Development of an observational measure of social disinhibition after traumatic brain injury

ABSTRACT

Introduction: This study aimed to validate a new observational measure of socially disinhibited behavior for use in a population of individuals with traumatic brain injury (TBI). Method: Participants were twenty-two adults with severe TBI (mean age = 50.45 years) and 21 healthy comparison participants (mean age = 45.29 years). Ratings of observed social disinhibition were correlated with the disinhibition domain scores of the Neuropsychiatric Inventory–Disinhibition (NPI–D) and with Sydney Psychosocial Reintegration Scale (SPRS) scores. A regression analysis was undertaken to determine whether formal measures of disinhibition could predict observed disinhibition. Results: The interrater absolute agreement for the social disinhibition ratings was good, intraclass correlation coefficient (ICC) = .69. Participants with TBI were rated as significantly more disinhibited than comparison participants, t(25.05) = –2.07, p = .049. The ratings were positively correlated with the NPI frequency score (r = .45, p = .038) and distress score (r = .45, p = .035). The ratings were not related to change in employment or in interpersonal relationships on the SPRS, and formal measures of disinhibition were unable to predict observed social disinhibition. Conclusions: This study demonstrates good interrater reliability and construct validity of the observational measure. The results evidence the usefulness of this measure and the NPI–D for detecting social disinhibition after TBI.

KEYWORDS:

• Social disinhibition
• Traumatic brain injury
• Observational measure
• Neuropsychiatric Inventory