Cognitive Factors Underpinning Poor Expressive Communication Skills after Traumatic Brain Injury: Theory of Mind or Executive Function?
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
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”
From Creativity, Critical Thinking, Communication, and Collaboration: Assessment, Certification, and Promotion of 21st Century Skills for the Future of Work and Education (2023) · cites this paper as McDonald et al. 2014
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Lovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523 · see citing works
Does the autistic child have a “theory of mind” ?
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985) · Cognition · doi:10.1016/0010-0277(85)90022-8 · Cited by 8,599 · see citing works
(1980) · Medical Entomology and Zoology · Cited by 4,712 · see citing works
Baron‐Cohen, S., Wheelwright, S. J., Hill, J., Raste, Y., & Plumb, I. (2001) · PubMed · Cited by 4,313 · see citing works
The functional architecture of human empathy
Decety, J., & Jackson, P. L. (2004) · Behavioral and Cognitive Neuroscience Reviews · doi:10.1177/1534582304267187 · Cited by 3,407 · see citing works
Self-referential processing in our brain—A meta-analysis of imaging studies on the self
Northoff, G., Heinzel, A., de Greck, M., Bermpohl, F., Dobrowolny, H., & Panksepp, J. (2006) · NeuroImage · doi:10.1016/j.neuroimage.2005.12.002 · Cited by 2,792 · see citing works
Shamay-Tsoory, S. G., Aharon-Peretz, J., & Perry, D. (2009) · Brain · doi:10.1093/brain/awn279 · Cited by 1,544 · see citing works
Frontal Lobe Contributions to Theory of Mind
Stone, V. E., Baron-Cohen, S., & Knight, R. T. (1998) · Journal of Cognitive Neuroscience · doi:10.1162/089892998562942 · Cited by 1,524 · see citing works
Communicative competence and theory of mind in autism: A test of relevance theory
Happe, F. G. E. (1993) · Cognition · doi:10.1016/0010-0277(93)90026-r · Cited by 1,161 · see citing works
Multilingual Aphasia Examination
Patterson, J. P. (2018) · Springer eBooks · doi:10.1007/978-3-319-57111-9_900 · Cited by 1,096 · see citing works
Burgess, P., & Shallice, T. (1997) · UCL Discovery (University College London) · Cited by 972 · see citing works
Is ADHD a disinhibitory disorder?
Nigg, J. T. (2001) · Psychological Bulletin · doi:10.1037/0033-2909.127.5.571 · Cited by 893 · see citing works
The Link between Social Cognition and Self-referential Thought in the Medial Prefrontal Cortex
Mitchell, J. P., Banaji, M. R., & Macrae, C. N. (2005) · Journal of Cognitive Neuroscience · doi:10.1162/0898929055002418 · Cited by 806 · see citing works
Ruby, P., & Decety, J. (2004) · Journal of Cognitive Neuroscience · doi:10.1162/0898929041502661 · Cited by 659 · see citing works
Mcdonald (2003) · doi:10.1097/00001199-200305000-00001 · Cited by 657 · see citing works
Late outcome of very severe blunt head trauma: a 10-15 year second follow-up.
Thomsen, I. V. (1984) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.47.3.260 · Cited by 582 · see citing works
Wechsler Memory Scale–Third Edition
Dumont, R., & Willis, J. O. (2008) · Encyclopedia of Special Education · doi:10.1002/9780470373699.speced2206 · Cited by 552 · see citing works
D'Argembeau, A., Ruby, P., Collette, F., Degueldre, C., Balteau, E., Luxen, A., Maquet, P., & Salmon, E. (2007) · Journal of Cognitive Neuroscience · doi:10.1162/jocn.2007.19.6.935 · Cited by 495 · see citing works
Rowe, A. D., Bullock, P. R., Polkey, C. E., & Morris, R. G. (2001) · Brain · doi:10.1093/brain/124.3.600 · Cited by 400 · see citing works
Winner, E., Brownell, H., Happe, F. G. E., Blum, A., & Pincus, D. B. (1998) · Brain and Language · doi:10.1006/brln.1997.1889 · Cited by 389 · see citing works
Personality and behavioural change after severe blunt head injury--a relative's view.
Brooks, D. N., & McKinlay, W. W. (1983) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.46.4.336 · Cited by 344 · see citing works
Long-term neuropsychological outcome of closed head injury
Levin, H. S., Grossman, R. G., Rose, J. E., & Teasdale, G. M. (1979) · Journal of neurosurgery · doi:10.3171/jns.1979.50.4.0412 · Cited by 336 · see citing works
McDonald, S., Bornhofen, C., Shum, D., Long, E., Saunders, C., & Neulinger, K. (2006) · Disability and Rehabilitation · doi:10.1080/09638280600646185 · Cited by 319 · see citing works
Self-citationDistinguishing irony from deception: Understanding the speaker's second‐order intention
Winner, E., & Leekam, S. R. (1991) · British Journal of Developmental Psychology · doi:10.1111/j.2044-835x.1991.tb00875.x · Cited by 293 · see citing works
McDonald, S., & Flanagan, S. (2004) · Neuropsychology · doi:10.1037/0894-4105.18.3.572 · Cited by 277 · see citing works
Self-citationBigler, E. D. (2007) · Neuropsychology · doi:10.1037/0894-4105.21.5.515 · Cited by 275 · see citing works
Milders, M. M., Fuchs, S. C. P. C., & Crawford, J. R. (2003) · Journal of Clinical and Experimental Neuropsychology · doi:10.1076/jcen.25.2.157.13642 · Cited by 274 · see citing works
Allen, D. N., & Haderlie, M. (2010) · The Corsini Encyclopedia of Psychology · doi:10.1002/9780470479216.corpsy1003 · Cited by 260 · see citing works
Theory of mind after traumatic brain injury
Bibby, H., & McDonald, S. (2004) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2004.04.027 · Cited by 230 · see citing works
Self-citationHenry, J. D., Phillips, L. H., Crawford, J. R., Ietswaart, M., & Summers, F. (2006) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2006.03.020 · Cited by 212 · see citing works
McDonald, S. (1993) · Brain and Language · doi:10.1006/brln.1993.1003 · Cited by 182 · see citing works
Self-citationGalski, T., Tompkins, C. A., & Johnston, M. V. (1998) · Brain Injury · doi:10.1080/026990598122160 · Cited by 179 · see citing works
Narrative and procedural discourse after closed head injury
Hartley, L. L., & Jensen, P. J. (1991) · Brain Injury · doi:10.3109/02699059109008097 · Cited by 168 · see citing works
Spikman, J. M., Timmerman, M. E., Milders, M. V., Veenstra, W. S., & van der Naalt, J. (2011) · Journal of Neurotrauma · doi:10.1089/neu.2011.2084 · Cited by 165 · see citing works
Exploring theory of mind after severe traumatic brain injury
Muller, F., Simion, A., Reviriego, E., Galéra, C., Mazaux, J., Barat, M., & Joseph, P. (2009) · Cortex · doi:10.1016/j.cortex.2009.08.014 · Cited by 163 · see citing works
The Functional Anatomy of Inhibition Processes Investigated with the Hayling Task
Collette, F., der Linden, M. V., Delfiore, G., Degueldre, C., Luxen, A., & Salmon, É. (2001) · NeuroImage · doi:10.1006/nimg.2001.0846 · Cited by 162 · see citing works
Milders, M. M., Ietswaart, M., Crawford, J. R., & Currie, D. G. (2008) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617708080351 · Cited by 151 · see citing works
The ecological validity of TASIT: A test of social perception
McDonald, S., Flanagan, S., Martin, I., & Saunders, C. (2004) · Neuropsychological Rehabilitation · doi:10.1080/09602010343000237 · Cited by 138 · see citing works
Self-citationDisturbance of social cognition after traumatic orbitofrontal brain injury
Cicerone, K. D., & Tanenbaum, L. N. (1997) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/12.2.173 · Cited by 129 · see citing works
Closed head trauma and aphasia
Heilman, K. M., Safran, A. B., & Geschwind, N. (1971) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.34.3.265 · Cited by 128 · see citing works
Social interaction following severe closed head injury
Elsass, L., & Kinsella, G. (1987) · Psychological Medicine · doi:10.1017/s003329170001299x · Cited by 128 · see citing works
The Nature of Verbal Impairment after Closed Head Injury
Sarno, M. T. (1980) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198011000-00008 · Cited by 126 · see citing works
Neuroimaging and neuropathology of TBI
Bigler, E., & Maxwell, W. (2011) · NeuroRehabilitation (Reading, MA) · doi:10.3233/nre-2011-0633 · Cited by 123 · see citing works
Narrative language in traumatic brain injury
Marini, A., Galetto, V., Zampieri, E., et al. (2011) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2011.06.017 · Cited by 122 · see citing works
Characteristics of verbal impairment in closed head injured patients.
Sarno, M. T., Buonaguro, A., & Levita, E. (1986) · PubMed · Cited by 120 · see citing works
What about theory of mind after severe brain injury?
Havet-Thomassin, V., Allain, P., Etcharry‐Bouyx, F., & Gall, D. L. (2006) · Brain Injury · doi:10.1080/02699050500340655 · Cited by 118 · see citing works
Aphasic disorder in patients with closed head injury.
Levin, H. S., Grossman, R. G., & Kelly, P. J. (1976) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.39.11.1062 · Cited by 114 · see citing works
BOND, F., & Godfrey, H. P. D. (1997) · Brain Injury · doi:10.1080/026990597123476 · Cited by 114 · see citing works
Brookshire, B. L., Chapman, S. B., Song, J., & Levin, H. S. (2000) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617700677019 · Cited by 95 · see citing works
Dennis, M., Agostino, A., Roncadin, C., & Levin, H. S. (2009) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390802572419 · Cited by 92 · see citing works
Conversation-based assessment of social cognition in adults with traumatic brain injury
Turkstra, L. S. (2008) · Brain Injury · doi:10.1080/02699050802027059 · Cited by 89 · see citing works
Working memory and discourse production abilities following closed-head injury
Youse, K. M., & COELHO, C. A. (2005) · Brain Injury · doi:10.1080/02699050500109951 · Cited by 88 · see citing works
Evaluating the causes of impaired irony comprehension following traumatic brain injury
Martin, I., & McDonald, S. (2005) · Aphasiology · doi:10.1080/02687030500172203 · Cited by 84 · see citing works
Self-citationTheory of Mind and social beliefs in adolescents with traumatic brain injury
Turkstra, L. S., Dixon, T. M., & Baker, K. K. (2004) · Neurorehabilitation · doi:10.3233/nre-2004-19307 · Cited by 83 · see citing works
Impairments in theory of mind shortly after traumatic brain injury and at 1-year follow-up.
Milders, M. M., Ietswaart, M., Crawford, J. R., & Currie, D. G. (2006) · Neuropsychology · doi:10.1037/0894-4105.20.4.400 · Cited by 82 · see citing works
Mentalising and social problem-solving after brain injury
Channon, S., & Crawford, S. (2010) · Neuropsychological Rehabilitation · doi:10.1080/09602011003794583 · Cited by 82 · see citing works
Geraci, A., Surian, L., Ferraro, M., & Cantagallo, A. (2010) · Brain Injury · doi:10.3109/02699052.2010.487477 · Cited by 78 · see citing works
de Sousa, A., McDonald, S., Rushby, J. A., Li, S. H., Dimoska, A., & James, C. (2010) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2010.08.008 · Cited by 77 · see citing works
Self-citationReferential cohesion and logical coherence of narration after closed head injury
Davis, G. A., & COELHO, C. A. (2004) · Brain and Language · doi:10.1016/j.bandl.2004.01.003 · Cited by 76 · see citing works
Pragmatic language interpretation after closed head injury: Relationship to executive functioning
Channon, S., & Watts, M. (2003) · Cognitive Neuropsychiatry · doi:10.1080/135468000344000002 · Cited by 76 · see citing works
Neuropragmatics: Extralinguistic Communication after Closed Head Injury
Bara, B. G., Cutica, I., & Tirassa, M. (2001) · Brain and Language · doi:10.1006/brln.2000.2430 · Cited by 76 · see citing works
McDonald, S., & Pearce, S. (1998) · Brain and Language · doi:10.1006/brln.1997.1846 · Cited by 74 · see citing works
Self-citationMaternal reporting of behaviour following very severe blunt head injury.
Kinsella, G., Packer, S., & Olver, J. (1991) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.54.5.422 · Cited by 69 · see citing works
Measuring social cognition in adolescents: Implications for students with TBI returning to school
Turkstra, L. S., Williams, W. H., Tonks, J., & Frampton, I. J. (2008) · Neurorehabilitation · doi:10.3233/nre-2008-23606 · Cited by 62 · see citing works
Is performance on the Wechsler test of adult reading affected by traumatic brain injury?
Mathias, J. L., Bowden, S. C., Bigler, E. D., & Rosenfeld, J. V. (2007) · British Journal of Clinical Psychology · doi:10.1348/014466507x190197 · Cited by 53 · see citing works
Verbal Impairment after Closed Head Injury Report of a Replication Study
Sarno, M. T. (1984) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-198408000-00006 · Cited by 52 · see citing works
The ‘dice’ game: A new test of pragmatic language skills after closed-head injury
McDonald, S., & Pearcei, S. (1995) · Brain Injury · doi:10.3109/02699059509008197 · Cited by 52 · see citing works
Self-citationNarrative discourse following severe traumatic brain injury: a longitudinal follow-up
Snow, P. C., Douglas, J. M., & PONSFORDOE, J. L. (1999) · Aphasiology · doi:10.1080/026870399401993 · Cited by 47 · see citing works
Evaluating Social Skills Following Traumatic Brain Injury: The BRISS as a Clinical Tool
Flanagan, S., McDonald, S., & Togher, L. (1995) · Brain Injury · doi:10.3109/02699059509005773 · Cited by 42 · see citing works
Self-citationTreatment of interpersonal deficits for head-trauma patients in inpatient rehabilitation settings
Crosson, B. (1987) · The Clinical Neuropsychologist · doi:10.1080/13854048708520069 · Cited by 36 · see citing works
Social and emotional competence in traumatic brain injury: New and established assessment tools
Hynes, C. A., Stone, V. E., & Kelso, L. A. (2011) · Social Neuroscience · doi:10.1080/17470919.2011.584447 · Cited by 33 · see citing works
Relationship between cognitive deficits and social skill after head injury.
Marsh, N. V., & Knight, R. G. (1991) · Neuropsychology · doi:10.1037//0894-4105.5.2.107 · Cited by 32 · see citing works
The Assessment of Social Problem Solving Ability Following Traumatic Brain Injury
Kendall, E. A., Shum, D., Halson, D., et al. (1997) · Journal of Head Trauma Rehabilitation · doi:10.1097/00001199-199706000-00007 · Cited by 32 · see citing works
Topic repetitiveness after traumatic brain injury: An emergent, jointly managed behaviour
Body, R., & Parker, M. W. (2005) · Clinical Linguistics & Phonetics · doi:10.1080/02699200400027189 · Cited by 32 · see citing works
Nonaphasic language disturbances after closed head injury
Prigatano, G. P., Roueche, J. R., & Fordyce, D. J. (1985) · Language Sciences · doi:10.1016/s0388-0001(85)80020-6 · Cited by 30 · see citing works
Relationship between cognitive deficits and social skill after head injury.
Marsh, N. V., & Knight, R. G. (1991) · Neuropsychology · doi:10.1037/0894-4105.5.2.107 · Cited by 29 · see citing works
Premorbid intelligence and brain injury
Morris, P. G., Wilson, L., Dunn, L., et al. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466505x34174 · Cited by 24 · see citing works
Godfrey, H. P. D., Knight, R. G., & Bishara, S. N. (1991) · Brain Injury · doi:10.3109/02699059109008091 · Cited by 20 · see citing works
Examining perspective-taking in the severely head-injured
Spiers, M. V., Pouk, J. A., & Santoro, J. M. (1994) · Brain Injury · doi:10.3109/02699059409150998 · Cited by 18 · see citing works
Body, R., & Perkins, M. R. (1998) · Brain Injury · doi:10.1080/026990598122016 · Cited by 14 · see citing works
Sarno, M. T. (1988) · PubMed · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- 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.
- Wechsler, D. (1997a). Wechsler Adult Intelligence Scale-Third Edition (WAIS-III). San Antonio, TX: The Psychological Corporation.
Cited by
Sorted by citations
Thornhill-Miller, B., Camarda, A., Mercier, M., Burkhardt, J.-M., Morisseau, T., Bourgeois-Bougrine, S., Vinchon, F., El Hayek, S., Augereau-Landais, M., Mourey, F., et al. (2023) · Journal of Intelligence · doi:10.3390/jintelligence11030054 · Cited by 768 · see citing works
Arcara, G., Tonini, E., Muriago, G., Mondin, E., Sgarabottolo, E., Bertagnoni, G., Semenza, C., & Bambini, V. (2020) · Aphasiology · doi:10.1080/02687038.2019.1615033 · Cited by 35 · see citing works
- 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
- green
- hdl.handle.net
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review