- Title
- Social cognition in people with an acquired brain injury or a diagnosis on the schizophrenia spectrum: validating a multidimensional screening measure, the Brief Assessment of Social Skills
- Creator
- Wallis, Kimberley
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Our ability to interact with others is essential for our physical, mental, and emotional health. However, social cognition, the cognitive processes underlying social interactions can be impaired in various clinical populations including those with acquired brain injury (ABI) and schizophrenia spectrum disorder (schizophrenia). While still in its infancy, the field is currently lacking in two crucial areas: 1) consensus on which domains and measures of social cognition in ABI adequately describes intact and impaired functioning, and 2) an efficient way to identify and characterise deficits in social cognition in both research and clinical practice. This thesis presents a synthesis of social cognitive literature in ABI as well as the modification and validation of the Brief Assessment of Social Skills (BASS), a comprehensive screening measure of social cognition, in ABI and in schizophrenia. Study 1 presents a systematic scoping review of the social cognitive and ABI literature. It aimed to determine the most assessed domains of social cognition in ABI, their assessment tools, and the appropriateness of these tools for researchers and clinicians. Three hundred and sixty-seven studies were identified as relevant, and across these studies’ emotion perception, theory of mind, social communication, identity recognition, and empathy were identified as the most commonly assessed domains. The Ekman and Friesen photo series, Faux Pas Recognition Test, La Trobe Communication Questionnaire, Benton Facial Recognition Test, and Interpersonal Reactivity Index were the most used measures of these domains. While all measures could distinguish between clinical and control participants there are several identified problems with the current measures including a lack of availability of normative data, and excessive administration and scoring time. Further, validated measures are underused in favour of the development of one’s own measure in research or non-standardised measures clinically. This is problematic due to psychometric limitations. This scoping review highlights the need for not only a psychometrically sound measure of social cognition for this population, but one that can be integrated with the current clinical assessment battery to screen for deficits in social cognition. To establish a brief, comprehensive screen for deficits in social cognition, Study 2 examined the validity of a modified BASS in people with an ABI. Twenty-seven adults with an ABI and 27 matched healthy control participants completed the BASS alongside a series of standardised and normative general cognitive, social cognitive and self- and informant-report social functioning measures. Consistent with predictions, ABI participants demonstrated impairments on the BASS in comparison to healthy control participants. There was also evidence of convergent and divergent validity with BASS performance correlating with established measures of social cognition, as well as being distinguishable from general cognitive measures. Further, a moderate relationship was observed between BASS performance and informant-report social functioning, measured with the Sydney Psychosocial Reintegration Scale. No relationship was observed between self-report social functioning. Given that similar social cognitive impairments are observed in neuropsychiatric populations, Study 3 piloted the BASS as a measure of social cognition in people with a diagnosis on the schizophrenia spectrum. The BASS was administered to 9 adults with schizophrenia and 9 matched healthy control participants along with self- and informant-report social functioning measures. Consistent with predictions, schizophrenia participants demonstrated impairments on the BASS in comparison to healthy control participants but only in emotion perception and facial identification. Bayesian factors determined that all remaining domains had inconclusive evidence. Additionally, significant relationships were observed between several BASS domains and both self- and informant reported social functioning, measured with the Social Functioning Scale. To establish the clinical utility of the BASS, Study 4 determined normative performance for people aged 18 – 60 years and explored the construct validity of the BASS. One hundred and twenty-one adults completed the BASS alongside a series of standardised and normative general and social cognitive measures. Gender, age, education, and IQ differently affected performance on BASS domains with reference data stratified by these variables. Like Study 2, there was evidence for convergent and divergent validity of the BASS with case studies providing additional evidence for the construct validity of the BASS. Specifically, the BASS could identify discrete areas of social cognitive impairments between and within clinical populations. This thesis enhances our understanding and assessment of social cognition. Firstly, in the ABI literature, by synthesising and summarising the current field it is facilitating essential discussion regarding the direction of this field and providing a roadmap for future research. Secondly, by adapting and administering the BASS to adults with ABI and schizophrenia there is preliminary evidence for the utility of the BASS as a measure of social cognition in these clinical populations, with several advantages over established social cognitive measures, for example, assessing multiple domains of social cognition and shorter administration time. Finally, the development of reference data allows for the BASS to be integrated with current clinical assessment batteries, providing a brief and comprehensive measure of social cognition that can be used to identify strengths and weaknesses, to inform treatment and facilitate a deeper understanding of the changes in social functioning for the individual, their family, and friends.
- Subject
- social cognition; acquired brain injury (ABI); schizophrenia; BASS; Brief Assessment of Social Skills
- Identifier
- http://hdl.handle.net/1959.13/1504582
- Identifier
- uon:55555
- Rights
- Copyright 2022 Kimberley Wallis
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
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| View Details Download | ATTACHMENT01 | Thesis | 3 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 5 MB | Adobe Acrobat PDF | View Details Download |