Hyposmia, Not Emotion Perception, Is Associated With Psychosocial Outcome After Severe Traumatic Brain Injury

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Objective: The current study aimed to determine whether 2 variables associated with orbitofrontal damage, hyposmia and emotion perception deficits, are associated with socially disinhibited behavior and psychosocial outcome after traumatic brain injury (TBI). Methods: The Brief Smell Identification Test (BSIT), an emotion labeling task, an emotion intensity rating task, and an observational measure of social disinhibition were completed by 23 individuals with severe TBI. The disinhibition domain of the Neuropsychiatric Inventory and the interpersonal relationships subscale of the Sydney Psychosocial Reintegration Scale (SPRS-IR) were completed by a close other. Fifteen control participants provided norms against which to assess performance on the emotion intensity rating task. Results: BSIT scores predicted informant-reported change in interpersonal relationships on the SPRS-IR. Hyposmia, though, was not associated with informant-reported or observed social disinhibition. An impairment in accuracy scores on both emotion perceptions tasks was found for participants with TBI, yet intensity ratings did not differ between groups. This suggests that people with TBI are not actually impaired at detecting intensity of emotion but are less likely to perceive the target emotion as the dominant emotion. Emotion perception was not related to disinhibition or change in interpersonal relationships. Conclusions: These results support previous claims that hyposmia has prognostic significance following TBI. On the other hand, emotion perception impairment measured by standardized tasks does not appear to be an important factor in interpersonal outcomes. Finally, these results suggest that standardized emotion perception tasks may underestimate the emotion perception capabilities of people with TBI.

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