Higher cognition and social behavior: Changes in cognitive flexibility and empathy after cerebral lesions.

Abstract
We examined the extent to which one aspect of interpersonal behavior, i.e., empathy, may be related to compromises in cognitive flexibility following brain injury. Fifty persons with cerebral lesions were administered standardized measures of cognitive flexibility (Wisconsin Card Sorting Test and Alternate Uses Test) and empathy (Hogan's Empathy Measure). Empathy scores were compared with the reports of significant others and a normal comparison group. There was no difference between self-reported empathy scores and those of significant others. Brain-injured subjects obtained significantly lower empathy scores than the comparison group. Significant correlations were found between cognitive flexibility and empathy. These interrelationships may be considered from three perspectives: (1) that flexibility is a prerequisite skill for empathy; (2) that the two variables share common neural and/or cognitive processes; and (3) that empathic change after brain injury occurs as an emotional reaction to acquired disabilities, including inflexibility.

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