participants then completed measures of socioemotional functioning at a 6-month follow-up. Baseline difficulties on the two measures were found to predict distinct types of socioemotional difficulties. The RMET uniquely predicted self-reported depression and loneliness whereas the Reversal Learning task uniquely predicted peer-reported social behavior, specifically social inappropriateness and stereotyping and prejudice. Importantly, a measure of general cognitive function did not explain variance in these outcome measures, suggesting that social cognitive difficulties are linked to poor socioemotional outcomes. By showing for the first time that social cognitive deficits observed acutely post-stroke are related to longer term functional outcomes, these findings reinforce the importance of including brief social cognitive measures as part of routine post-stroke clinical assessment.