Social perception and social communication in adults with traumatic brain injury

描述（由申请人提供）：社交行为障碍是成人中度至重度创伤性脑损伤（TBI）的标志。随着时间的推移，社会行为问题是稳定的，并且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，这反过来又与患创伤性脑损伤的成年人抑郁、自杀意念和生活质量差的高风险有关。因此，社会问题对TBI患者及其护理人员来说是一个常见的、慢性的、昂贵的问题。虽然创伤性脑损伤会导致一系列认知和行为障碍，但最常见的抱怨，也许是重新融入社区和就业的最大障碍，是创伤性脑损伤患者有“奇怪的”社会行为，例如发表不恰当或无关紧要的评论，垄断谈话，通常对他人的社会需求不敏感。这些都是社会沟通问题。社会沟通问题在创伤性脑损伤研究和临床文献中都有很好的记载。然而，到目前为止，几乎没有证据表明这些问题的治疗可以从治疗室推广到日常的社会交往中。传统的治疗方法侧重于重新教授“适当的”行为（例如，训练眼神交流或轮流）。这些治疗方法的有限成功可能是没有考虑到行为问题的潜在原因的结果。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，即社会感知受损。脑外伤后的社会感知问题可能包括无法阅读基本的非语言线索，如凝视方向，以及对复杂的社会线索的错误感知，如讽刺。了解成人脑外伤患者的社会知觉问题对治疗计划至关重要：如果患者不能感知社会线索，他或她将不知道何时在结构化治疗环境之外执行习得行为。为了开发有效的治疗方法，有必要了解成人TBI患者的社会感知问题，并确定这些问题与特定沟通行为的关系。这就是拟议研究的目的。这些研究还将研究社会感知中与性别相关的差异，因为在之前的研究中没有考虑到这一可能导致沟通结果差异的因素。这一发现将直接导致对成年脑外伤患者的干预方法的改进，并将推进关于日常生活中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.