The relationship between social cognition and participation in the long term after stroke

ABSTRACT

Social cognitive impairments may play a role in participation restrictions after stroke. Understanding their relationship could inform treatment approaches to improve participation. We investigated the relationship between social cognition and participation in the long term after stroke. Of 395 patients participating in a large prospective cohort study, cross-sectional data were available at 3–4 years post-stroke of 118 patients on tests for emotion recognition, theory of mind, empathy, and behaviour regulation. Participation was assessed with the Utrecht Scale for Evaluation of Rehabilitation – Participation (USER-P). Bivariate and multivariate regression analysis were used to examine the relationship between social cognitive domains and participation. The majority suffered from minor stroke (83.1% scored NIHSS 0–4). Only behaviour regulation was related to participation restrictions in bivariate analysis, but social cognitive impairments did not predict participation restrictions in multivariate regression in this group. To conclude, in a sample of minor stroke patients with mild impairments in theory of mind, emotion recognition and behavioural control, there were no associations with restrictions in participation. Research should examine whether a relationship is present in patients with more severe stroke. In addition, measuring social aspects of participation is necessary to further unravel this relationship, to determine treatment targets for improving participation.

KEYWORDS:

• Brain injury
• Theory of mind
• Empathy
• Emotion recognition
• Participation

Acknowledgement

We would like to thank Charlotte Southcombe for proofreading and correcting our manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Raw data were generated at six hospitals in the Netherlands. Derived data supporting the findings of this study are available from the corresponding author (CvH) on request.

Additional information

Funding

The Restore4Stroke study was funded by the VSBfonds (the Dutch Organization to support Dutch society with money, knowledge and networks; grant number 89000004), and coordinated by ZonMw (Dutch Organization for Health Research and Development).