Does impaired socioemotional functioning account for behavioral dysexecutive disorders? Evidence from a transnosological study

ABSTRACT

Behavioral dysexecutive disorders are highly prevalent in patients with neurological diseases but cannot be explained by cognitive dysexecutive impairments. In fact, the underlying mechanisms are poorly understood. Given that socioemotional functioning underlies appropriate behavior, socioemotional impairments may contribute to the appearance of behavioral disorders. To investigate this issue, we performed a transnosological study.

Seventy-five patients suffering from various neurological diseases (Alzheimer’s disease (AD), Parkinson’s disease (PD), frontotemporal lobar degeneration, and stroke) were included in the study. The patients were comprehensively assessed in terms of cognitive and behavioral dysexecutive disorders and socioemotional processes (facial emotion recognition and theory of mind). As was seen for cognitive and behavioral dysexecutive impairments, the prevalence of socioemotional impairments varied according to the diagnosis. Stepwise logistic regressions showed that (i) only cognitive executive indices predicted hypoactivity with apathy/abulia, (ii) theory of mind impairments predicted hyperactivity–distractibility–impulsivity and stereotyped/perseverative behaviors, and (iii) impaired facial emotion recognition predicted social behavior disorders. Several dysexecutive behavioral disorders are associated with an underlying impairment in socioemotional processes but not with cognitive indices of executive functioning (except for apathy). These results strongly suggest that some dysexecutive behavioral disorders are the outward signs of an underlying impairment in socioemotional processes.

KEYWORDS:

• Social cognition
• emotion recognition
• theory of mind
• neurological diseases
• behavioral disorders

Acknowledgments

This work was funded by grants from the French Ministry of Education and Research (which notably provided PN with a doctoral fellowship) and the Picardie Regional Council. The authors are grateful to the psychologists F. Fourré-Renard, A. Routier, V. Tourbier and S. Wannepain (Neurology Department, Amiens University Medical Center) for contributing to the neuropsychological testing. We thank David Fraser (Biotech Communication, Damery, France) for improving the manuscript’s English.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was funded by grants from the French Ministry of Education and Research (which notably provided PN with a doctoral fellowship) and the Picardie Regional Council.