Exploring Changes in Social Inferencing and Negative Attributions Following an Intervention for Individuals with Brain Injury

Abstract

<h3>Research Objectives</h3> To investigate changes in social inferencing abilities and negative attribution tendencies in participants with traumatic brain injury (TBI) before and after receiving an intervention designed to teach more benign interpretations of others' behaviors. Secondarily, to examine the correlation between changes in social inferencing and negative attributions. <h3>Design</h3> Secondary analyses of measures employed in a randomized waitlist-controlled trial. <h3>Setting</h3> One TBI rehabilitation center <h3>Participants</h3> 15- 21 participants with complicated mild to severe TBI who were ≥1 year post-injury. All participants eventually received the ICAN intervention. <h3>Interventions</h3> Intervention to Change Attributions that are Negative (ICAN), is a 6-week group therapy that utilizes role-playing and perspective-positioning as techniques to alter participants' interpretations and judgments of others' actions. <h3>Main Outcome Measures</h3> The Awareness of Social Inference Test (TASIT) is a 3-part video assessment: Emotional Evaluation Test (EET); Social Inference-Minimal (SI-M) and Social Inference-Enriched (SI-E). EET involves identifying actors' emotions from multiple cues. SI-M requires inferences from sincere and sarcastic exchanges, and SI-E requires inferences from sarcasm and lies with additional context. The Ambiguous Intentions Hostility Questionnaire (AIHQ) uses hypothetical scenarios to evaluate participants' negative attributions of intent, hostility, and blame regarding characters' actions, as well as how much anger and aggression participants felt in response to the scenarios. <h3>Results</h3> Due to low enrollment, subject data was pooled for before/after analyses. On average, scores on the TASIT subtests (n=21) did not significantly change post-ICAN; however, a minimum clinically important difference of .5 SD was identified in 38%, 19%, and 29% for EET, SI-M, and SI-E, respectively. On the AIHQ (n=15), attributions of intent, anger response, and aggression response significantly reduced post-intervention (p <.05). Hostility and blame attributions trended towards significant improvements (p=.084 and .094 respectively). Changes in SI-M scores correlated with changes in blame (r=-.620, p<.05) and aggression (r=-.836, p<.01). <h3>Conclusions</h3> The ICAN intervention may reduce negative attributions post TBI, which may be related to changes in social inferencing. These promising results warrant more research. <h3>Author(s) Disclosures</h3> No conflicts of interest.