Social perception and social communication in adults with traumatic brain injury

描述（由申请人提供）：社会行为障碍是成人中重度创伤性脑损伤（TBI）的标志。社会行为问题随着时间的推移是稳定的，是照顾者压力和负担的主要来源。这些问题可能导致失业和社会孤立，这反过来又与抑郁症，自杀意念和TBI成年人生活质量差的高风险相关。因此，对于TBI患者及其护理人员来说，社会问题是一个常见的，慢性的和昂贵的问题。 虽然TBI可能导致一系列认知和行为障碍，但最常见的投诉，也可能是重返社区和就业的最大障碍，是TBI患者有“奇怪”的社会行为，例如做出不恰当或不相关的评论，垄断谈话，以及通常对他人的社会需求表现出不敏感。这些都是社会沟通问题。社会沟通问题已经在TBI研究和临床文献中有很好的记录。然而，迄今为止，几乎没有证据表明，这些问题的治疗推广到治疗室以外的日常社会交往。传统的治疗方法侧重于重新教授“适当”的行为（例如，训练目光接触或轮流）。这些治疗方法的有限成功可能是未能考虑行为问题的根本原因的结果。具体来说，越来越多的证据表明，表现受损的原因可能是无法阅读社会线索，即，社会认知受损TBI后的社会感知问题可能从无法阅读基本的非语言线索（如凝视方向）到错误感知复杂的社会线索（如讽刺）。了解TBI成人的社会感知问题对于治疗计划至关重要：如果患者无法感知社会线索，他或她将不知道何时在结构化治疗环境之外执行学习行为。为了开发有效的治疗方法，有必要了解TBI成年人的社会感知问题，并确定这些问题与特定的沟通行为的关系。这是拟议研究的目的。这些研究还将研究与性别有关的社会感知差异，因为这种潜在的沟通结果差异的贡献者在以前的研究中没有被考虑过。这些发现将直接导致改善TBI成人的干预方法，并将推进有关日常生活背景下人类社会沟通的理论和临床知识。

DESCRIPTION (provided by applicant): Impairments in social behavior are a hallmark of moderate-to-severe traumatic brain injury (TBI) in adults. Social behavior problems are stable over time, and are a major source of stress and burden for caregivers. These problems can lead to loss of employment and social isolation, which in turn are associated with a high risk of depression, suicidal ideation, and poor quality of life among adults with TBI. Thus, social problems are a common, chronic, and costly problem for individuals with TBI and their caregivers. While TBI can result in a range of cognitive and behavioral disorders, the most common complaint, and perhaps the greatest obstacle to community re-integration and employment, is that persons with TBI have "odd" social behaviors, such as making inappropriate or irrelevant comments, monopolizing conversations, and generally appearing to be insensitive to the social needs of others. These are social communication problems. Social communication problems have been well documented in the TBI research and clinical literature. To date, however, there is little evidence that treatment of these problems generalizes beyond the therapy room to everyday social interactions. Traditional treatments focus on re-teaching "appropriate" behaviors (e.g., training eye contact or turn-taking). The limited success of these treatment methods may be the result of failing to consider the underlying causes of behavior problems. Specifically, there is growing evidence that the cause of impaired performance may be failure to read social cues, i.e., impaired social perception. Social perception problems after TBI may range from failure to read basic nonverbal cues such as gaze direction, to errors perceiving complex social cues such as sarcasm. An understanding of social perception problems in adults with TBI is critical for treatment planning: if the patient cannot perceive socil cues, he or she will not know when to execute learned behaviors outside of the structured therapy environment. To develop effective treatments, it is necessary to understand social perception problems in adults with TBI and determine how these problems relate to specific communication behaviors. This is the aim of the proposed research. The studies also will examine sex-related differences in social perception, as this potential contributor to differences in communication outcome has not been considered in previous research. The findings will lead directly to improved intervention approaches for adults with TBI, and will advance theoretical and clinical knowledge about human social communication in the context of everyday life.