This page is closely related to the page about lack of empathy.
Non-congenital brain injury not only has major effects on the body and cognitive functioning such as memory, attention and concentration. On top of that patients with brain injury may also show behavioral changes. In addition, they can show behaviour that is inappropriate in a social context. These changes are related to disorders in social cognition.
Social cognition consists of cognitive processes that are involved in understanding social situations and other people.
With social cognition we can predict the behavior of others, we exchange experiences and we communicate effectively with our environment.
It includes cognitive processes that are necessary to observe, process, understand and respond to social information. Social cognition is therefore an important basis for social functioning.
Possible disorders in social cognition after brain injury
Recognizing facial expressions (expressing emotions) is one of the most studied domains of social cognition. It has been repeatedly demonstrated that many brain injured have limitations in recognizing and labeling emotional facial expressions. The main constraints are seen in recognizing the emotions of fear, anger and sadness. Being able to sympathize with someone else is also a capacity in which limitations are often seen. Many people with brain injury have a little more difficulty understanding and predicting the mental state of another person based on feelings and behavior.
An example: a person withdraws and looks sad. A person with Non-Congenital Brain Injury with Social Cognition Injury will not so easily recognize that this person is sad and therefore will not be inclined to ask what is going on. Because of this it seems that this person is not interested in the other, while in reality it is different; they don't know what's going on. By the way, every injury and every person is different.
The above capabilities are very important aspects for being able to maintain social relationships. Disorders in this area are accompanied by a more difficult social life. These disorders (and therefore changes in behavior) ultimately mean that many people with brain injuries are less or less able to maintain their friendships, lose their work and therefore cannot easily reintegrate into society.
These negative consequences can then also lead to the breaking of friendships and intimate relationships, unemployment and ultimately to gradual social isolation. Social isolation can cause people affected by brain injury to develop psychiatric illnesses such as depression and anxiety.
For family members of people with brain injury these behavioral changes are often a greater burden than physical or cognitive disorders. Family members often report changes in personality and behavior (for example socially inappropriate behavior), childishness, disinterest in others and self-centeredness.
Dealing with these changes is very difficult, especially since the relatives often do not know what causes these changes and how to deal with them.
Parts of the brain
Brain areas known as "the social brain" are primarily associated with frontal and temporal, (sub) cortical areas. Cortical areas are located in the cerebral cortex.
Subcortical areas are below the cerebral cortex.
Although each injury differs per location and in severity and complaints, there are certain areas of the brain that are particularly vulnerable to (traumatic) brain injury, including the frontal and temporal areas of the brain.
The interpretation of facial expressions is among others linked to the following brain areas:
- Posterior Superior Temporal Sulcus (PSTs), a sulcus in the temporal lobe,
- Occipito-temporal cortex,
- Orbitofrontal cortex,
- The limbic system,
- The basal ganglia.
Understanding the mental state of another and empathic ability is linked to the prefrontal cortex, the area located at the front of the brain.
See also our page lack of empathy.
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