The assessment of social problem-solving ability following traumatic brain injury

Objective: To investigate the nature of social problem-solving deficits following TBI using the D'Zurilla and Goldfried(14) model of social problem solving, which consists of four social problem-solving skills that traditionally have been assessed by self-report inventory. To overcome the problems associated with self-report following TBI, the current study developed a video task for the assessment of social problem solving. Design: Cohort study. Participants: The study involved 15 community-dwelling individuals with TBI caused by motor vehicle accidents who volunteered to be involved in the study. A matched control sample without psychiatric or neurologic conditions consisted of 15 members of a community group who also volunteered to assist. Main Outcome Measures: Two measures were used, the Social Problem-Solving Inventory(17) and a problem-solving video vignette task designed specifically for the study. Both instruments assessed the components of the model-namely, problem definition and goal formulation, solution generation, decision making, and solution implementation and verification. Results: Individuals with TBI were impaired relative to the control sample in their ability to recognize and define social problems and to generate a range of solutions. However, these differences emerged only when using the video task. Correlations between the video task and the self-report scales were nonsignificant for both groups. Conclusions: Current social problem-solving training may lack validity due to an inappropriate focus on the later stages rather than the early stages of problem solving, when the major deficits following TBI tend to occur. In addition, the difficulties associated with self-report assessment following TBI can be overcome by using the video task.