Affiliations: Division of Behavioral Medicine and Clinical
Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical
Center and University of Cincinnati College of Medicine, Cincinnati, OH,
USA | Department of Pediatrics, The Ohio State University
& Center for Biobehavioral Health, The Research Institute at Nationwide
Children's Hospital, Columbus, OH, USA | Divison of Pediatric Rehabilitation, Cincinnati
Children's Hospital Medical Center and University of Cincinnati College of
Medicine, Cincinnati, OH, USA
Note: [] Corresponding author: Nicolay Chertkoff Walz, Ph.D., Cincinnati
Children's Hospital Medical Center, Division of Behavioral Medicine and
Clinical Psychology, MLC 10006, 2800 Winslow Ave., Cincinnati, OH 45229-3039,
USA. Tel.: +1 513 636 4675; Fax: +1 513 636 7756; E-mail:
nicolay.walz@cchmc.org
Abstract: 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.
