Relationship between Social Cognition and Depressive Symptomatology, Anxiety and Social Functioning in Individuals with Multiple Sclerosis
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1 Relationship between Social Cognition and Depressive Symptomatology, Anxiety and Social Functioning in Individuals with Multiple Sclerosis Helen M. Genova, Ph.D. Senior Research Scientist Kessler Foundation West Orange, New Jersey, USA Associate Professor, Department of Physical Medicine & Rehabilitation Rutgers, New Jersey Medical School Newark, New Jersey, USA
2 Disclosures Pilot funding by the Consortium of MS Centers
3 Outline What is social cognition and how it is assessed? Social cognition deficits in MS Examining the relationship between social cognition and depressive symptoms, anxiety and social functioning Future Directions
4 What is Social Cognition? Abilities related to how we process social and emotional information Stimulus Processing Social Behavior Happy Smile Back
5 Types of Social Cognition Emotional Processing Facial Affect Recognition Emotional Prosody Recognition Theory of Mind Empathy * *
6 Facial Affect Recognition Anger Fear Disgust Surprise Happy Sad
7 Assessment of Facial Affect Recognition
8 Theory of Mind The ability to understand the thoughts, beliefs, inferences of others, even when they may differ from one s own Putting yourself in someone else s shoes
9 Theory of Mind Assessments Verbal tasks Strange Stories (Happe, 1994) Faux Pas (Stone et al., 2002)
10 Verbal Tasks of ToM Strange Stories (Happe, 1994) Helen knew at Christmas she could ask her parents for a rabbit. Helen wanted a rabbit more than anything... Christmas Day arrived, and Helen ran to unwrap the box her parents had given her. She felt sure it would contain a little rabbit... But when she opened it, with all the family standing round, she found her present was just a boring old set of encyclopedias, which Helen did not want at all! Still, when Helen s parents asked her how she liked her Christmas present, she said, It s lovely, thank you. It s just what I wanted. Why did Helen say this?
11 Theory of Mind Assessments Verbal tasks Strange Stories (Happe, 1994) Faux Pas (Stone et al., 2002) Visual Tests Reading the Mind in the Eyes Task (Baron-Cohen, 2001)
12 terrified arrogant upset annoyed
13 annoyed horrified hostile preoccupied
14 Assessments Verbal tasks Theory of Mind Strange Stories (Happe, 1994) Faux Pas (Stone et al., 2002) Visual Tests Reading the Mind in the Eyes Task (Baron-Cohen, 2001) Other tests Video based tests Comic strips
15 Outline What is social cognition and how it is assessed? Social cognition deficits in MS Examining the relationship between social cognition and depressive symptoms, anxiety and social functioning Future Directions
16 6 Social Cognition Articles in MS
17
18 Social Cognition Deficits in MS Cotter et al., Neurology (2016)
19 Importance in MS Social Cognition Deficits may lead to: Shrinking social network Reduced employment Difficulties with family and social interpersonal communication Reduction in quality of life Depression and anxiety Reduced social functioning HOWEVER, VERY FEW STUDIES HAVE EXAMINED THIS TOPIC
20 Outline What is social cognition and how it is assessed? Social cognition deficits in MS Examining the relationship between social cognition and depressive symptoms, anxiety and social functioning Future Directions
21 Current Study Examining the relationship between social cognition: Depressive symptoms Anxiety Social functioning
22 Methods Participants: 28 individuals with MS Experiment: Subjects completed a battery of tests and questionnaires Social Cognition (Facial Emotion Identification Tast; Reading Mind in the Eyes, Strange Stories) Depression (Beck Depression Inventory-II) Anxiety (State-Trait Anxiety Scale) Social Functioning (Modified Fatigue Impact Scale- Psychosocial Fatigue subscale)
23 Demographics Range Mean (SD) Age (9.1) Education (yrs) (1.6) Gender 22 Female / 6 Male n/a Years since diagnosis (9.2) Subtype RR: 19 PP: 3 SP: 4 PR: 2 n/a
24 Analysis Pearson correlation coefficients were calculated to examine the associations between: Social cognitive measures (each emotion of the FEIT, Reading the Mind in the Eyes total score, and Strange Stories total score) Total score on the BDI, State and Trait scores, and MFIS-psychosocial subscores.
25 Beck Depression Results State Trait MFISpsychosocial Facial Affect Recognition happy **-.576 anger *-.362 *-.353 **-.503 fear *-.391 **-.544 sad *-.411 **-.471 *-.350 disgust *-.339 surprise *.387 *.400 *p<.05, **p<.01
26 Results Reading Mind in the Eyes Strange Stories Beck Depression State Trait MFISpsychosoci al *-.361 **-.463 *-.332 *-.330 *-.346 *-.339 *p<.05, **p<.01
27 Results Beck Depression State Trait MFISpsychosocial Facial Affect Recognition happy ** anger * * ** fear * ** sad * ** * disgust * surprise * * * ** * Reading Mind in the Eyes Strange Stories * * * *p<.05, **p<.01
28 Discussion Overall, lower performance on social cognitive measures was associated with increased depressive symptomatology, anxiety and psychosocial fatigue
29 Depression Depression was associated with worse facial affect recognition (happy, angry, fear, sad), but not ToM measures This is consistent with studies on depression which show that depressed individuals have worse facial affect recognition Further, individuals with MS who are depressed perform worse on cognitive tasks (although social cognition not examined) More research needed to determine why ToM not correlated with depression
30 Anxiety State anxiety was associated with: Ability to identify fear, disgust and surprise* Both ToM tasks Trait anxiety was associated with: Ability to identify anger, sad and surprise* Both ToM tasks Anxiety also has been show to affect performance on social cognition tests in general public. Recently, the effects of anxiety on cognition were examined in individuals with MS Anxious individuals performed worse on PASAT and BVMT *Better recognition of surprise was associated with increased anxiety
31 Social Functioning MFIS-psychosocial fatigue is also related to social cognition Anger, sad/ Both ToM measures A limitation is that psychosocial fatigue is difficult to interpret. Is it representative of social functioning? Recently, it was reported that more psychosocial fatigue was associated with less work hours (Van der Hiele, 2014) Although psychosocial fatigue is less well understood compared to depression and anxiety, may represent an important variable of social functioning.
32 Potential Model Depression Anxiety Social Cognition Deficits Depression Anxiety Psychosocial Fatigue Psychosocial Fatigue
33 Potential Model Social Isolation Social Cognition Deficits Depression Anxiety Psychosocial fatigue Interpersonal Relationships suffer
34 Future Directions Regression analysis to determine causality Examine in Progressive MS Examine the effects of an emotional processing intervention on these outcome variables
35 Acknowledgements Co-investigators Jean Lengenfelder, Ph.D. Nancy Chiaravalloti, Ph.D. John DeLuca, Ph.D. Research Coordinator Angela Smith, M.S. Research Assistants/Students Chris Bober, B.A. Christopher Cagna, M.S. Alison Haight, B.A. Hayley O Donnell, B.A. Samantha Schmidt, B.A. Rebecca Zanotti, B.A. Joseph DeAngelis, B.A.
36 Acknowledgments Funding Sources
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