Cited by 75Traumatic Brain Injury ResearchCognitive Functions and MemoryNeurobiology of Language and Bilingualism

Cognitive Factors Underpinning Poor Expressive Communication Skills after Traumatic Brain Injury: Theory of Mind or Executive Function?

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McDonald, Skye, Gowland, Alison, Randall, Rebekah, Fisher, Alana, Osborne-Crowley, Katie, Honan, Cynthia·2014·Neuropsychology

Abstract

OBJECTIVE: The ability to see things from another's perspective, that is, have a theory of mind (ToM), is essential to effective communication. So too is the ability to regulate verbal output, that is, to exercise executive control. People with traumatic brain injuries (TBIs) have impaired communication abilities, but the extent to which this reflects ToM versus executive dysfunction is unclear. This study explored the relative contributions of executive abilities, specifically flexibility and inhibition and ToM abilities in language production post-TBI. METHOD: Twenty-five adults (18 males: mean age of 48.2 years, SD = 12.0 years) with moderate to severe TBI (posttraumatic amnesia = 69.2, SD = 54.6 days) and 28 noninjured adults (19 males: mean age 49.0, SD = 12.2 years) completed three sets of communication tasks with low executive demands, high flexibility, and high inhibition demands. Within each, parallel versions had low or high ToM requirements. RESULTS: For low executive and high flexibility tasks, scores on the high ToM versions were predicted by scores on the low ToM versions, suggesting that poor performance was explained by the executive demands the parallel tasks had in common. The exception was the high inhibition task. In this case, speakers with TBI had differential difficulty with the high ToM version, that is, they had specific difficulty inhibiting self-referential thoughts in order to cater for another's perspective. CONCLUSION: We found problems with inhibiting the self-perspective accords with descriptive accounts of the egocentric nature of some communication patterns following TBI, which points to potential targets for remediation.

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  • Communication skills are supported by different abilities, classically conceptualized as motivational functions, knowledge, or cognitive and socio-cognitive functions, implying different specific types of evaluations.

    “Moreover, as Spitzberg (2003) pointed out, communication skills are supported by different abilities, classically conceptualized as motivational functions (e.g., confidence and goal-orientation), knowledge (e.g., content and procedural knowledge), or cognitive and socio-cognitive functions (e.g., theory of mind, verbal cognition, emotional intelligence, and empathy; McDonald et al. 2014; Rotherm”

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  1. Prince, S., Haynes, W. O., & Haak, N. J. (2002). Occurrence of Contingent Queries and Discourse Errors in Referential Communication and Conversational Tasks: A Study of College Students With Closed Head Injury. Journal of Medical Speech Language Pathology, 10(1), 19-39.
  2. Wechsler, D. (1997a). Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). San Antonio, TX: The Psychological Corporation.

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Authors
McDonald, S., Gowland, A., Randall, R., Fisher, A., Osborne-Crowley, K., & Honan, C.
Affiliations
UNSW Sydney (AU)
Venue
Neuropsychology
Published
2014-09
Volume
28
Issue
5
Pages
801-811
ISSN
  • 0894-4105 (ISSN-L)
  • 1931-1559
OpenAlex
W2104539070
Cited by
75
References
81
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 10 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 7 · 2018: 7 · 2017: 11 · 2016: 9 · 2015: 6 · 2014: 1
FWCI
6.82
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Neuropsychology (publishedVersion)
  • PubMed (publishedVersion)
  • UNSWorks (UNSW Sydney) (submittedVersion, cc-by-nc-nd)
  • eCite Digital Repository (University of Tasmania) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
Australian Research Council
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
Keywords
traumatic brain injury, expressive communication, theory of mind, executive function, cognitive flexibility, inhibition, language production, self-perspective, post-traumatic amnesia, communication disorders
MeSH terms
Adult, Brain Injuries, Facial Expression, Female, Humans, Male, Middle Aged, Social Perception, Verbal Behavior, Executive Function, Theory of Mind

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