Social information processing skills in adolescents with traumatic brain injury: Relationship with social competence and behavior problems

Objective: To examine social information processing (SIP) skills, behavior problems, and social competence following adolescent TBI and to determine whether SIP skills were predictive of behavior problems and social competence. Design: Cross-sectional analyses of adolescents with TBI recruited and enrolled in a behavioral treatment study currently in progress. Setting: Two tertiary care children's hospitals with Level 1 trauma centers. Participants: Adolescents aged 11 to 18 years with severe TBI (n = 19) and moderate TBI (n = 24) who were injured up to 24 months prior to recruitment. Assessment of risk factors: TBI severity, race, maternal education, and age at testing. Main outcome measurements: a measure of SIP skills, Child Behavior Checklist (CBCL), Youth Self Report (YSR), and Home and Community Social Behavior Scale (HCSBS). Results: The severe TBI group did not obtain significantly lower scores on the SIP measures than the moderate TBI group. In comparison to adolescents with moderate TBI, those with severe TBI had significantly more parent-reported externalizing behaviors and self-reported weaknesses in social competence. SIP skills were strong predictors of problems and social competence in adolescents with TBI. More specifically, an aggressive SIP style predicted externalizing problems and a passive SIP style predicted internalizing problems. Both passive and aggressive SIP skills were related to social competence and social problems. Conclusions: Adolescents with TBI are at risk for deficits in social and behavioral outcomes. SIP skills are strongly related to behavior problems and social competence in adolescents with TBI. SIP skills, social competence, and behavior problems are important targets for intervention that may be amenable to change and lead to improved functional outcomes following TBI.