BACKGROUND: Adults with traumatic brain injury (TBI) may have deficits recognizing spoken social cues, with major negative social consequences. We do not know if these deficits extend to written social cues. Written cues, such as letterhead, provide information we use to make critical inferences about an author's perspective, and interpret subsequent text considering that perspective, and thus are critical for social communication. This study examined response to written social cues in adults with and without TBI.

METHODS AND PROCEDURES: We asked adults with TBI (n = 38) and uninjured adults (n = 20) to read an article describing actions of a mass murderer and give reasons for the those actions. Materials were presented on letterhead from either a social or a personality institute, to bias responses to either situational or dispositional factors. We hypothesized persons with TBI would be less likely to show bias consistent with the letterhead.

MAIN OUTCOMES AND RESULTS: Significantly more comparison-group responses (72%) than TBI-group responses (52%) were biased (p = 0.01) to match the institute in the letterhead.

CONCLUSIONS: Results indicated reduced sensitivity to written social cues in adults with TBI. Our findings add to evidence of impaired social cue response after TBI, and extend this to written text.