TASIT: A New Clinical Tool for Assessing Social Perception After Traumatic Brain Injury

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ObjectiveTo develop a clinically sensitive test of social perception for people with traumatic brain injury (TBI).DesignAn assessment tool comprising videotaped vignettes and response probes was developed in successive stages and tested on both normal participants and those with TBI.SubjectsA total of 169 normal adults and 7 adults with severe TBI (pilot studies), 283 normal adults, and 12 people with severe TBI (main studies).Main outcome measures“The Awareness of Social Inference Test” (TASIT) comprises videotaped vignettes of everyday social interactions and has three parts, each with alternate forms. The Emotion Evaluation Test (EET) assesses recognition of spontaneous emotional expression (happy, surprised, sad, anxious, angry, disgusted, and neutral). The Social Inference–Minimal (SI-M) test assesses comprehension of sincere versus sarcastic exchanges, whereas the Social Inference–Enriched test (SI-E) assesses lies versus sarcasm. In both SI-M and SI-E speaker demeanor (voice, facial expression) indicate the intended meaning of the exchange. In addition, the SI-E vignettes have other contextual clues that reveal the speakers’ intentions. Performance on SI-E and SI-E is assessed via four standard questions per item probing for understanding of the emotions, intentions, beliefs, and meanings of the speakers and their exchanges.ResultsGroups taken from the pool of 283 normal adults achieved a high level of performance on all aspects of the test with some influence from both education and intelligence. The 12 people with TBI were poorer at judging emotions than were matched controls, with particular difficulties recognizing neutral items, fear, and disgust. They were as capable as matched controls when understanding sincere exchanges and lies but had difficulty with sarcasm.ConclusionsTASIT is straightforward for people with a normal range of social skills while being sensitive to social perception deficits after traumatic brain injury.

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