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Kenzie ES, Parks EL, Carney N, Wakeland W. System dynamics modeling for traumatic brain injury: Mini-review of applications. Front Bioeng Biotechnol 2022; 10:854358. [PMID: 36032727 PMCID: PMC9411712 DOI: 10.3389/fbioe.2022.854358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/05/2022] [Indexed: 11/13/2022] Open
Abstract
Traumatic brain injury (TBI) is a highly complex phenomenon involving a cascade of disruptions across biomechanical, neurochemical, neurological, cognitive, emotional, and social systems. Researchers and clinicians urgently need a rigorous conceptualization of brain injury that encompasses nonlinear and mutually causal relations among the factors involved, as well as sources of individual variation in recovery trajectories. System dynamics, an approach from systems science, has been used for decades in fields such as management and ecology to model nonlinear feedback dynamics in complex systems. In this mini-review, we summarize some recent uses of this approach to better understand acute injury mechanisms, recovery dynamics, and care delivery for TBI. We conclude that diagram-based approaches like causal-loop diagramming have the potential to support the development of a shared paradigm of TBI that incorporates social support aspects of recovery. When developed using adequate data from large-scale studies, simulation modeling presents opportunities for improving individualized treatment and care delivery.
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Affiliation(s)
- Erin S. Kenzie
- Oregon Rural Practice-Based Research Network, Oregon Health and Science University, Portland, OR, United States
- Systems Science Program, Portland State University, Portland, OR, United States
- *Correspondence: Erin S. Kenzie,
| | | | - Nancy Carney
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, United States
| | - Wayne Wakeland
- Systems Science Program, Portland State University, Portland, OR, United States
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2
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Li B, Fang Y, Lin J, Chen X, Li C, He M. Forensic psychiatric analysis of organic personality disorders after craniocerebral injury in Shanghai, China. Front Psychiatry 2022; 13:944888. [PMID: 35966473 PMCID: PMC9374033 DOI: 10.3389/fpsyt.2022.944888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To explore the incidence rate and the differences of clinical manifestations of organic personality disorders with varying degrees of craniocerebral trauma. MATERIALS AND METHODS According to the International Classification of Diseases-10, 1,027 subjects with craniocerebral trauma caused by traffic accidents were reviewed, the degrees of craniocerebral trauma were graded and those with personality disorder after craniocerebral trauma were diagnosed. The personality characteristics of all patients were evaluated by using the simplified Neuroticism Extraversion Openness Five-Factor Inventory (NEO-FFI). RESULTS The incidence rate of organic personality disorder after all kinds of craniocerebral trauma was 33.1%, while it was 38.7 and 44.2% in the patients after moderate and severe craniocerebral trauma, respectively, which was significantly higher than that in the patients after mild craniocerebral trauma (18.0%) (P < 0.05). Compared with the patients without personality disorder, the neuroticism, extraversion and agreeableness scores all showed significantly differences (P < 0.05) in the patients with personality disorder after craniocerebral trauma; especially the conscientiousness scores showed significant differences (P < 0.05) in the patients with personality disorder after moderate and severe craniocerebral trauma. The agreeableness and conscientiousness scores in the patients with personality disorder after moderate and severe craniocerebral trauma were significantly lower than that after mild craniocerebral trauma, and the patients with personality disorder after severe craniocerebral trauma had lower scores in extraversion than that after mild craniocerebral trauma. CONCLUSION The severity and area of craniocerebral trauma is closely related to the incidence rate of organic personality disorder, and it also affects the clinical manifestations of the latter, which provides a certain significance and help for forensic psychiatric appraisal.
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Affiliation(s)
- Beixu Li
- School of Policing Studies, Shanghai University of Political Science and Law, Shanghai, China.,Shanghai Fenglin Forensic Center, Shanghai, China
| | - Youxin Fang
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Junyi Lin
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xueyan Chen
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Chenhu Li
- Shanghai Xuhui Mental Health Center, Shanghai, China
| | - Meng He
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai, China
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3
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Ohayagha C, Perrin PB, Cariello AN, Arango-Lasprilla JC. Is Helping Really Helping? Health-Related Quality of Life after TBI Predicting Caregiver Depression Symptom Trajectories in Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031247. [PMID: 33573228 PMCID: PMC7908361 DOI: 10.3390/ijerph18031247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 12/23/2022]
Abstract
Previous research connecting health-related quality of life (HRQoL) in people with traumatic brain injury (TBI) and caregiver mental health has primarily been conducted cross-sectionally in the U.S. and Western Europe. This study, therefore, examined how HRQoL in individuals immediately after their TBI predicts longitudinal caregiver depression symptom trajectories in Latin America. A sample of 109 patients with an acute TBI and 109 caregivers (total n = 218) was recruited from three hospitals in Mexico City, Mexico, and in Cali and Neiva, Colombia. TBI patients reported their HRQoL while they were still in hospital, and caregivers reported their depression symptoms at the same time and at 2 and 4 months later. Hierarchal linear models (HLM) found that caregiver depression symptom scores decreased over time, and lower patient mental health and pain-related quality of life at baseline (higher pain) predicted higher overall caregiver depression symptom trajectories across the three time points. These findings suggest that in Latin America, there is an identifiable relationship between psychological and pain-related symptoms after TBI and caregiver depression symptom outcomes. The results highlight the importance of early detection of caregiver mental health needs based in part upon patient HRQoL and a culturally informed approach to rehabilitation services for Latin American TBI caregivers.
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Affiliation(s)
- Chimdindu Ohayagha
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA; (C.O.); (P.B.P.); (A.N.C.)
| | - Paul B. Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA; (C.O.); (P.B.P.); (A.N.C.)
| | - Annahir N. Cariello
- Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284, USA; (C.O.); (P.B.P.); (A.N.C.)
| | - Juan Carlos Arango-Lasprilla
- BioCruces Bizkaia Health Research Institute, 40903 Barakaldo, Spain
- IKERBASQUE, Basque Foundation for Science, 48009 Bilbao, Spain
- Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain
- Correspondence:
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4
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Balcioglu YH, Dogan M, Incı I, Solmaz M. Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case. J Forensic Sci 2020; 65:1779-1783. [PMID: 32525581 DOI: 10.1111/1556-4029.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
Abstract
Organic brain disturbances particularly related to frontal cortex structures and subcortical areas including the basal ganglia may play a role in behavioral disinhibition disorders. Kluver-Bucy syndrome (KBS), which is one of the better knowns of these syndromes, includes hyperorality, visual agnosia, and hypersexuality, has been reported to occur after temporal lobe and amygdala lesions; however, several patients who had focal lesions in areas other than the temporal cortex and amygdala have been reported to present partial KBS symptoms. Nucleus lentiformis refers to a large portion of the basal ganglia including the putamen and globus pallidus, and specific structures within this broad area are known to be important for reward and value-based decision making. To date, KBS symptoms including hypersexual behavior associated with nucleus lentiformis lesions have never been reported. Here, we present a 38-year-old male patient who developed increased sexual interest and hyperorality after infarctions in the right lenticular nucleus and right occipitotemporal region and committed a first-degree sexual assault. He was sent to our institution for the assessment of criminal responsibility to the index sexual crime. According to a comprehensive and thorough forensic psychiatric evaluation, he was diagnosed as having an organic personality disorder with partial KBS symptoms. To the best of our knowledge, this is the first reported case of deviant sexual behavior and hyperorality developing after nucleus lentiformis infarction. We aimed to discuss possible neurobiologic explanations of late-onset deviant sexual behavior, which resulted in sexual criminal behavior following a cerebrovascular infarction.
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Affiliation(s)
- Yasin Hasan Balcioglu
- Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Forensic Psychiatry Unit, Istanbul, Turkey
| | - Mehmet Dogan
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey
| | - Ipek Incı
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey
| | - Mustafa Solmaz
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey.,Department of Psychiatry, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Silveira K, Smart CM. Cognitive, physical, and psychological benefits of yoga for acquired brain injuries: A systematic review of recent findings. Neuropsychol Rehabil 2019; 30:1388-1407. [DOI: 10.1080/09602011.2019.1583114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kristen Silveira
- Department of Psychology, University of Victoria, Victoria, Canada
| | - Colette M. Smart
- Department of Psychology, University of Victoria, Victoria, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada
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Kinnunen L, Niemelä M, Hakko H, Miettunen J, Merikukka M, Karttunen V, Ristikari T, Gissler M, Räsänen S. Psychiatric diagnoses of children affected by their parents’ traumatic brain injury: the 1987 Finnish Birth Cohort study. Brain Inj 2018; 32:933-940. [DOI: 10.1080/02699052.2018.1470331] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Lotta Kinnunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Mika Niemelä
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Jouko Miettunen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marko Merikukka
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Vesa Karttunen
- Department of Neurology, Oulu University Hospital, Oulu, Finland
| | - Tiina Ristikari
- Department of Welfare, National Institute for Health and Welfare, Oulu, Finland
| | - Mika Gissler
- Information Services Department, National Institute for Health and Welfare, Helsinki, Finland
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine, Karolinska Institute, Stockholm, Sweden
| | - Sami Räsänen
- Department of Psychiatry, Oulu University Hospital, Oulu, Finland
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Zheng ZT, Dong XL, Li YD, Gao WW, Zhou Y, Jiang RC, Yue SY, Zhou ZW, Zhang JN. Electrical stimulation improved cognitive deficits associated with traumatic brain injury in rats. Brain Behav 2017; 7:e00667. [PMID: 29201537 PMCID: PMC5698854 DOI: 10.1002/brb3.667] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/29/2016] [Accepted: 01/26/2017] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Cognitive deficits associated with traumatic brain injury (TBI) reduce patient quality of life. However, to date, there have been no effective treatments for TBI-associated cognitive deficits. In this study, we aimed to determine whether electrical stimulation (ES) improves cognitive deficits in TBI rats. METHODS Rats were randomly divided into three groups: the Sham control group, electrical stimulation group (ES group), and No electrical stimulation control group (N-ES group). Following fluid percussion injury, the rats in the ES group received ES treatment for 3 weeks. Potent cognitive function-relevant factors, including the escape latency, time percentage in the goal quadrant, and numbers of CD34+ cells, von Willebrand Factor+ (vWF +) vessels, and circulating endothelial progenitor cells (EPCs), were subsequently assessed using the Morris water maze (MWM) test, immunohistochemical staining, and flow cytometry. RESULTS Compared with the rats in the N-ES group, the rats in the ES group exhibited a shorter escape latency on day 3 (p = .025), day 4 (p = .011), and day 5 (p = .003), as well as a higher time percentage in the goal quadrant (p = .025) in the MWM test. After 3 weeks of ES, there were increased numbers of CD34+ cells (p = .008) and vWF + vessels (p = .000) in the hippocampus of injured brain tissue in the ES group compared with those in the N-ES group. Moreover, ES also significantly increased the number of EPCs in the peripheral blood from days 3 to 21 after TBI in the ES group (p < .05). CONCLUSIONS Taken together, these findings suggest that ES may improve cognitive deficits induced by TBI, and this protective effect may be a result, in part, of enhanced angiogenesis, which may be attributed to the increased mobilization of EPCs in peripheral blood.
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Affiliation(s)
- Zhi-Tong Zheng
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
| | - Xin-Long Dong
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
| | - Ya-Dan Li
- Intensive Care Units Tianjin Huanhu Hospital Tianjin China
| | - Wei-Wei Gao
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
| | - Yuan Zhou
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
| | - Rong-Cai Jiang
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
| | - Shu-Yuan Yue
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China
| | - Zi-Wei Zhou
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
| | - Jian-Ning Zhang
- Department of Neurosurgery Tianjin Neurological Institute Tianjin Medical University General Hospital Tianjin China.,Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of Education Tianjin China.,Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System Tianjin China
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Martínez-Pernía D, Huepe D, Huepe-Artigas D, Correia R, García S, Beitia M. Enactive Approach and Dual-Tasks for the Treatment of Severe Behavioral and Cognitive Impairment in a Person with Acquired Brain Injury: A Case Study. Front Psychol 2016; 7:1712. [PMID: 27847494 PMCID: PMC5088209 DOI: 10.3389/fpsyg.2016.01712] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 10/17/2016] [Indexed: 11/23/2022] Open
Abstract
One of the most important sequela in persons who suffer from acquired brain injury is a behavioral disorder. To date, the primary approaches for the rehabilitation of this sequela are Applied Behavior Analysis, Cognitive-Behavior Therapy, and Comprehensive-Holistic Rehabilitation Programs. Despite this theoretical plurality, none of these approaches focuses on rehabilitating behavioral disorders considering the relation between affordance and environmental adaptation. To introduce this therapeutic view to neurorehabilitation, we apply the theoretical tenets of the enactive paradigm to the rehabilitation of a woman with severe behavioral and cognitive impairment. Over seventeen sessions, her behavioral and cognitive performance was assessed in relation to two seated affordances (seated on a chair and seated on a ball 65 cm in diameter) and the environmental adaptation while she was working on various cognitive tasks. These two seated affordances allowed to incorporate the theoretical assumptions of the enactive approach and to know how the behavior and the cognition were modified based on these two postural settings and the environmental adaptation. The findings indicate that the subject exhibited better behavioral (physical and verbal) and cognitive (matching success and complex task) performances when the woman worked on the therapeutic ball than when the woman was on the chair. The enactive paradigm applied in neurorehabilitation introduces a level of treatment that precedes behavior and cognition. This theoretical consideration allowed the discovery of a better relation between a seated affordance and the environmental adaptation for the improvement behavioral and cognitive performance in our case study.
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Affiliation(s)
- David Martínez-Pernía
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo IbáñezSantiago, Chile; Experiential Neurorehabilitation Research Department, Fundación PolibeaMadrid, Spain; Laboratory of Experimental Psychology and Neuroscience, Institute of Cognitive and Translational Neuroscience, INECO Foundation, Favaloro UniversityBuenos Aires, Argentina
| | - David Huepe
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez Santiago, Chile
| | - Daniela Huepe-Artigas
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibáñez Santiago, Chile
| | - Rut Correia
- Faculty of Education, Universidad Diego Portales Santiago, Chile
| | - Sergio García
- Experiential Neurorehabilitation Research Department, Fundación Polibea Madrid, Spain
| | - María Beitia
- Experiential Neurorehabilitation Research Department, Fundación Polibea Madrid, Spain
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9
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Traumatic Brain Injury and Substance Related Disorder: A 10-Year Nationwide Cohort Study in Taiwan. Neural Plast 2016; 2016:8030676. [PMID: 27774322 PMCID: PMC5059606 DOI: 10.1155/2016/8030676] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/18/2016] [Indexed: 02/07/2023] Open
Abstract
Whether traumatic brain injury (TBI) is causally related to substance related disorder (SRD) is still debatable, especially in persons with no history of mental disorders at the time of injury. This study analyzed data in the Taiwan National Health Insurance Research Database for 19,109 patients aged ≥18 years who had been diagnosed with TBI during 2000-2010. An additional 19,109 randomly selected age and gender matched patients without TBI (1 : 1 ratio) were enrolled in the control group. The relationship between TBI and SRD was estimated with Cox proportional hazard regression models. During the follow-up period, SRD developed in 340 patients in the TBI group and in 118 patients in the control group. After controlling for covariates, the overall incidence of SRD was 3.62-fold higher in the TBI group compared to the control group. Additionally, patients in the severe TBI subgroup were 9.01 times more likely to have SRD compared to controls. Notably, patients in the TBI group were prone to alcohol related disorders. The data in this study indicate that TBI is significantly associated with the subsequent risk of SRD. Physicians treating patients with TBI should be alert to this association to prevent the occurrence of adverse events.
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A Meta-Analytic Review of Minnesota Multiphasic Personality Inventory—2nd Edition (MMPI-2) Profile Elevations Following Traumatic Brain Injury. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9236-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lang FU, Dudeck M, Becker T, Jäger M. [Organic personality disorder: conceptual principles, clinical symptoms and treatment]. DER NERVENARZT 2015; 86:332-339. [PMID: 25492699 DOI: 10.1007/s00115-014-4144-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The organic personality disorder is primarily characterized by a change of premorbid behavior due to an organic impairment or disease of the central nervous system. German psychopathological preliminary work had a determining influence on the current diagnostic concepts in the international classification of diseases 10 (ICD-10) and the diagnostic and statistical manual of mental disorders 5 (DSM-5). An analysis of the literature in the MEDLINE database shows that most studies can be found for traumatic brain injury and epilepsy. The most common symptoms described were symptoms of depression, emotional instability, irritability and impulsive behavior. Psychopathological symptoms were not related to the etiopathogenesis but showed some relation to the neuroanatomical location of functional disorders or damages. Only few publications on treatment strategies were found. The empirical findings point to the necessity of multiaxial diagnostic measures to distinguish between the levels of etiology and symptomatology. Therapeutic interventions should be planned on the basis of psychopathological symptoms.
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Affiliation(s)
- F U Lang
- Klinik für Psychiatrie und Psychotherapie II, Universität Ulm, Bezirkskrankenhaus Günzburg, Ludwig-Heilmeyer-Str. 2, 89312, Günzburg, Deutschland,
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12
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Block CK, West SE. Psychotherapeutic treatment of survivors of traumatic brain injury: Review of the literature and special considerations. Brain Inj 2013; 27:775-88. [DOI: 10.3109/02699052.2013.775487] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Response to hypothetical social scenarios in individuals with traumatic brain injury who present inappropriate social behavior: a preliminary report. Behav Sci (Basel) 2013; 3:72-98. [PMID: 25379227 PMCID: PMC4217612 DOI: 10.3390/bs3010072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 12/24/2012] [Accepted: 01/18/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Very little research thus far has examined the decision making that underlies inappropriate social behavior (ISB) post-TBI (traumatic brain injury). OBJECTIVES To verify the usefulness of a new instrument, the Social Responding Task, for investigating whether, in social decision making, individuals with TBI, who present inappropriate social behavior (ISB), have difficulty anticipating their own feelings of embarrassment and others' angry reactions following an ISB. METHODS Seven subjects with TBI presenting with inappropriate social behavior (TBI-ISB), 10 presenting with appropriate social behavior (TBI-ASB), and 15 healthy controls were given 12 hypothetical scenarios three times, each time ending with a different behavioral response. Subjects were asked to gauge the likelihood of their displaying the behavior in that situation (part A) and of it being followed by an angry reaction from the other or by feelings of embarrassment in themselves (part B). RESULTS TBI-ISB subjects scored higher than TBI-ASB and healthy controls on a scale of likelihood of displaying an ISB. RESULTS regarding expectations of angry reactions from others and feelings of embarrassment after an ISB were similar among groups. Negative correlations between endorsement of an inappropriate behavior and anticipation of negative emotional consequences were significant for both TBI-ASB and control subjects, but not for TBI-ISB subjects. CONCLUSIONS RESULTS suggest that the TBI-ISB participants were likely to endorse an ISB despite being able to anticipate a negative emotional response in themselves or others, suggesting that there were other explanations for their poor behavior. A self-reported likely response to hypothetical social scenarios can be a useful approach for studying the neurocognitive processes behind the poor choices of individuals with TBI-ISB, but the task needs further validation studies. A comprehensive discussion follows on the underlying mechanisms affecting social behaviors after a TBI.
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Bastert E, Schläfke D, Pein A, Kupke F, Fegert JM. Mentally challenged patients in a forensic hospital: a feasibility study concerning the executive functions of forensic patients with organic brain disorder, learning disability, or mental retardation. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2012; 35:207-212. [PMID: 22405977 DOI: 10.1016/j.ijlp.2012.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The past years have seen an increasing number of patients of lower intelligence or with organic brain disorder being committed into our forensic psychiatry. Our clinic has an ongoing scientific project to investigate the possibilities of reducing costs while at the same time guaranteeing adequate treatment and enforcement practice in forensic hospitals. This current project did not take these kinds of patients into consideration initially. This feasibility study is intended to examine if and to what extent these patients can be part of the scientific project. All patients of forensic psychiatry in Rostock (Mecklenburg-Western-Pomerania) with an IQ<80 (learning disorder) or a primary or secondary organic brain dysfunction that have been committed to the clinic since 2009 are included. These patients went through an extensive battery of neuropsychological tests. Furthermore, the treating psychotherapists had to rate the prognoses for criminal re-offending at discharge. Patients affected by lower intelligence or an organic brain dysfunction achieve lower results in neuropsychological testing than other patients participating in the main project. Nevertheless, participation in neuropsychological testing does not appear to overtax them. Future examination of the patients will be conducted to investigate to what extent certain therapeutic methods have been of noticeable benefit to this problematic group.
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Affiliation(s)
- Eva Bastert
- Klinik für forensische Psychiatrie, Klinikum der Universität Rostock, Zentrum für Nervenheilkunde, Gehlsheimer Str. 20, 18147 Rostock, Germany.
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Abstract
Present literature states that people with acquired organic brain dysfunctions face problems with attention, executive functions and social interaction. During the past years an increasing number of patients with organic brain disorders have been committed into our forensic psychiatry. In current literature studies on this group of patients are underrepresented. This study wanted to verify the impairment of cognitive functions of this specific group of patients. Included were all patients of the forensic psychiatry in Rostock (Mecklenburg-Western-Pomerania) with a primary or secondary organic brain dysfunction who have been committed into the clinic since 2009. These patients went through an extensive neuropsychological test battery. It was found that patients affected by organic brain dysfunction achieve lower results in the neuropsychological testing than non impaired patients, but their results are not as below average than it would have been expected. Further studies should show, if these patients are able to improve their performance while successfully undergoing psychotherapy.
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Affiliation(s)
- E Bastert
- Klinik für Forensische Psychiatrie, Klinikum der Universität Rostock, Zentrum für Nervenheilkunde, Rostock, Germany
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16
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Bjork JM, Grant SJ. Does traumatic brain injury increase risk for substance abuse? J Neurotrauma 2010; 26:1077-82. [PMID: 19203230 DOI: 10.1089/neu.2008.0849] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Wars in Afghanistan and Iraq have resulted in thousands of military personnel suffering traumatic brain injury (TBI), including closed-head injuries. Of interest is whether these individuals and other TBI survivors are at increased risk for substance use disorder (SUD). While it has been well established that drug or alcohol intoxication itself increases probability of suffering a TBI in accidents or acts of violence, little is known about whether the brain insult itself increases the likelihood that a previously non-drug-abusing individual would develop SUD. Might TBI survivors be unusually vulnerable to addiction to opiate analgesics compared to other pain patients? Similarly, it is not known if TBI increases the likelihood of relapse among persons with SUD in remission. We highlight challenges in answering these questions, and review neurochemical and behavioral evidence that supports a causal relationship between TBI and SUD. In this review, we conclude that little is known regarding the directionality of TBI increasing drug abuse, and that collaborative research in this area is critically needed.
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Affiliation(s)
- James M Bjork
- Division of Clinical Neuroscience and Behavioral Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland 20892, USA.
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Schellhorn A, Pössl J. Soziales Kompetenztraining nach erworbener Hirnschädigung – Zufriedenheits- und Erfolgs- einschätzungen von Patienten, Angehörigen und Therapeuten. ZEITSCHRIFT FUR NEUROPSYCHOLOGIE 2010. [DOI: 10.1024/1016-264x/a000008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In dieser Studie wurden die Erfahrungen von 55 Teilnehmern mit einem speziell für hirngeschädigte Patienten entwickelten Sozialen Kompetenztraining erfasst. Auch Angehörige und Therapeuten wurden zu Verhaltensänderungen befragt. Obwohl fast die Hälfte der Patienten eine mangelnde Störungseinsicht hatte, zeigten sie eine hohe Zufriedenheit mit dem Trainingsprogramm; die Beurteilung von Verhaltensänderungen fiel etwas zurückhaltender aus. Besonders positiv wurden die Gruppenatmosphäre und die Rollenspiele mit Videoaufnahmen bewertet. Patienten schätzten die erreichten Veränderungen im Sozialverhalten positiver ein als Angehörige und diese wiederum positiver als die Therapeuten. Zwischen den Selbsteinschätzungen und den Fremdeinschätzungen ergaben sich keine signifikanten Zusammenhänge, wohl aber zwischen den Beurteilungen von Angehörigen und Therapeuten. Die Ergebnisse zeigen, dass das Soziale Kompetenztraining von den Patienten unabhängig von der Störungseinsicht sehr gut angenommen wird.
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Affiliation(s)
- Anne Schellhorn
- Entwicklungsgruppe Klinische Neuropsychologie, Städtisches Klinikum München-Bogenhausen
| | - Josef Pössl
- Entwicklungsgruppe Klinische Neuropsychologie, Städtisches Klinikum München-Bogenhausen
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Neuropsychologische Diagnostik: Ökologische Validität und Prognosen. NeuroRehabilitation 2010. [DOI: 10.1007/978-3-642-12915-5_42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Himanen L, Portin R, Tenovuo O, Taiminen T, Koponen S, Hiekkanen H, Helenius H. Attention and depressive symptoms in chronic phase after traumatic brain injury. Brain Inj 2009; 23:220-7. [PMID: 19205958 DOI: 10.1080/02699050902748323] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To study whether attention deficits differ between TBI (traumatic brain injury) patients with and without depressive symptoms. METHOD The study group (n = 61, mean age = 59 years) consisted of symptomatic TBI patients injured on average 30 years earlier. They were studied with a broad range of attention tasks including computerized methods. The patients were divided into those with depressive symptoms (n = 32) and those without (n = 29), according to the short form of the Beck depression scale with a cut-off score of 5. In addition, a diagnosis of major depression was applied according to the Schedules for Clinical Assessment in Neuropsychiatry (SCAN) (n = 6). The groups with depression or depressive symptoms were compared with the non-depressed TBI patients and with an age- and education-matched healthy control group (n = 31). RESULTS Cognitive methods that require flexibility (Trail making B, Card sorting, Word fluency) and working memory (Subtraction test) were sensitive to discriminate TBI patients without depressive symptoms from the control subjects (p < 0.001). Only a few methods were able to discriminate the TBI patients with depressive symptoms from those without (p < 0.001 for Simple reaction time, p < 0.003 for Vigilance test). The depressed TBI patients (assessed by SCAN) did not differ from the non-depressed TBI patients in attention functions. CONCLUSIONS The results suggest that problems in complex attention processing are more specific to TBI, while slowness in simple psychomotor speed and impaired sustained attention may be mostly related to depressive symptoms in patients with chronic TBI sequelae.
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Affiliation(s)
- Leena Himanen
- Department of Neurology, Turku University Hospital, Turku, Finland.
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Gordon WA, Zafonte R, Cicerone K, Cantor J, Brown M, Lombard L, Goldsmith R, Chandna T. Traumatic brain injury rehabilitation: state of the science. Am J Phys Med Rehabil 2006; 85:343-82. [PMID: 16554685 DOI: 10.1097/01.phm.0000202106.01654.61] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Wayne A Gordon
- Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, New York 10029-6574, USA
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21
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Warriner EM, Velikonja D. Psychiatric disturbances after traumatic brain injury: neurobehavioral and personality changes. Curr Psychiatry Rep 2006; 8:73-80. [PMID: 16513045 DOI: 10.1007/s11920-006-0083-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Traumatic brain injuries (TBI) are frequently accompanied by psychiatric disturbances, which can include striking to relatively minor alterations in personality, behavior, and emotional regulation. The persistence of these neurobehavioral syndromes often leads to deleterious effects on recovery and rehabilitation outcomes. A recent surge of studies has emerged in the past several years to quantify the extent of psychiatric disorders in TBI and to describe differential clinical presentations. Various pre- and post-injury factors also have been hypothesized to contribute to the development and maintenance of psychiatric symptoms in survivors of brain injuries. The identification of high-risk individuals with distinct neuropathophysiological and psychosocial features permits the development of multidisciplinary and tailored approaches to the assessment, prevention, and management of the negative effects of personality and behavioral changes in TBI. This article summarizes the most recent research in these areas and highlights the gaps that need to be filled in subsequent future.
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Affiliation(s)
- Erin M Warriner
- McMaster University Medical Centre, Room 3G-30, Hamilton Health Sciences, 1200 Main Street West, Hamilton, ON L8N 3Z5, Canada.
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