Development of an observational measure of social disinhibition after traumatic brain injury

Katherine Osborne-Crowley*, Skye Mcdonald, Heather Francis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Introduction: This study aimed to validate a new observational measure of socially disinhibited behavior for use in a population of individuals with traumatic brain injury (TBI). Method: Participants were twenty-two adults with severe TBI (mean age = 50.45 years) and 21 healthy comparison participants (mean age = 45.29 years). Ratings of observed social disinhibition were correlated with the disinhibition domain scores of the Neuropsychiatric Inventory-Disinhibition (NPI-D) and with Sydney Psychosocial Reintegration Scale (SPRS) scores. A regression analysis was undertaken to determine whether formal measures of disinhibition could predict observed disinhibition. Results: The interrater absolute agreement for the social disinhibition ratings was good, intraclass correlation coefficient (ICC) =.69. Participants with TBI were rated as significantly more disinhibited than comparison participants, t(25.05) = -2.07, p =.049. The ratings were positively correlated with the NPI frequency score (r =.45, p =.038) and distress score (r =.45, p =.035). The ratings were not related to change in employment or in interpersonal relationships on the SPRS, and formal measures of disinhibition were unable to predict observed social disinhibition. Conclusions: This study demonstrates good interrater reliability and construct validity of the observational measure. The results evidence the usefulness of this measure and the NPI-D for detecting social disinhibition after TBI.

Original languageEnglish
Pages (from-to)341-353
Number of pages13
JournalJournal of Clinical and Experimental Neuropsychology
Issue number3
Publication statusPublished - 15 Mar 2016
Externally publishedYes


  • Neuropsychiatric Inventory
  • Observational measure
  • Social disinhibition
  • Traumatic brain injury


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