title: Investigating social cognition in epilepsy using a naturalistic task.
abstract: The primary objective for this study was to assess social cognition in patients with focal epilepsy using a naturalistic task, which accurately models complex real-world social interaction.
  
  
  
  We conducted an observational study of social cognition in 43 patients with focal epilepsy and in 22 controls. Patients and controls completed The Awareness of Social Inference Test, which measures both basic and advanced social cognition in a realistic video-based format. Patient and controls also completed standard measures of cognitive functioning and measures of depression.
  
  
  
  Compared to controls, we found that patients with epilepsy (PWEs) had no difficulty identifying positively valenced emotional states (happiness) yet had difficulty identifying most negatively valenced emotional states (anger, fear, and disgust). In addition, PWEs were able to identify sincere exchanges correctly but could not identify sarcastic and insincere exchanges. We found that basic social cognition significantly correlated with standard generalized cognitive measures, whereas advanced social cognition did not. Finally, age at onset had significant impact on social cognition, whereas other epilepsy characteristics did not.
  
  
  
  PWEs have deficits in social cognition when measured using a naturalistic video-based task. Advanced social cognition may be an independent cognitive domain in PWEs that is not adequately measured using standard psychometric instruments. Problems with social cognition may arise as a consequence of epilepsy during the periods of robust social development in childhood and adolescence.
authors.affiliation: Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Krzysztof A
authors.initials: KA
authors.lastname: Bujarski
authors.affiliation: Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Laura
authors.initials: L
authors.lastname: Flashman
authors.affiliation: Biostatistics Shared Resource, Norris Cotton Cancer Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Zhongze
authors.initials: Z
authors.lastname: Li
authors.affiliation: Biostatistics Shared Resource, Norris Cotton Cancer Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Tor D
authors.initials: TD
authors.lastname: Tosteson
authors.affiliation: Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Barbara C
authors.initials: BC
authors.lastname: Jobst
authors.affiliation: Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Vijay M
authors.initials: VM
authors.lastname: Thadani
authors.affiliation: Department of Neurology, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Kobylarz
authors.affiliation: Department of Neurosurgery, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: David W
authors.initials: DW
authors.lastname: Roberts
authors.affiliation: Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, U.S.A.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Roth
mesh_terms: D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications* / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012919:Social Behavior; D055815:Young Adult
keywords: Age at onset; Assessment; Epilepsy; Social cognition