Traumatic brain injury patients misjudge situations

http://www.eurekalert.org/pub_releases/2015-10/smp-wpd101415.php

Public Release: 15-Oct-2015
When punishment doesn't fit the crime
New research reveals traumatic brain injury patients struggle with discipline in social, family and work life
Rehabilitation Institute of Chicago

New research finds people with traumatic brain injuries (TBI) --such as those incurred from violent accidents or combat -- are more prone to misjudge when faced with situations involving dispute or requiring discipline.

The study, led in part by Dr. Jordan Grafman at the Rehabilitation Institute of Chicago and published this month in Social Cognitive and Affective Neuroscience (SCAN), is the first to objectively assess how people with frontal lobe lesions punish -- a key indicator for how they will function in society. These findings can guide doctors in providing patients with more effective treatment.

Traumatic brain injury is pervasive in America, affecting nearly 2 million patients per year, as well as countless others, including family members, colleagues and people encountered in everyday activities.

TBI is often connected to altered social behaviors -- from the veteran struggling with a short temper to the football player in hot water for public altercations. This new research sheds additional light on this connection by focusing on a common effect of TBI, frontal lobe injuries, and how these injuries affect a patient's ability to punish.

"The ability to judge such things as a business dispute, family argument or a child's misbehavior and then assess reasonable discipline is fairly indicative of one's ability to rationally and socially integrate within society," said Grafman, Ph.D., study investigator and director of brain injury research at the Rehabilitation Institute of Chicago. "This study finds that those suffering from penetrating TBI may not have the capacity to appropriately assess proper punishments, a factor which suggests how people will do in the real world."

Impartial third-party punishment, or TPP, is the ability to judge the severity of a crime and assess a reasonable punishment. If a patient struggles with TPP, he or she likely struggles with several important social skills, such as interpreting another person's intentions, showing empathy and making rational judgments. The absence of these skills, which regulate behavior, indicate poorer prognoses for resuming normal work, school and family life.

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For example, subjects with altruism deficits tended to have right frontal lobe injuries, while subjects who had trouble forming concepts (the ability to determine the overall theme from different pieces of information) showed left lobe damage.

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