Social cognition

What is social cognition in PTSD?

Social cognition may be disrupted in people with PTSD. It describes the ability to understand the actions and intentions of other people; the cognitive processes underlying social interactions that are used to guide behaviour. Social cognition is crucial for effective communication and relates to social competence and may predict work functioning.

Aspects of social cognition may be altered in people with a mental illness, including theory of mind, social perception, emotion processing, emotion regulation, and empathy. Theory of mind refers to the ability to infer the mental states of other people. Social perception is an awareness of social cues and norms that dictate social interactions. Emotion processing is the ability to perceive emotional cues, such as the emotional content of facial expressions or vocal inflections (prosody). Emotion regulation is the conscious or unconscious effort to affect the likelihood, intensity, or duration of an emotion. Empathy involves showing concern for others, understanding their perspective, experiencing distress when exposed to others’ negative events, and having the ability to place oneself into fictional situations and empathically relate to the characters (‘fantasy’).

What is the evidence for social cognition in people with PTSD?

Moderate quality evidence found the emotional and affective aspects of theory of mind (but not cognitive aspects) were disturbed in people with PTSD. Most people with PTSD also exhibit altered perception of emotions, including difficulty processing threatening expressions and a reduction in the perception of positive emotions such as happiness. There were disturbances in affective empathy, from emotional resonance to compassionate feelings. Finally, social behaviour is disturbed in individuals with PTSD, which damages interactions within the family circle. Anger, impulsivity, and physical and verbal aggression underpin these difficulties.

There was a medium to large association between increased emotion regulation and increased PTSD symptoms. Small to medium-sized associations were also found with experiential avoidance, expressive suppression, rumination, thought suppression, and worry. There were no associations between reappraisal and acceptance and PTSD symptoms.

August 2021

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Last updated at: 5:59 am, 15th October 2021
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