Social cognition in alcohol use disorder: a meta‐analysis

Background and aims Deficits in social cognitive abilities including emotion recognition and theory of mind (ToM) can play a significant role in interpersonal difficulties observed in alcohol use disorder (AUD). This meta-analysis aims to estimate mean effect sizes of deficits in social cognition in AUD and examines the effects of demographic and clinical confounding factors on the variability of effect sizes across studies. Methods A literature review was conducted on research reports published from January 1990 to January 2016. Twenty-five studies investigating ToM and facial emotion recognition performances of 756 individuals with AUD and 681 healthy controls were selected after applying inclusion and exclusion criteria. Weighted effect sizes (d) were calculated for ToM, decoding and reasoning aspects of ToM, total facial emotion recognition and recognition of each of six basic emotions. Results Facial emotion recognition was significantly impaired (d = 0.65, 95% confidence interval (CI) = 0.42-0.89), particularly for disgust and anger. AUD was also associated with deficits in ToM (d = 0.58, 95% CI = 0.36-0.81). These deficits were evident in tasks measuring both decoding (d = 0.46, 95% CI = 0.19-0.73) and reasoning (d = 0.72, 95% CI = 0.37-1.06) aspects of ToM. The longer duration of alcohol misuse and more depressive symptoms were associated with more severe deficits in recognition of facial emotions. Conclusions Alcohol use disorder appears to be associated with significant impairment in facial emotion recognition and theory of mind.