Social Outcomes

Childhood TBI often results in problems with social functioning. This is not surprising, given that the neuropathology associated with TBI often involves the frontal and temporal regions, which have been implicated in social behavior (Yeates et al. 2007). Cognitive explanations for a link between TBI and later problems with social functioning have also been offered (Yeates et al. 2004). Numerous studies have documented adverse social outcomes following childhood and adolescent TBI. Bohnert et al. (1997) investigated friendships and social outcomes and found that children with TBI were perceived by their parents as less socially competent with peer relations, especially in the context of severe TBI. Gender effects were also found such that boys with TBI were less likely than girls with TBI to maintain pre-injury friendships. Andrews et al. (1998) found that children with TBI had lower self-reported ratings of self-esteem and higher ratings of loneliness than a control group. Warschausky et al. (1997) found that children with TBI generated fewer solutions when confronted with hypothetical peer dilemmas than did children without TBI. Janusz et al. (2002) extended these findings by investigating the social problem-solving skills of children following TBI and found that children with severe TBI chose less de-velopmentally mature social problem-solving strategies than children without TBI. Dennis et al. (2001) examined the neuropathological correlates of TBI-related social problems and determined that children with severe frontal lobe injury were more likely to have problems with social discourse. Finally, Yeates et al. (2004) compared the short- and long-term social outcomes of TBI and found that children with TBI experienced worse social outcomes than an orthopedic-injured control group. Children with severe TBI had more adverse social outcomes than did children with moderate TBI. In addition, these authors found that the relation between TBI and social outcomes was moderated by environmental variables (Yeates et al. 2004). More specifically, poor social outcomes following TBI were exacerbated by poor family functioning, lower socioeconomic status, and lack of family resources.

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