Social cognitive performance in posttraumatic stress disorder: A meta-analysis

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Background: Social support represents a key factor in the development of post-traumatic stress disorder (PTSD). Social cognition - the ability to perceive, interpret, and respond to other people - is considered fundamental in making use of social support. Gaining knowledge on the link between PTSD and social cognition is therefore essential. Whilst social cognitive difficulties in patients with PTSD are documented, an understanding of which particular social cognitive processes might be affected more than others, is lacking. The current meta-analysis was therefore aimed to examine social cognitive functioning in four underlying social cognitive domains (mentalization, emotion recognition, social perception, and attributional style) in PTSD diagnosed patients versus controls. Methods: Meta-analyses were conducted on studies examining performance on at least one social cognitive domain in PTSD diagnosed patients compared to controls. Results: 19 studies were included, involving 565 patients and 641 controls. Relative to controls, the PTSD group scored lower on overall social cognitive functioning (SMD = -0.42), specifically on mentalization (SMD = -0.81) and social perception (SMD = -0.30), whilst the latter should be interpreted with caution as only one study was found pertaining to this domain. No emotion recognition and attributional style differences were found. Limitations: There was evidence of moderate heterogeneity in the results of the included studies for overall social cognition and attributional style. Conclusions: Findings indicate that social cognition represents a potential important clinical factor in PTSD and underscore the importance of differentiating between underlying social cognitive processes in research and treatment of PTSD.