Social cognition governs appropriate social interactions and is involved in accurately processing interpersonal cues.
Much of our daily decisions, routines, and actions are governed by social factors. For example, we feel guilty when we have hurt someone’s feelings and quickly act to restore our erroneous actions. We may purchase a cup of coffee for our colleague when we know they are having a bad day. We may stop and console someone who just fell down the stairs and are in pain. Collectively, the ability to form and sustain interpersonal relationships, and thus interact with others in a socially acceptable manner, is governed by social cognition. Social cognition encompasses the cognitive functions that govern appropriate social interactions and the ability to accurately process interpersonal cues. Social cognition is often evaluated in reference to the ability to recognize emotions and one’s capacity for empathy. Emotion recognition refers to the ability to accurately infer the emotions of another individual through various modalities including facial expressions or nonverbal vocal cues. Additionally, empathy has been suggested to include two separate but related components: cognitive and emotional empathy. Cognitive empathy, or theory of mind, involves inferring another’s mental state, and emotional empathy refers to the capacity to experience an emotional reaction in response to another’s experience (Shamay-Tsoory 2011). Evidence for these two distinct but related components of empathy has been strongly suggested through neuroimaging studies showing dissociable underlying brain regions (see Marsh (2018) for an in-depth review) and clinical populations that feature selective dysfunction in one of the constructs.
Humans are inevitable social creatures, and thus, the ability to appropriately guide one’s behaviors and decisions in a socially appropriate manner is vital. Deficits in recognizing other’s emotions or responding to other’s emotions can lead to detrimental social functioning. This entry will provide a brief overview of the importance of social cognition and examine how social cognitive functioning is impacted in different clinical populations. As social cognitive abilities govern how social and emotional information is processed and represented, impairments in these abilities may in turn present with abnormal social behaviors.
The Importance of Social Cognition
Defects in one or more domains of social cognition can present clinically in many ways. For example, it may present as a disregard for others’ distress or losses, lack of interest in social activities, failure to understand jokes or sarcasm, and failure to process social cues such as anger or embarrassment (Henry et al. 2016). Ultimately, impairments in social cognition can critically alter one’s social behavior which governs capabilities to form and maintain social connections. Furthermore, social connections and social support are vital protective factors for many mental health problems.
Emotional facial expressions serve a communicatory function, eliciting information from the communicator (the creator of the expression) to the observer (e.g., the one to provoke the expression; Blair 2003). Specifically, expressions of fear, sadness, and happiness modulate the probability that the actions that caused the display of the emotions will be displayed again (Blair 2003). Whereas fearfulness and sadness discourage the associated actions, happiness increases the probability of the occurrence of the action. Disgusted expressions signal aversive information but often pertaining to food or taste. Furthermore, expressions of anger or embarrassment modulate current behaviors or actions, especially in social situations involving hierarchy interactions (e.g., a situation between a teacher and a student). Thus, the inability to appropriately and accurately recognize and process emotional facial expressions could potentially lead to failures in developing and maintaining healthy social relationships. In fact, poor emotion recognition abilities are related to lower quality of life (Phillips et al. 2010). Deficits in recognizing distress cues including fear and sadness are associated with the presence of antisocial behavior (Marsh and Blair 2008). In neurodegenerative diseases, emotion recognition impairment is associated with caregiver depression (Brown et al. 2018). In contrast, the ability to recognize emotions accurately has been associated with engagement of prosocial behavior (Marsh et al. 2007) and relationship well-being in adulthood (Carton et al. 1999). Overall, accurately recognizing emotions serve as a vital component to our everyday social functioning and forming and maintaining appropriate interpersonal relationships.
As with emotion recognition, empathy is important to social functioning and the engagement of appropriate social behavior. Impaired theory of mind abilities (cognitive empathy) are related to smaller social networks (Stiller and Dunbar 2007) and poorer social competence (Brune et al. 2007). Callous and unemotional (CU) traits, a marker used to gauge deficient emotional empathy, predicts poorer peer functioning (Haas et al. 2018) and higher rates of violent recidivism (i.e., re-offending in incarcerated individuals after release; Hart et al. 1988). CU traits in children and adolescents are significantly associated with measures of antisocial and aggressive behavior, even after controlling for level of aggression and conduct problem severity (Frick et al. 2014); hence, levels of CU traits seem to be uniquely vital in predicting the occurrence of aggressive behaviors.
How Is Social Cognition Measured?
The appropriate and accurate assessment of social cognitive abilities is quite important as these abilities are disrupted in certain neuropsychiatric, developmental, and neurodegenerative disorders. The importance of social cognitive abilities can be exemplified by the most recent version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (American Psychiatric Association 2013), which has included social cognition as a cognitive domain of neurocognitive disorders. The objective and valid ascertainment of these abilities is crucial. This section will provide a brief overview of the types of tasks used to assess social cognition (see Henry et al. (2016) for an in-depth review of the various measures used to assess social cognition).
The DSM-5 has recognized performance on emotion recognition tasks as an example of social cognitive abilities (American Psychiatric Association 2013). Emotion recognition tasks often employ the universal emotions including sadness, happiness, fear, disgust, anger, and surprise; however, some researchers have incorporated other emotions such as embarrassment, pride, shame, and guilt. Typically, these tasks display static pictures of actors displaying emotional faces, and the participants are instructed to select the emotional label that best describes the emotion being portrayed. Other variants of emotion recognition tasks may present dynamic stimuli (e.g., actor creating an emotional face from a neutral face), video clips, or virtual images of actors. Furthermore, emotion recognition tasks can be graded in difficulty by presenting participants with emotional faces of varying emotional intensity. Specifically, pictures of the actor’s emotional face are morphed with their corresponding neutral face to create different emotional intensities (e.g., 100% would correspond to the actor’s emotional face, where 90% would be a morph of the actor’s emotional face with 10% of their neutral face). Importantly, these techniques make the task more challenging, which increases the sensitivity of these tasks to detect subtle differences in performance between populations. Emotion recognition tasks can extend beyond faces and involve other modalities including nonverbal vocal cues (e.g., laughing for happiness or a scream for fear) or require participants to identify the emotional prosody from speech. Though, emotion recognition from facial stimuli seems to be the most common mechanism for testing emotion recognition abilities. Importantly, the assessment of emotion recognition does not only require participants to depict the appropriate emotion, but it also requires other intact cognitive processing including language and face-processing abilities. Control tasks can be utilized to ensure that participants do not have any deficits that may better encapsulate their emotion recognition performance. For example, to assess visuo-perceptual abilities, researchers may use a face identity matching task whereby the participant’s goal is to match the identity of a target face with the appropriate face from an array of distractors. Poor performance on this task would suggest dysfunctional visuo-perceptual abilities, which may interfere with emotion recognition tasks involving faces. Ultimately, using control tasks is critical in the assessment of social cognition, especially in disorders that feature various impairments.
Both cognitive and emotional empathy can be assessed through questionnaire and task-based assessments. Questionnaires tapping into emotional empathy may involve directly asking the individual (self-report) or an informant (informant-report), the degree to which the person experiences compassion or concern for another individual. In contrast, questionnaires measuring cognitive empathy may ask for ratings of abilities to understand and predict other people’s behaviors (Henry et al. 2016). Although self-report measures may seem appealing, as it may be suggested that the individual themselves will more accurately report the degree of cognitive and emotional empathy, informant ratings may be more important in some instances (Henry et al. 2016). Specifically, self-report measures necessitate that the participant has sufficient insight into their behavior and emotional processing abilities, a feature that is sometimes absent in some neurodegenerative disorders. Furthermore, self-report measures require that participants are willing to disclose personal information. Therefore, in most instances, both self-report and informant-report measures are warranted.
Cognitive and emotional empathy can also be measured with task-based measures; these may offer an opportunity to assess “online” empathizing abilities. The majority of measures tapping into cognitive empathy require the participant to infer the mental states and thoughts of a protagonist in a story/picture sequence. Specifically, the participant is instructed to follow a story and then interpret the character’s behaviors and identify and understand false beliefs, sarcasm, irony, or humor. In contrast, emotional empathy tasks require the participant to describe what they feel toward the protagonist in the story/picture sequence and indicate the level of emotional intensity or emotional arousal. Levels of arousal can also be evaluated through acquiring physiological measures including skin conductance or heart rate. Although task-based measurements may be less susceptible to participants responding in a socially desirable way – a concern in questionnaire measures – they often rely on intact language and executive functioning, which may be problematic in some disorders that specifically interfere with language skills, or when the disorder has progressed too far. Control tasks may be utilized to help identify possible confounds including poorer cognitive skills, which may account for cognitive empathy abilities.
Based on the current literature on assessments of social cognitive performance, Henry et al. (2016) developed a preliminary algorithm for the evaluation and treatment of social cognitive impairments in clinical populations. When social cognitive deficits are suspected through history and current presentation, it is recommended that an assessment using reliable and clinically validated measures is completed to ascertain the specific social cognitive deficit, such that a more comprehensive evaluation focusing on the domains in question can be conducted (for a detailed overview of validated measures, see Henry et al. (2016)). When available, test performance should be interpreted in relation to population norms. Notably, the availability of norms for many measures is limited, increasing the difficulty of interpreting performance in these tasks. Next, identifying whether the social cognitive impairments reflect the primary impairment or is the consequence of other neurocognitive dysfunction is critical and can be ascertained through appropriate control tasks. Once the social cognitive deficit is identified as the primary or secondary impairment, appropriate interventions can be directed to the appropriate cognitive system. There has been much progress on developing treatments targeting social cognitive deficits, and this continues to be an active area of research and development. For example, recent work is investigating the role of oxytocin in modulating social behavior including empathy and emotion recognition in developmental disorders (Yamasue and Domes 2018) and in neurodegenerative diseases (Finger et al. 2018). Furthermore, modulating attention to critical regions of the face has been shown to enhance recognition of fear (Dadds et al. 2006), which is often poorly recognized in individuals with psychopathic traits or in individuals with damage to the amygdala. Following treatment, performance on social cognitive tasks and importantly social functioning including quality of life, employment, social relationships, and social behavior should be evaluated.
Clinical Disorders Featuring Impaired Social Cognition
Psychopathy is a developmental disorder characterized by the engagement in antisocial behaviors and pronounced emotional processing impairments including a reduction in feelings of guilt, remorse, and empathy. Although there is some overlap in symptomology, psychopathy is not equivalent to antisocial behavioral disorders, which only focuses on the presence of antisocial behaviors. Importantly, a subgroup of individuals with antisocial behavioral disorders including conduct disorder, oppositional defiant disorder, and antisocial personality disorder display the classic emotional impairments evident in psychopathy, namely, the CU traits, a marker of reduced emotional empathy (Blair 2013). The identification of this subgroup may have important clinical implications as they are at a higher risk for more persistent and severe antisocial behaviors and show a different response to treatments (see Frick et al. (2014) for an in-depth review). In light of these research findings, the DSM-5 has incorporated a “limited prosocial emotions” specifier for the diagnosis of conduct disorder, to assist clinicians in identifying this subgroup (American Psychiatric Association 2013).
It is well established that relative to healthy controls, individuals with disruptive behaviors and CU traits are less likely to respond, attend, or accurately recognize emotional stimuli that express distress (Viding and McCrory 2018). In a meta-analysis of emotion recognition abilities in individuals with psychopathic traits and individuals who exhibited only antisocial behaviors (20 studies), it was found that relative to controls, this sample of individuals experienced deficits in recognizing fearful and sad expressions (Marsh and Blair 2008). Another meta-analysis assessing exclusively individuals with psychopathic traits (22 studies) revealed a small significant association between psychopathy and recognition deficits across all emotions (i.e., fear, sadness, anger, surprise, disgust, and happiness), with the largest associations found for fear and sadness (Wilson et al. 2011). Specifically, youth with psychopathic traits have been found to show a selective impairment for recognizing fearful (Blair et al. 2004) and sad emotional faces (Blair et al. 2001) and vocal tones (Stevens et al. 2001). When presented with facial emotional expressions that were displayed in increasing emotional intensity, children with psychopathic traits required greater emotional intensity before they could accurately recognize sadness. Furthermore, even when the fearful faces were presented at 100% intensity, youth with psychopathic traits were more likely to make recognition errors relative to healthy controls. It has been suggested that healthy individuals avoid engaging in antisocial behavior due to the aversive nature of the victim’s distress (i.e., fear and sad facial expressions); however, when the recognition of these distress cues is disrupted as in individuals with psychopathic traits, these cues are not considered aversive. Hence, individuals with psychopathic traits may not avoid engaging in antisocial behavior due to the lower aversiveness emanated by these social cues (Blair et al. 2004).
Individuals with psychopathic traits show deficits in emotional empathy but have preserved cognitive empathy abilities. For example, individuals with psychopathic traits can successfully identify higher-level mental states from photographs of the eye regions of faces (Richell et al. 2003) and successfully recognized first-order false belief (i.e., what another person might mistakenly think) and second-order false belief (i.e., what one person mistakenly thinks another person thinks; Jones et al. 2010). Furthermore, psychopathic traits are not related to performance on tasks requiring perspective-taking (Lockwood et al. 2013). With respect to emotional empathy, psychopathy is associated with atypical vicarious experience in response to the distress of others (Lockwood 2016). For example, relative to healthy controls, youth with psychopathic traits show reduced skin conductance response to distress and threatening stimuli (Blair 1999). Furthermore, youth with psychopathic traits report reduced physiological responses during fear-evoking situations, relative to healthy controls; this group difference was only found for fear and not for other emotions. Additionally, the youth with psychopathic traits report to feel fear less strongly and less often relative to controls (Marsh et al. 2011). Overall, there is an abundance of evidence suggesting that individuals with psychopathic traits show selective impairments in empathy abilities whereby their cognitive empathy – the ability to infer mental states and take the perspective of another individual – is intact; however, crucially, their ability to resonate with other’s feelings is disrupted.
Autism Spectrum Disorder
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication/interaction and the engagement in restricted or repetitive types of behaviors and interests. These symptoms are present during childhood and cause a clinically significant impairment in everyday functioning. Importantly, these symptoms are not better explained by intellectual disability or global developmental delay (American Psychiatric Association 2013). With respect to the social communication/interaction domain, symptoms may present as impairments in social-emotional reciprocity (e.g., lack of social engagement and sharing of thoughts and feelings), deficits in nonverbal communication used in social interactions (e.g., absent or reduced eye contact), and difficulty developing and maintaining social relationships (e.g., reduced social interest). Additionally, symptoms for restricted, repetitive patterns of behaviors may present behaviorally as inflexible adherence to changes in routines, engaging in repetitive motor movements, having highly intense and focused interests, and abnormal sensitivity to sensory inputs (American Psychiatric Association 2013).
A meta-analysis including over 932 participants (48 studies) reported that individuals with ASD showed an overall emotion recognition deficit (Cohen’s d = 0.80) relative to healthy controls. Interestingly, age and IQ did not have a significant effect on these results. When individual emotions were examined, patients showed deficits in recognizing all emotions with the exception of happiness which was marginally impaired (Uljarevic and Hamilton 2013). In line with these results, a more recent meta-analysis of 1545 participants (43 studies) found a general emotion recognition deficit in the ASD group relative to healthy controls. The recognition deficits were not limited to one emotion specifically; but were found for fear, surprise, and anger following conservative statistical corrections for multiple comparisons; recognition impairments for happiness, sadness, and disgust did not remain significant following these corrections (Lozier et al. 2014). Overall, these meta-analyses suggest that individuals with ASD are impaired in recognizing emotional facial expressions, with some variability regarding which specific emotions are impaired. This variability may speak to the importance of methodological considerations. For example, as reviewed in Blair (2003), when children with ASD and healthy controls are matched on mental age, children with ASD are often found to be unimpaired in facial emotion recognition tasks. Though, other studies have found that when IQ is not a confounder, individuals with ASD continue to show impairments in affect recognition (Sucksmith et al. 2013). Overall, there seems to be variability in the literature regarding the influence of potential confounders on emotion recognition abilities and should be taken into consideration for future studies.
Individuals with ASD demonstrate impaired cognitive empathy but intact emotional empathy [see review Blair (2005)]. In a task-based measure where participants are shown an emotional picture (e.g., individual falling down and getting injured), individuals with ASD perform worse relative to controls when asked to deduce the mental state of the character but perform normally when they were asked to rate how concerned/happy they personally feel for the character in the picture (explicit measure) or their personal ratings of arousal (implicit measure) (Dziobek et al. 2008). In a community sample, Lockwood (2016) found that ASD traits were associated with difficulty in a cognitive perspective-taking task, but not resonating with other’s emotions (emotional empathy). Additionally, autistic traits are associated with deficits in identifying the mental states from photographs of the eye regions of face (Baron-Cohen et al. 2001). Overall, individuals with ASD show a dissociation in cognitive and emotional empathy, which is in direct contrast with individuals with psychopathic traits who show opposing pattern of deficits.
Frontotemporal dementia (FTD) is a highly hereditary neurodegenerative disorder and is often diagnosed at approximately 45–65 years of age. There are three clinical syndromes, with each presenting a unique pattern of atrophy and clinical symptomology: behavioral variant (bvFTD) and two types of primary progressive aphasias (PPA), semantic variant (svPPA) and nonfluent-agrammatic (nfvPPA).
bvFTD is the most common syndrome and presents clinically by a loss of social mannerism (e.g., burping in public or making rude comments), engagement of impulsive actions (e.g., spending recklessly), and diminished response to other’s needs. Furthermore, patients may engage in perseverative behaviors such as making repetitive movements and dietary changes including increased consumptions of carbohydrates and sweets. Individuals with bvFTD are classified with possible bvFTD if they meet the behavioral symptoms, probable bvFTD if they additionally show neuroimaging evidence of involvement of the frontal and/or temporal lobes, or bvFTD with definite frontotemporal lobar degeneration (FLTD) pathology if there is either the presence of a pathogenic mutation or evidence of FTD-related pathology (Rascovsky et al. 2011). With regard to the other subtypes, the classical symptom of svPPA includes loss of word meaning and anomia. Patients may experience difficulty naming objects, especially for low-frequency words, and may present with surface dyslexia or dysgraphia. Lastly, patients with nfvPPA demonstrate intact object knowledge but present with effortful and halting speech. Patients present with agrammatism, demonstrated by the omission of functional words, and apraxia of speech which results in sound errors and articulation planning deficits (Gorno-Tempini et al. 2011).
The challenges in diagnosing patients early and accurately are well acknowledged, especially bvFTD given the insidious nature of the behavioral symptoms. Additionally, as there is much overlap between FTD and other neurodegenerative or psychiatric disorders, many patients are initially misdiagnosed. Relatedly, research is being conducted to establish and validate social cognitive tests to help differentiate between FTD and other-related disorders and increase diagnostic accuracy.
Patients with FTD show deficits in recognizing emotions from a variety of modalities including facial expressions and nonverbal vocalizations (Hsieh et al. 2013). Although cognitive domains including language, attention, and perceptual abilities contribute to emotion recognition performance, visuo-perceptual processing is often intact, and cognitive impairments alone do not adequately account for emotion recognition deficits (Kumfor and Piguet 2012). Although emotion recognition impairments have been found across all syndromes, with more milder impairments in nfvPPA (Kumfor and Piguet 2012), it is important to note that fewer studies have investigated emotion recognition performance in svPPA and nfvPPA relative to the bvFTD subtype (Kumfor and Piguet 2012). Assessing recognition performance across all subtypes is critical as it has been suggested that some syndromes benefit from enhanced emotional intensity to facilitate emotion recognition performance (Kumfor et al. 2011).
In a recent meta-analysis comparing 288 patients with bvFTD and 329 healthy controls (18 studies), patients performed more poorly relative to controls across all emotions, with severe impairments for negative emotions (Cohen’s d = 1.24), especially for anger (d = 1.48) and disgust (d = 1.41; Bora et al. 2016). Additionally, there was a modest impairment for recognition of happiness. In general, patients are found to be impaired in recognizing negative emotions, with some variability regarding the specific emotion impaired, whereas deficits for recognizing positive emotions such as happiness are rather inconsistent. Importantly, when multiple positive emotions are included, patients with bvFTD show impaired recognition, suggesting that some of the inconsistent findings may be the result from limited number of positive emotions included in tasks (Goodkind et al. 2015). Patients with bvFTD show more severe emotion recognition impairments relative to Alzheimer’s Disease (d = 1.23). These impairments include negative emotions (d = 0.75) including disgust, anger, and fear, but not happiness (d = 0.13). Importantly, scores on tests of general cognition, age, and gender do not contribute to these group differences (Bora et al. 2016).
The evidence briefly reviewed above suggests that patients with FTD show marked impairments in recognizing emotions, particularly for negative emotions. More research on the different subtypes of FTD is warranted to identify specific patterns of deficits, especially within the PPA subtypes. Additionally, longitudinal studies evaluating emotion recognition abilities over time are also needed to better understand the progressive nature of FTD on these skills.
Reduced empathy is a hallmark symptom in bvFTD but can present in the other FTD subtypes depending on the brain regions impaired during the progression of the disease. Through questionnaire measures, caregivers report that patients with bvFTD show reduce ratings of cognitive and emotional empathy relative to controls; however, patients’ self-report do not yield these differences (Eslinger et al. 2011). This contrast highlights the importance of utilizing both caregiver and self-report measures in clinical populations to obtain a well-rounded understanding of the empathy deficits. In a meta-analysis of cognitive empathy performance of 334 patients with bvFTD (18 studies), patients were significantly impaired in cognitive empathy tasks relative to healthy controls (d = 1.79), with the greatest impairment identified in tasks requiring the detection of faux pas, sarcasm, and mental states from pictures of the eyes (Bora et al. 2015). Importantly, longer disease duration was associated with greater cognitive empathy deficits. Furthermore, in a meta-analytic comparison of 228 patients with bvFTD and 229 patients with Alzheimer’s disease (13 studies), bvFTD were greatly impaired. This difference remained, even when matched on general cognition and disease duration. In task-based measurements of cognitive empathy, patients with FTD demonstrate difficulties in identifying mental states from photographs of eye regions in a face relative to healthy controls (Couto et al. 2013). Additionally, when presented with a story of characters in social situations, patients with FTD are impaired at interpreting the belief and intentions of the protagonists (Eslinger et al. 2007). Interestingly, theory of mind impairments are found in patients with intact executive functioning and general neuropsychological functioning (Lough et al. 2001).
Although most of the literature focusing on task-based assessments have focused on cognitive empathy abilities, one study parsing emotional and cognitive empathy utilizing task-based assessments found deficits in both emotional and cognitive empathy in patients with bvFTD (Oliver et al. 2015). Furthermore, a recent meta-analysis focusing solely on emotional empathy in 281 bvFTD patients (10 studies) found a moderate effect size (d = 0.98) of impaired performance across an array of emotional empathy tasks (questionnaires and task-based) relative to controls (Carr and Mendez 2018). Considering the debilitating consequences of impairments in empathy, current work is exploring the use of oxytocin for the symptomatic treatment of deficits in emotional empathy and other aspects of social cognition (Finger et al. 2018) in FTD.
Overall, patients with FTD demonstrate impairments in both cognitive and emotional empathy utilizing task-based assessments and questionnaire measures. Although the majority of studies have focused on cognitive empathy abilities, some work has examined emotional empathy. Given the apparent discrepancy between caregiver and patient self-reported questionnaires, more work assessing emotional empathy utilizing task-based assessments is warranted.
The current entry provided a brief overview of the importance of social cognition and methods of assessments. Furthermore, this entry also described how social cognitive domains are influenced differentially in three distinct clinical populations. Importantly, regardless of the social cognitive domain impaired, deficits in social cognition can impair social functioning and the ability to form and sustain interpersonal relationships. A thorough account of the social cognitive impairments is important to identify whether these impairments are the primary disturbance, or whether they are secondary to other cognitive deficits or brain insults. Research is actively assessing potential treatments and interventions targeting social cognitive deficits.
- Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” Test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241–251.CrossRefGoogle Scholar
- Blair, R. J., Mitchell, D. G. V., Peschardt, K. S., Colledge, E., Leonard, R. A., Shine, J. H., et al. (2004). Reduced sensitivity to others’ fearful expressions in psychopathic individuals. Personality and Individual Differences, 37(6), 1111–1122. https://doi.org/10.1016/j.paid.2003.10.008.CrossRefGoogle Scholar
- Bora, E., Velakoulis, D., & Walterfang, M. (2016). Meta-Analysis of Facial Emotion Recognition in Behavioral Variant Frontotemporal Dementia: Comparison With Alzheimer Disease and Healthy Controls. Journal of Geriatric Psychiatry and Neurology, 29(4), 205–211. https://doi.org/10.1177/0891988716640375.CrossRefPubMedGoogle Scholar
- Brown, C. L., Lwi, S. J., Goodkind, M. S., Rankin, K. P., Merrilees, J., Miller, B. L., & Levenson, R. W. (2018). Empathic Accuracy Deficits in Patients with Neurodegenerative Disease: Association with Caregiver Depression. The American Journal of Geriatric Psychiatry, 26(4), 484–493. https://doi.org/10.1016/j.jagp.2017.10.012.CrossRefPubMedGoogle Scholar
- Brune, M., Abdel-Hamid, M., Lehmkamper, C., & Sonntag, C. (2007). Mental state attribution, neurocognitive functioning, and psychopathology: What predicts poor social competence in schizophrenia best? Schizophrenia Research, 92(1–3), 151–159. https://doi.org/10.1016/j.schres.2007.01.006.CrossRefPubMedGoogle Scholar
- Couto, B., Manes, F., Montanes, P., Matallana, D., Reyes, P., Velasquez, M., et al. (2013). Structural neuroimaging of social cognition in progressive non-fluent aphasia and behavioral variant of frontotemporal dementia. Frontiers in Human Neuroscience, 7, 467. https://doi.org/10.3389/fnhum.2013.00467.CrossRefPubMedPubMedCentralGoogle Scholar
- Dziobek, I., Rogers, K., Fleck, S., Bahnemann, M., Heekeren, H. R., Wolf, O. T., & Convit, A. (2008). Dissociation of cognitive and emotional empathy in adults with Asperger syndrome using the Multifaceted Empathy Test (MET). Journal of Autism and Developmental Disorders, 38(3), 464–473. https://doi.org/10.1007/s10803-007-0486-x.CrossRefPubMedGoogle Scholar
- Eslinger, P. J., Moore, P., Troiani, V., Antani, S., Cross, K., Kwok, S., & Grossman, M. (2007). Oops! Resolving social dilemmas in frontotemporal dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 78(5), 457–460. https://doi.org/10.1136/jnnp.2006.098228.CrossRefPubMedPubMedCentralGoogle Scholar
- Eslinger, P. J., Moore, P., Anderson, C., & Grossman, M. (2011). Social cognition, executive functioning, and neuroimaging correlates of empathic deficits in frontotemporal dementia. The Journal of Neuropsychiatry and Clinical Neurosciences, 23(1), 74–82. https://doi.org/10.1176/appi.neuropsych.23.1.74, https://doi.org/10.1176/jnp.23.1.jnp74.
- Finger, E., Berry, S., Cummings, J., Coleman, K., Hsiung, R., Feldman, H. H., & Boxer, A. (2018). Adaptive crossover designs for assessment of symptomatic treatments targeting behaviour in neurodegenerative disease: A phase 2 clinical trial of intranasal oxytocin for frontotemporal dementia (FOXY). Alzheimer’s Research & Therapy, 10(1), 102. https://doi.org/10.1186/s13195-018-0427-2.CrossRefGoogle Scholar
- Frick, P. J., Ray, J. V., Thornton, L. C., & Kahn, R. E. (2014). Can callous-unemotional traits enhance the understanding, diagnosis, and treatment of serious conduct problems in children and adolescents? A comprehensive review. Psychological Bulletin, 140(1), 1–57. https://doi.org/10.1037/a0033076.CrossRefPubMedGoogle Scholar
- Goodkind, M. S., Sturm, V. E., Ascher, E. A., Shdo, S. M., Miller, B. L., Rankin, K. P., & Levenson, R. W. (2015). Emotion recognition in frontotemporal dementia and Alzheimer’s disease: A new film-based assessment. Emotion, 15(4), 416–427. https://doi.org/10.1037/a0039261.CrossRefPubMedPubMedCentralGoogle Scholar
- Jones, A. P., Happe, F. G., Gilbert, F., Burnett, S., & Viding, E. (2010). Feeling, caring, knowing: Different types of empathy deficit in boys with psychopathic tendencies and autism spectrum disorder. Journal of Child Psychology and Psychiatry, 51(11), 1188–1197. https://doi.org/10.1111/j.1469-7610.2010.02280.x.CrossRefPubMedGoogle Scholar
- Kumfor, F., Miller, L., Lah, S., Hsieh, S., Savage, S., Hodges, J. R., & Piguet, O. (2011). Are you really angry? The effect of intensity on facial emotion recognition in frontotemporal dementia. Social Neuroscience, 6(5–6), 502–514. https://doi.org/10.1080/17470919.2011.620779.CrossRefPubMedGoogle Scholar
- Lockwood, P. L., Bird, G., Bridge, M., & Viding, E. (2013). Dissecting empathy: High levels of psychopathic and autistic traits are characterized by difficulties in different social information processing domains. Frontiers in Human Neuroscience, 7, 760. https://doi.org/10.3389/fnhum.2013.00760.CrossRefPubMedPubMedCentralGoogle Scholar
- Marsh, A. A., Finger, E. C., Schechter, J. C., Jurkowitz, I. T., Reid, M. E., & Blair, R. J. (2011). Adolescents with psychopathic traits report reductions in physiological responses to fear. Journal of Child Psychology and Psychiatry, 52(8), 834–841. https://doi.org/10.1111/j.1469-7610.2010.02353.x.CrossRefPubMedGoogle Scholar
- Oliver, L. D., Mitchell, D. G., Dziobek, I., MacKinley, J., Coleman, K., Rankin, K. P., & Finger, E. C. (2015). Parsing cognitive and emotional empathy deficits for negative and positive stimuli in frontotemporal dementia. Neuropsychologia, 67, 14–26. https://doi.org/10.1016/j.neuropsychologia.2014.11.022.CrossRefPubMedGoogle Scholar
- Rascovsky, K., Hodges, J. R., Knopman, D., Mendez, M. F., Kramer, J. H., Neuhaus, J., et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134(Pt 9), 2456–2477. https://doi.org/10.1093/brain/awr179.CrossRefPubMedPubMedCentralGoogle Scholar
- Sucksmith, E., Allison, C., Baron-Cohen, S., Chakrabarti, B., & Hoekstra, R. A. (2013). Empathy and emotion recognition in people with autism, first-degree relatives, and controls. Neuropsychologia, 51(1), 98–105. https://doi.org/10.1016/j.neuropsychologia.2012.11.013.CrossRefPubMedGoogle Scholar