Abstract

Acquired brain injury (ABI) is a leading cause of death and disability worldwide. It presents with a wide range of symptoms affecting cognitive, behavioral, emotional, and social domains. The aim of this chapter is to analyze Theory of Mind (ToM) deficits in ABI and to offer different tools and considerations for clinicians due to their relevance. To do so, first a brief overview of the main considerations on ABI will be provided, addressing the demographics of this condition, as well as the main risk factors and the types into which ABI is classified. Subsequently, in the second section, the symptoms of ABI will be explored, looking at the different domains that are generally affected and placing special emphasis on its functional and social implications. In the third section, we will review the relationship between social cognition (SC) and ABI. We will define the most relevant constructs in SC: empathy, simulation, emotion recognition, and specially ToM, among others. We will link those constructs to the underlying brain networks that have been proposed as supporting brain structures. Studies regarding ABI-derived deficits in those functions are reviewed and linked to brain networks. In the fourth part, we will explain the relationship between SC, especially ToM, and other cognitive processes being executive function (EF) the most important one. Self-awareness will be introduced as a primary ability in ABI patients that is related with EF and ToM abilities. Subsequently, communicative capacities will be also recognized as commonly impaired in ABI population with SC deficits, considering again their relationship with EF. In order to conceptualize and summarize the main tools and scales commonly used to assess ToM impairment in ABI population, a section will focus on introducing those that have been previously reported in literature and will provide a useful insight regarding the general state of ToM in ABI. This section is aimed at giving a general overview of those available scales that could be utilized by experts, including them in the clinical evaluation process of this population. The measured constructs and the type of injury will be also considered. Finally, in the last section of the chapter we are going to address specific intervention programs and techniques that focus on general SC abilities and especially ToM in ABI population. Although the rehabilitation of ToM has been more frequently implemented in other patients (autism and psychiatric disorders), recently designed specifics programs aimed to improve this important process in ABI patients are showing promised results.