Piloting a new measure of social disinhibition: A failure to inhibit or produce favourable responses?

Background and aims: Common to many neurological conditions involving frontal lobe dysfunction is deficits in social disinhibition, a failure to inhibit automatic responses in favour of producing more socially acceptable responses. Measures of inhibition or interference control (such as the Haylings Sentence Completion test or the Stroop test), is often undertaken in clinical practice to infer difficulties in behaviour and emotion regulation. However, these measures may not be tapping into the type of difficulties that occur in social settings. This study aimed to develop and pilot a new clinical measure of social disinhibition.

Method: Participants included 19 moderate-to-severe TBI and 14 healthy controls. They viewed scenes of complex social situations, and were asked to describe a character in them (Part A), describe a character while inhibiting inappropriate or negative responses (Part B), and describe a character while not only inhibiting negative responses, but also providing positive utterances (Part C).

Results: While TBI individuals and healthy control participants were both inherently negative in their responding in Part A, when asked to inhibit this negative responding in Part B, TBI individuals were significantly impaired. There was a trend towards TBI individuals in Part C being impaired in their ability to produce positive and more socially acceptable responses.

Conclusions: This pilot study makes an important contribution toward meeting the need for a well-validated clinical assessment tool that is capable of assessing social disinhibition deficits in those with frontal lobe dysfunction.