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Calmette T, Meunier H. Is self-awareness necessary to have a theory of mind? Biol Rev Camb Philos Soc 2024; 99:1736-1771. [PMID: 38676546 DOI: 10.1111/brv.13090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/29/2024]
Abstract
Forty years ago, Gallup proposed that theory of mind presupposes self-awareness. Following Humphrey, his hypothesis was that individuals can infer the mental states of others thanks to the ability to monitor their own mental states in similar circumstances. Since then, advances in several disciplines, such as comparative and developmental psychology, have provided empirical evidence to test Gallup's hypothesis. Herein, we review and discuss this evidence.
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Affiliation(s)
- Tony Calmette
- Centre de Primatologie de l'Université de Strasbourg, Niederhausbergen, 67207, France
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364, CNRS, Université de Strasbourg, Strasbourg, 67000, France
| | - Hélène Meunier
- Centre de Primatologie de l'Université de Strasbourg, Niederhausbergen, 67207, France
- Laboratoire de Neurosciences Cognitives et Adaptatives, UMR 7364, CNRS, Université de Strasbourg, Strasbourg, 67000, France
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2
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Ricchetti G, Navarro-Egido A, Rodríguez-Bailón M, Salazar-Frías D, Narganes-Pineda C, Funes MJ. Identifying conflict monitoring as a specific executive component that contributes to impaired self-awareness in patients with acquired brain injury. J Clin Exp Neuropsychol 2024:1-14. [PMID: 39157972 DOI: 10.1080/13803395.2024.2391363] [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: 02/19/2024] [Accepted: 08/07/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE Impaired self-awareness (SA) after acquired brain injury (ABI) has traditionally been linked to deficits in executive functions. However, conflicting findings about this relationship have been reported in the literature. This inconsistency is probably due to the multicomponent nature of both constructs, as not all aspects of executive functions may be equally relevant to all components of self-awareness. This study explored whether offline SA (i.e. metacognitive knowledge) and online SA (i.e. error detection) relate to a less studied executive component, conflict monitoring/resolution. METHOD Twenty-six patients with ABI performed the Three-Conflict Cognitive Control Task (3CCT), an experimental task that allowed to measure the ability to monitor and solve three different types of conflicts (Distractors-filtering, Spatial Stroop and Simon). Measures of SA were collected: offline SA was based on self-informant discrepancy about patient's everyday functional difficulties, and online SA was based on error detection abilities during a performance-based naturalistic task (The Breakfast Conflict Task). RESULTS After controlling for global cognition, the conflict monitoring measure of 3CCT demonstarted incremental validity in predicting offline and online SA measured in naturalistic tasks. CONCLUSIONS Conflict monitoring/resolution seems to be an important component of SA. This finding contributes to further understand the relationship between executive functions and SA. In addition, conflict monitoring/resolution is an executive component that should be considered when designing assessment and intervention strategies to deal with ISA.
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Affiliation(s)
- Giorgia Ricchetti
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Alba Navarro-Egido
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - María Rodríguez-Bailón
- Physiotherapy (Occupational Therapy) Department, Health Science School, University of Málaga, Málaga, Spain
| | - Daniel Salazar-Frías
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Cristina Narganes-Pineda
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
| | - Mª Jesús Funes
- Mind, Brain and Behavior Research Centre (CIMCYC), Experimental Psychology Department, School of Psychology, University of Granada, Granada, Spain
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3
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Hendryckx C, Couture M, Gosselin N, Nalder E, Gagnon-Roy M, Thibault G, Bottari C. The dual reality of challenging behaviours: Overlapping and distinct perspectives of individuals with TBI and their caregivers. Neuropsychol Rehabil 2024; 34:485-509. [PMID: 37219424 DOI: 10.1080/09602011.2023.2212172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/03/2023] [Indexed: 05/24/2023]
Abstract
Challenging behaviours significantly impact the lives of people with traumatic brain injury (TBI) and their family caregivers. However, these behaviours are rarely defined from the perspectives of both individuals, a necessary step to developing interventions targeting meaningful goals for individuals and caregivers. This study aimed to (1) explore and confirm the perspective of individuals with TBI living in the community and their family caregivers on behaviours they consider challenging and, (2) identify overlapping or distinct views on challenging behaviours. A qualitative descriptive design was used. Twelve caregivers (8 females; 59.67 ± 11.64 years old) and 14 participants with mild-severe TBI (6 females; 43.21 ± 10.98 years old; time post-injury: 21.71 ± 10.84 years) were interviewed (10 dyads and two triads). Data were analysed using inductive qualitative analysis. Challenging behaviours most frequently reported by all participants were aggressive/impulsive behaviours, inappropriate social behaviours, and behavioural manifestations of cognitive impairments. Overlapping perspectives were identified regarding aggressive behaviours. Distinctions exist as inappropriate social behaviours and cognitive difficulties were mainly reported by caregivers. Our results confirm that perspectives may vary between dyad members. Interventions should include dyad inputs to formulate goals that are significant to the person with TBI and their caregiver.
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Affiliation(s)
- Charlotte Hendryckx
- Department of Psychology, Université de Montréal, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine (CEAMS), Hôpital du Sacré-Coeur de Montréal, Centre de recherche du CIUSSS NIM, Montreal, Canada
| | - Mélanie Couture
- Centre for research and expertise in social gerontology (CREGÉS), CIUSSS West-Central Montreal, Côte Saint-Luc, Canada
- École de travail social, Faculté des lettres et sciences humaines, Université de Sherbrooke, Sherbrooke, Canada
| | - Nadia Gosselin
- Department of Psychology, Université de Montréal, Montreal, Canada
- Center for Advanced Research in Sleep Medicine (CEAMS), Hôpital du Sacré-Coeur de Montréal, Centre de recherche du CIUSSS NIM, Montreal, Canada
| | - Emily Nalder
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mireille Gagnon-Roy
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- School of RehabilitationUniversité de Montréal, Montreal, Canada
| | - Geneviève Thibault
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Service québécois d'expertise en troubles graves du comportement (SQETGC), CIUSSS MCQ, Montreal, Canada
| | - Carolina Bottari
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal (CRIR), Montreal, Canada
- Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux (CIUSSS) Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
- School of RehabilitationUniversité de Montréal, Montreal, Canada
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4
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Halalmeh DR, Salama HZ, LeUnes E, Feitosa D, Ansari Y, Sachwani-Daswani GR, Moisi MD. The Role of Neuropsychology in Traumatic Brain Injury: Comprehensive Literature Review. World Neurosurg 2024; 183:128-143. [PMID: 38104936 DOI: 10.1016/j.wneu.2023.12.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/19/2023]
Abstract
Traumatic brain injury (TBI) is a major public health concern, often leading to significant behavioral and cognitive changes with subsequent impairment in daily functioning and personal interactions. The management of TBI involves a multidisciplinary approach. Neuropsychology has emerged as a critical discipline in assessing, diagnosing, treating, and rehabilitating individuals with TBI. Successful management also requires careful consideration of the patient's cognitive status. Therefore, clinicians must have a comprehensive understanding of the overall clinical picture of the patient at the cognitive and physical level. The primary aim of this research is to explore the role of neuropsychology in TBI management and rehabilitation thoroughly while providing an updated review of the literature. Various neuropsychological assessment tools used to evaluate cognitive functioning in individuals with TBI will be discussed in addition to their validity, reliability, and usefulness in identifying cognitive deficits and developing individualized treatment plans. The findings in this article will have significant implications on the clinical practice of neuropsychology in TBI patients, highlighting the importance of neuropsychological assessment in optimizing the management of this population. The need for increased awareness of neuropsychology among health care professionals, especially in the acute hospital setting, is growing along with the increase in diagnosis of TBI and its complications. Adequate understanding of the complex interplay between cognitive, emotional, and behavioral factors in TBI can inform the development of new interventions and treatment strategies, making it equally as important for patients and their families.
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Affiliation(s)
- Dia R Halalmeh
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA.
| | | | - Emma LeUnes
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - David Feitosa
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA
| | - Yusuf Ansari
- Temple University, Philadelphia, Pennsylvania, USA
| | - Gul R Sachwani-Daswani
- Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
| | - Marc D Moisi
- Department of Neurosurgery, Hurley Medical Center, Flint, Michigan, USA; Department of Surgery, Michigan State University-College of Human Medicine, Traverse City, Michigan, USA; Department of Trauma and Acute Care Surgery, Hurley Medical Center, Flint, Michigan, USA
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5
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Cheng WY, Klonoff PS, Perumparaichallai RK. Components of self-awareness affecting caregiver burden: a long-term follow-up study. Brain Inj 2024; 38:26-31. [PMID: 38258808 DOI: 10.1080/02699052.2024.2304883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVE Studies utilizing the discrepancy model of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) have commonly used the cognitive and physical domains to estimate self-awareness. This study included other aspects of self-awareness such as awareness of one's social and emotional status and daily functioning to explore their effects on caregiver burden for ABI survivors. METHODS We studied 64 patient-caregiver pairs up to 29 years post-discharge from a holistic, milieu-oriented outpatient neurorehabilitation program. Discrepancy scores between ABI survivors' and caregivers' reports on the MPAI-4 subscales (i.e. Abilities, Adjustment, and Participation) and Total Score were used to determine self-awareness. Caregiver burden was measured using the Zarit Burden Interview (ZBI). RESULTS Exploratory linear regression analyses revealed that caregiver burden derived from the ZBI was predicted by the discrepancy scores generated from the Abilities (p < 0.0001), Adjustment (p < 0.01), Participation subscales (p = 0.01), and Total Score (p < 0.001), respectively. Among the exploratory models generated, the Total Score model had the highest predictive value (R2 = .33) for caregiver burden. CONCLUSIONS Measures of self-awareness should be comprehensive by considering diverse components of self-awareness. Increasing ABI survivors' self-awareness in different domains has the potential to effectively alleviate caregiver burden.
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Affiliation(s)
- Wen-Yu Cheng
- The Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Pamela S Klonoff
- The Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
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Torregrossa W, Torrisi M, De Luca R, Casella C, Rifici C, Bonanno M, Calabrò RS. Neuropsychological Assessment in Patients with Traumatic Brain Injury: A Comprehensive Review with Clinical Recommendations. Biomedicines 2023; 11:1991. [PMID: 37509630 PMCID: PMC10376996 DOI: 10.3390/biomedicines11071991] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/30/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Traumatic brain injury is damage to the brain occurring after birth, often resulting in the deterioration of cognitive, behavioural, and emotional functions. Neuropsychological evaluation can assist clinicians to better assess the patient's clinical condition, reach differential diagnoses, and develop interventional strategies. However, considering the multiple rating scales available, it is not easy to establish which tool is most suitable for the different brain injury conditions. The aim of this review is to investigate and describe the most used neurocognitive assessment tools in patients with traumatic brain injury to provide clinicians with clear indications on their use in clinical practice. Indeed, during the acute phase, after the head trauma, alertness and wakefulness of the patients affected by a disorder of consciousness can be assessed using different scales, such as the Coma Recovery Scale-Revised. In both postacute and chronic phases after traumatic brain injury, general cognitive assessment tools (such as the Mini Mental State Examination) or more specific cognitive tests (e.g., Wisconsin Card Sorting Test and Trail Making Test) could be administered according to the patient's functional status. In this way, clinicians may be aware of the patient's neuropsychological and cognitive level, so they can guarantee a personalized and tailored rehabilitation approach in this frail patient population.
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Affiliation(s)
- William Torregrossa
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Michele Torrisi
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Carmela Casella
- Department of Clinical and Experimental Medicine "AOU Policlinico G. Martino", University Hospital "G. Martino", 98124 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino Pulejo", Via Palermo Cda Casazza, SS113, 98124 Messina, Italy
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Jha M, Sharma V, Anthony A. Neurocognitive and behavioral predictors of theory of mind (ToM) in patients with traumatic brain injury (TBI). Ind Psychiatry J 2023; 32:402-409. [PMID: 38161477 PMCID: PMC10756615 DOI: 10.4103/ipj.ipj_7_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 01/03/2024] Open
Abstract
Background Investigating the core component of social cognition, known as the theory of mind (ToM), becomes imperative in patients with moderate-to-severe traumatic brain injury (TBI) as they may present with social cognitive deficit-related disability interfering with patients' functional and behavioral status. Aims This study aimed to investigate the neurocognitive and behavioral predictors of the ToM in patients with traumatic brain injury (PtTBI). Settings and Design Thirty PtTBI and 30 healthy controls (HCs) were assessed on a set of tasks. Methods and Material The assessment included ToM tasks (cognitive and affective, verbal and nonverbal, and first-order and second-order) along with various neuropsychological (NP) assessments to explore their memory, executive functioning, and intelligence. Further, TBI participants also underwent behavioral and functional outcome measures using the Functional Status Examination (FSE) and the Neurobehavioral Rating Scale (NBRS). Statistical Analysis The obtained data were analyzed using descriptive statistics and regression analyses. Results Findings confirmed ToM deficit across all modes of ToM tasks in PtTBI and implicated the role of executive function and working memory in the expression of ToM in this group. While cognitive faux pas (FPC) and first-order false belief together could explain poor performance on NBRS, the nonverbal ToM task predicts functional outcome in PtTBI. Conclusions These findings have practical implications as they promote cognitive remediation intervention focused on restoring ToM, which may improve functional limitations and resulting disability in PtTBI.
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Affiliation(s)
- Manisha Jha
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences (IHBAS), Dilshad Garden, Delhi, India
| | - Vibha Sharma
- Department of Clinical Psychology, Institute of Human Behaviour and Allied Sciences (IHBAS), Dilshad Garden, Delhi, India
| | - Aldrin Anthony
- Department of Neurology, Institute of Human Behaviour and Allied Sciences (IHBAS), Dilshad Garden, Delhi, India
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8
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Morin A. The Self Course: Lessons Learned from Students' Weekly Questions. Behav Sci (Basel) 2023; 13:525. [PMID: 37503972 PMCID: PMC10376065 DOI: 10.3390/bs13070525] [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: 05/03/2023] [Revised: 06/03/2023] [Accepted: 06/19/2023] [Indexed: 07/29/2023] Open
Abstract
In this paper, I tentatively answer 50 questions sampled from a pool of over 10,000 weekly questions formulated by students in a course entitled "The Self". The questions pertain to various key topics related to self-processes, such as self-awareness, self-knowledge, self-regulation, self-talk, self-esteem, and self-regulation. The students' weekly questions and their answers highlight what is currently known about the self. Answers to the student questions also allow for the identification of some recurrent lessons about the self. Some of these lessons include: all self-processes are interconnected (e.g., prospection depends on autobiography), self-terms must be properly defined (e.g., self-rumination and worry are not the same), inner speech plays an important role in self-processes, controversies are numerous (are animals self-aware?), measurement issues abound (e.g., self-recognition as an operationalization of self-awareness), deficits in some self-processes can have devastating effects (e.g., self-regulatory deficits may lead to financial problems), and there are lots of unknowns about the self (e.g., gender differences in Theory-of-Mind).
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Affiliation(s)
- Alain Morin
- Department of Psychology, Mount Royal University, 4825 Richard Road S.W., Calgary, AB T3E 6K6, Canada
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9
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Neural Correlates of Impaired Self-awareness of Deficits after Acquired Brain Injury: A Systematic Review. Neuropsychol Rev 2023; 33:222-237. [PMID: 35112305 PMCID: PMC9998557 DOI: 10.1007/s11065-022-09535-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 11/29/2021] [Indexed: 10/19/2022]
Abstract
Self-awareness is essential for the process and outcome of rehabilitation but is often affected by acquired brain injury (ABI). While many studies investigated the psychological aspects of self-awareness deficits, the biological underpinnings are not well understood. The aim of this systematic review was to identify the neural correlates of self-awareness after ABI. Results indicate that anticipation of future problems is associated with lesions and decreased neural functioning in the right frontal lobe, as well as increased diffusivity throughout the white matter of the brain. Poor behavioral adjustment on implicit awareness tasks is associated with less functional connectivity of anterior cingulate cortex and right or middle inferior frontal gyri to the fronto-parietal control network, as well as more activation in the left insula and left parietal operculum during error processing. Recognition of mistakes is associated with internetwork connectivity of anterior or posterior default mode network to salience network. In conclusion, after ABI, different results in brain activation and connectivity are found depending on level of awareness measured. Future studies are necessary to confirm these findings.
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10
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Zhou H, He Y, Yuan Z, Zhou Y, Yin J, Chark R, Fong DKC, Fong LHN, Wu AMS. Altered hierarchical organization between empathy and gambling networks in disordered gamblers. Front Psychiatry 2023; 14:1083465. [PMID: 36846215 PMCID: PMC9947716 DOI: 10.3389/fpsyt.2023.1083465] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Despite the demonstrated association between empathy and gambling at the behavioral level, limited neuroimaging research on empathy and gambling disorder (GD) has been conducted. Whether and how the brain network of empathy and that of gambling interact in disordered gamblers has not been investigated. This study aimed to address this research gap by examining the hierarchical organizational patterns, in which the differences of causal interactions of these networks between disordered gamblers and healthy controls were revealed. METHODS Resting-state functional magnetic resonance imaging (fMRI) data of 32 disordered gamblers and 56 healthy controls were included in the formal analysis. Dynamic causal modeling was used to examine the effective connectivity within and between empathy and gambling networks among all participants. RESULTS All participants showed significant effective connectivity within and between empathy and gambling networks. However, compared with healthy controls, disordered gamblers displayed more excitatory effective connectivity within the gambling network, the tendency to display more excitatory effective connectivity from the empathy network to the gambling network, and reduced inhibitory effective connectivity from the gambling network to the empathy network. CONCLUSION The exploratory study was the first to examine the effective connectivity within and between empathy and gambling networks among disordered gamblers and healthy controls. These results provided insights into the causal relationship between empathy and gambling from the neuroscientific perspective and further confirmed that disordered gamblers show altered effective connectivity within and between these two brain networks, which may be considered to be a potential neural index for GD identification. In addition, the altered interactions between empathy and gambling networks may also indicate the potential targets for the neuro-stimulation intervention approach (e.g., transcranial magnetic stimulation).
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Affiliation(s)
- Hui Zhou
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China
| | - Yuwen He
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China.,Bioimaging Core, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Zhen Yuan
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China.,Bioimaging Core, Faculty of Health Sciences, University of Macau, Macao, Macao SAR, China
| | - Yuan Zhou
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jingwen Yin
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China
| | - Robin Chark
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China.,Department of Integrated Resort and Tourism Management, Faculty of Business Administration, University of Macau, Macao, Macao SAR, China
| | - Davis Ka Chio Fong
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China.,Department of Integrated Resort and Tourism Management, Faculty of Business Administration, University of Macau, Macao, Macao SAR, China
| | - Lawrence Hoc Nang Fong
- Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China.,Department of Integrated Resort and Tourism Management, Faculty of Business Administration, University of Macau, Macao, Macao SAR, China
| | - Anise M S Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, Macao SAR, China.,Centre for Cognitive and Brain Sciences, Institute of Collaborative Innovation, University of Macau, Macao, Macao SAR, China
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11
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Mostert CQB, Singh RD, Gerritsen M, Kompanje EJO, Ribbers GM, Peul WC, van Dijck JTJM. Long-term outcome after severe traumatic brain injury: a systematic literature review. Acta Neurochir (Wien) 2022; 164:599-613. [PMID: 35098352 DOI: 10.1007/s00701-021-05086-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/07/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Expectation of long-term outcome is an important factor in treatment decision-making after severe traumatic brain injury (sTBI). Conclusive long-term outcome data substantiating these decisions is nowadays lacking. This systematic review aimed to provide an overview of the scientific literature on long-term outcome after sTBI. METHODS A systematic search was conducted using PubMed from 2008 to 2020. Studies were included when reporting long-term outcome ≥ 2 years after sTBI (GCS 3-8 or AIS head score ≥ 4), using standardized outcome measures. Study quality and risk of bias were assessed using the QUIPS tool. RESULTS Twenty observational studies were included. Studies showed substantial variation in study objectives and study methodology. GOS-E (n = 12) and GOS (n = 8) were the most frequently used outcome measures. Mortality was reported in 46% of patients (range 18-75%). Unfavourable outcome rates ranged from 29 to 100% and full recovery was seen in 21-27% of patients. Most surviving patients reported SF-36 scores lower than the general population. CONCLUSION Literature on long-term outcome after sTBI was limited and heterogeneous. Mortality and unfavourable outcome rates were high and persisting sequelae on multiple domains common. Nonetheless, a considerable proportion of survivors achieved favourable outcome. Future studies should incorporate standardized multidimensional and temporal long-term outcome measures to strengthen the evidence-base for acute and subacute decision-making. HIGHLIGHTS 1. Expectation of long-term outcome is an important factor in treatment decision-making for patients with severe traumatic brain injury (sTBI). 2. Favourable outcome and full recovery after sTBI are possible, but mortality and unfavourable outcome rates are high. 3. sTBI survivors are likely to suffer from a wide range of long-term consequences, underscoring the need for long-term and multi-modality outcome assessment in future studies. 4. The quality of the scientific literature on long-term outcome after sTBI can and should be improved to advance treatment decision-making.
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Affiliation(s)
- Cassidy Q B Mostert
- University Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, Leiden The Hague, Albinusdreef 2, J-11-R-83, 2333 ZA, Leiden, The Netherlands.
| | - Ranjit D Singh
- University Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, Leiden The Hague, Albinusdreef 2, J-11-R-83, 2333 ZA, Leiden, The Netherlands
| | - Maxime Gerritsen
- University Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, Leiden The Hague, Albinusdreef 2, J-11-R-83, 2333 ZA, Leiden, The Netherlands
| | - Erwin J O Kompanje
- Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Gerard M Ribbers
- Department of Rehabilitation Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
- Rijndam Rehabilitation, Rotterdam, The Netherlands
| | - Wilco C Peul
- University Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, Leiden The Hague, Albinusdreef 2, J-11-R-83, 2333 ZA, Leiden, The Netherlands
| | - Jeroen T J M van Dijck
- University Neurosurgical Center Holland, Leiden University Medical Center & Haaglanden Medical Center & Haga Teaching Hospital, Leiden The Hague, Albinusdreef 2, J-11-R-83, 2333 ZA, Leiden, The Netherlands
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12
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13
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Umucu E, Lee B, Genova HM, Chopik WJ, Sung C, Yasuoka M, Niemiec RM. Character Strengths Across Disabilities: An International Exploratory Study and Implications for Positive Psychiatry and Psychology. Front Psychiatry 2022; 13:863977. [PMID: 35280155 PMCID: PMC8914428 DOI: 10.3389/fpsyt.2022.863977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine the differences in character strengths for people with disabilities by using an international dataset by the VIA Institiute on Character. Specifically, we aimed to explore (a) the top and bottom five character strengths reported by different disability groups and all people with disabilities more broadly, and (b) group differences in each character strength and total character strengths. The investigator contacted the VIA Institute on Character (http://www.viacharacter.org/) for obtaining the dataset for the current study. After data cleaning, our sample size resulted in 11,699 people with disabilities. Among most people with disabilities, the top five character strengths scores were love of learning, honesty, appreciation of beauty and excellence, kindness, and fairness. The bottom five character strengths scores were self-regulation, perseverance, zest, spirituality, and prudence. Knowing that there is heterogeneity in character strengths across groups gives us a better understanding of the areas that people with different disabilities and conditions might thrive and provides clinicians and practitioners with a more nuanced understanding for how to possibly intervene with their clients. Positive psychiatry and psychology implications are discussed.
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Affiliation(s)
- Emre Umucu
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, United States
| | - Beatrice Lee
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, United States
| | - Helen M Genova
- Center for Neuropsychology and Neuroscience Research, Kessler Foundation, West Orange, NJ, United States
| | - William J Chopik
- Department of Psychology, Michigan State University, East Lansing, MI, United States
| | - Connie Sung
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, United States
| | - Mizuka Yasuoka
- Department of Counseling, Educational Psychology, and Special Education, Michigan State University, East Lansing, MI, United States
| | - Ryan M Niemiec
- Education Director of the VIA Institute, VIA Institute on Character, Cincinnati, OH, United States
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14
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Villalobos D, Bivona U. Post-traumatic Stress Disorder after Severe Traumatic Brain Injury: A Systematic Review. Arch Clin Neuropsychol 2021; 37:583-594. [PMID: 34933334 DOI: 10.1093/arclin/acab095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The review aimed to summarize the existing knowledge base regarding post-traumatic stress disorder after severe traumatic brain injury (TBI) and try to guide future research. METHOD Web of Science, Scopus, and PubMed databases were used to identify original studies that explored the relationship between severe TBI and post-traumatic stress disorder. RESULTS A total of 13 studies were included in the review. They have been examined in terms of potentially compatible and incompatible mechanisms, as well as of possible confounding factors in relation to the diagnosis of post-traumatic stress disorder after severe TBI. CONCLUSION Only a few studies in the literature have addressed the present topic; therefore, the prevalence of post-traumatic stress disorder in patients with severe TBI still needs to be further investigated. In particular, future studies should be conducted only in severe TBI populations, considering their premorbid personality characteristics and their reactivity alteration. They should also obtain an accurate and appropriate assessment of post-traumatic stress disorder with clinical interviews as well as clarifying the role of post-traumatic amnesia in this population by incorporating control groups of patients.
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Affiliation(s)
- Dolores Villalobos
- Department of Experimental Psychology, School of Psychology, Complutense University, Madrid, Spain.,Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology (Technical University of Madrid and Complutense University of Madrid), Madrid, Spain.,The European Centre of Neuroscience, Madrid, Spain
| | - Umberto Bivona
- IRCCS Fondazione Santa Lucia, Neuroriabilitazione 2, Rome, Italy
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15
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Bivona U, Costa A, Ciurli P, Donvito T, Lombardi G, Misici I, Moretti G, Caltagirone C, Formisano R, Prigatano GP. Modification of the Patient Competency Rating Scale to Measure Anosodiaphoria after Severe Acquired Brain Injury: Preliminary Findings. Arch Clin Neuropsychol 2021; 37:753-761. [PMID: 34933340 DOI: 10.1093/arclin/acab096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Impaired self-awareness (ISA) of altered functional capacities is a common sequelae of severe acquired brain injury that can severely hamper neuro-rehabilitation in this clinical population. ISA is frequently associated with anosodiaphoria and/or apathy. Although several scales are available to measure apathy, no tools have been published to specifically assess anosodiaphoria after acquired brain injury. In this paper, we reported an initial effort to develop an anosodiaphoria subscale in a commonly used measure of ISA, that is, the Patient Competency Rating scale-neurorehabilitation form (PCRS-NR). METHOD A sample of 46 participants with severe acquired brain injury completed a functional, ISA, apathy, and anosodiaphoria assessment. One informal caregiver of each patient participated in the study. Thus, we were able to obtain external data on his/her level of functional competencies, and self-awareness, which allowed separating patients with low self-awareness (LSA) from those with high self-awareness (HSA). Finally, the patients were compared with 44 healthy age-gender-years of formal education matched control participants (HCs). RESULTS Compared to both patients with HSA and HCs, patients with LSA demonstrated greater anosodiapvhoria and lower levels of functioning than both HSA patients and HCs. A stronger relationship emerged between ISA and anosodiaphoria rather than with apathy. CONCLUSIONS These initial findings provide support that PCRS scale can be adapted to measure anosodiaphoria as well as ISA. The findings reveal a stronger correlation between this measure of anosodiaphoria and ISA compared with the correlation of apathy to ISA. The present method for measuring anosodiaphoria takes into account the actual levels of patients' functioning.
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Affiliation(s)
- U Bivona
- IRCCS, Santa Lucia Foundation, Neuroriabilitazione 2, Rome, Italy
| | - A Costa
- IRCCS, Santa Lucia Foundation, Rome, Italy.,Unicusano University, Rome, Italy
| | - P Ciurli
- IRCCS, Santa Lucia Foundation, Neuropsychology Unit, Rome, Italy
| | - T Donvito
- IRCCS, Santa Lucia Foundation, Neuroriabilitazione 2, Rome, Italy
| | - G Lombardi
- IRCCS, Santa Lucia Foundation, Neuroriabilitazione 2, Rome, Italy
| | - I Misici
- IRCCS, Santa Lucia Foundation, Neuroriabilitazione 2, Rome, Italy
| | - G Moretti
- IRCCS, Santa Lucia Foundation, Neuroriabilitazione 2, Rome, Italy
| | - C Caltagirone
- IRCCS, Santa Lucia Foundation, Neuropsychology Unit, Rome, Italy.,Tor Vergata University, Rome, USA
| | - R Formisano
- IRCCS, Santa Lucia Foundation, Neuroriabilitazione 2, Rome, Italy
| | - G P Prigatano
- Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
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Valentini F, Fabio V, Boccia M, Tanzilli A, Iannetti M, Cinelli MC, De Angelis C, Fasotti L, Formisano R, Guariglia C, Ciurli MP. Two Ecological Tools for Testing Slowness of Information Processing in Italian Patients with Moderate-to-Severe Traumatic Brain Injury. Arch Clin Neuropsychol 2021; 37:677-691. [PMID: 34718376 DOI: 10.1093/arclin/acab085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/12/2021] [Accepted: 09/24/2021] [Indexed: 11/12/2022] Open
Abstract
Slowness of Information Processing (SIP) is frequently experienced after traumatic brain injury (TBI); however, the impact of SIP on everyday functioning may be underestimated by standard neuropsychological tests. OBJECTIVE we aimed to adapt two ecological instruments assessing SIP in Italian patients with moderate-to-severe TBI, as formerly proposed by Winkens and colleagues for persons with stroke, testing also its possible relation with other neuropsychological processes and functional outcomes. METHOD we performed an observational study on 37 patients with moderate-to-severe TBI and 35 demographically matched healthy controls, who underwent the Mental Slowness Observation Test (MSOT) and the Mental Slowness Questionnaire (MSQ), which had been adapted through a pilot study on independent sample of participants; extensive neuropsychological and functional evaluations were performed as well. RESULTS We found good clinical and psychometric properties of the Italian adaptation of the MSOT and MSQ; also, performance on MSOT significantly correlated with executive functions. Moreover, patients with TBI are significantly slower and less accurate than healthy controls on the MSOT, in particular in tasks with time limits. Even if the subjective feeling of SIP does not differ between patients and controls, we found a significant correlation between MSQ and MSOT. Finally, the performances on the MSOT correlated with measures of functional outcome and community integration. CONCLUSIONS the results support the use of the MSOT and the MSQ to measure SIP in an ecological fashion in patients with TBI, so that specific treatments for persons with acquired brain injury can be prescribed.
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Affiliation(s)
- Federica Valentini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Valentina Fabio
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Maddalena Boccia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Antonio Tanzilli
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy.,Neuro-Oncology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
| | - Manuela Iannetti
- Neurorehabilitation 2 and Post-coma Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Maria Cristina Cinelli
- Cognitive and Motor Rehabilitation and Neuroimaging Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Carmela De Angelis
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Luciano Fasotti
- Rehabilitation Medical Centre Groot Klimmendaal, 6813 Arnhem, The Netherlands.,Donders Institute for Brain, Cognition, and Behaviour, Radboud University, 6525 Nijmegen, The Netherlands
| | - Rita Formisano
- Neurorehabilitation 2 and Post-coma Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Cecilia Guariglia
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy.,Neuropsychology Unit, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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Costa A, Bivona U, Sulpizio V, Nappo R, Mastrilli L, Formisano R, Aloisi M, Contrada M, Caltagirone C, Galati G. Reduced Priming Effect for Visual-Spatial Perspective Taking in Patients With Severe Acquired Brain Injury. Arch Clin Neuropsychol 2021; 37:227-239. [PMID: 34423813 DOI: 10.1093/arclin/acab069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Social cognition can be impaired after a severe acquired brain injury (sABI), but mechanisms potentially underlying these difficulties remain to be clarified. This study aimed at investigating perspective taking ability in individuals with sABI. METHOD Twenty individuals with sABI and 20 healthy controls (HCs) have been enrolled in this case-control study. All participants were submitted to an experimental visual-spatial priming memory procedure and a self-report assessment of perspective taking (i.e., the Interpersonal Reactivity Index [IRI]). Individuals with sABI were submitted to neuropsychological tests to assess executive subcomponents, working memory, and visual attention. RESULTS The analysis on self-report scales data documents a significant between groups difference in the IRI-Fantasy subscale, with HCs showing a higher tendency to imaginatively transpose oneself into fictional situations than individuals with sABI. Analysis of performance on the experimental procedure revealed the priming effect in HCs but not in sABI individuals. Moreover, individuals with sABI performed significantly poorer than HCs on the indices of the experimental procedure. CONCLUSIONS Our data preliminarily demonstrated that visual-spatial perspective taking is reduced after sABI. Findings above could give some clues for the rehabilitative intervention in sABI and suggest the possible application of the procedure here used in assessing perspective taking after sABI.
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Affiliation(s)
- Alberto Costa
- Niccolò Cusano University, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Valentina Sulpizio
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Sapienza University, Rome, Italy
| | | | | | | | | | | | - Carlo Caltagirone
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Tor Vergata University, Rome, Italy
| | - Gaspare Galati
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Sapienza University, Rome, Italy
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Dromer E, Kheloufi L, Azouvi P. Impaired self-awareness after traumatic brain injury: A systematic review. Part 2. Consequences and predictors of poor self-awareness. Ann Phys Rehabil Med 2021; 64:101542. [PMID: 34029754 DOI: 10.1016/j.rehab.2021.101542] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Impaired self-awareness (ISA) has frequently been found both frequent and deleterious in patients with moderate to severe traumatic brain injury (TBI). OBJECTIVES This is the second of a two-part systematic review on ISA after TBI, focusing on the consequences and predictors of ISA after TBI. METHODS Following the PRISMA guidelines, 95 articles meeting the inclusion criteria were included; 46 were specifically related to this second part of the review. RESULTS Among 16 studies that investigated the effect of ISA on outcome, most (n=13) found poor self-awareness associated with poor rehabilitation, functional, social and vocational outcome and with increased burden on relatives. Multiple factors have been found associated with increased frequency of ISA. ISA was found significantly related to injury severity in 8 of 10 studies, impaired executive functions in 12 of 15 studies, and poor social cognition in 3 studies, but paradoxically inverse associations were repeatedly found between self-awareness and emotional status (11 of 12 studies). Finally, although research in the field is still scarce, ISA seems associated with a dysfunction within brain networks involving the anterior cingulate cortex, anterior insula and fronto-parietal control network. CONCLUSIONS ISA is a complex and multifaceted disorder associated with poor rehabilitation outcome, severe injuries, and deficits of executive functions and social cognition but has an inverse association with mood impairments.
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Affiliation(s)
- Emilie Dromer
- AP-HP, GHU Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - Lyes Kheloufi
- AP-HP, GHU Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France
| | - Philippe Azouvi
- AP-HP, GHU Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré, Garches, France; Université Paris-Saclay, UVSQ, Inserm, CESP, Team DevPsy, 94807 Villejuif, France.
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19
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Brown L, Fish J, Mograbi DC, Bellesi G, Ashkan K, Morris R. Awareness of deficit following traumatic brain injury: A systematic review of current methods of assessment. Neuropsychol Rehabil 2021; 31:154-188. [PMID: 31642719 DOI: 10.1080/09602011.2019.1680393] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
Background: Awareness of deficit plays an important role in adjustment following a brain injury and has been noted to impact on engagement with and outcome of rehabilitation. However, there are challenges associated with the assessment of awareness. Aim: To systematically review all instruments used to assess intellectual awareness of deficits following Traumatic Brain Injury (TBI) in adults, and evaluate instrument characteristics (e.g., the format and focus of measures of awareness) and assessment methods adopted. Results: Thirty-four studies, all rated as fair to good quality, were identified and within these twenty-three different assessment tools were adopted. The most common method of assessment was patient-proxy discrepancy, with three frequently used instruments employed in a total of 22 of the 34 studies. Across studies, variability was noted regarding the type of assessment method dependent on various sample demographics (e.g., age of sample) and injury characteristics (e.g., time post injury). Conclusions: There is no consensus on the preferred instrument to assess intellectual awareness of deficits after TBI. Continued instrument development should attempt to incorporate multiple perspectives and assessment should take into account demographic and injury-related factors. An insightful avenue for future research would be to determine which factors are likely to impact awareness measurement.
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Affiliation(s)
- Laura Brown
- King's College Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Jessica Fish
- King's College Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Daniel C Mograbi
- King's College Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janerio, Brazil
| | - Giulia Bellesi
- King's College Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | - Robin Morris
- King's College Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Lin X, Zhang X, Liu Q, Zhao P, Zhang H, Wang H, Yi Z. Theory of mind in adults with traumatic brain injury: A meta-analysis. Neurosci Biobehav Rev 2020; 121:106-118. [PMID: 33359093 DOI: 10.1016/j.neubiorev.2020.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/27/2020] [Accepted: 12/08/2020] [Indexed: 01/11/2023]
Abstract
Studies of abnormal theory of mind (ToM) performance in adult patients with traumatic brain injury (TBI) have reported inconsistent results. Therefore, we conducted a meta-analysis to characterize ToM performance in adult patients with TBI. Random-effects models were employed to estimate the overall effect size and the differential effect sizes across different ToM aspects. Based on a sample of 28 studies (1031 patients and 865 healthy controls), the meta-analytic findings revealed that ToM was significantly impaired in adult patients with TBI compared to healthy controls (g = -1.13). Besides, patients with TBI showed significant impairments in individual ToM tasks, as well as for different stimulus modes and contents involved in these ToM tasks. A meta-regression indicated a positive association between ToM performance and Glasgow Coma Scale score. The results of the current meta-analysis suggest that the performance in ToM tasks may be a good predictor of functional outcomes in adults with TBI, which is important for the identification of targets for cognitive interventions and the development of useful training intervention programs.
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Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Hui Zhang
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - HongSheng Wang
- Department of Neurosurgery, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China.
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China.
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21
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Tomaiuolo F, Cerasa A, Lerch JP, Bivona U, Carlesimo GA, Ciurli P, Raffa G, Quattropani MC, Germanò A, Caltagirone C, Formisano R, Nigro S. Brain Neurodegeneration in the Chronic Stage of the Survivors from Severe Non-Missile Traumatic Brain Injury: A Voxel-Based Morphometry Within-Group at One versus Nine Years from a Head Injury. J Neurotrauma 2020; 38:283-290. [PMID: 32962533 DOI: 10.1089/neu.2020.7203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The long-term time course of neuropathological changes occurring in survivors from severe traumatic brain injury (TBI) remains uncertain. We investigated the brain morphometry and memory performance modifications within the same group of severe non-missile traumatic brain injury patients (nmTBI) after about ∼one year and at ∼ nine years from injury. Brain magnetic resonance imaging (MRI) measurements were performed with voxel-based morphometry (VBM) to determine specific changes in the gray matter (GM) and white matter (WM) and the overall gray matter volume modifications (GMV) and white matter volume modifications (WMV). Contemporarily, memory-tests were also administered. In comparison with healthy control subjects (HC), those with nmTBI showed a significant change and volume reduction in the GM and WM and also in the GMV and WMV after ∼one year; conversely, ∼nine years after injury, neurodegenerative changes spared the GM and GMV, but a prominent loss was detected in WMV and in WM sites, such as the superior longitudinal fasciculi, the body of the corpus callosum, the optic radiation, and the uncinate fasciculus. Memory performance at ∼one year in comparison with ∼nine years was stable with a subtle but significant trend toward recovery. These data demonstrate that patients with nmTBI undergo neurodegenerative processes during the chronic stage affecting mainly the cerebral WM rather than GM. Despite these anatomical brain parenchyma losses, memory performance tends to be stable or even slightly recovered. These results suggest possible correlations between progressive demyelinization and/or neuropsychiatric changes other than memory performance, and support possible treatments to prevent long-term WM degeneration of the examined nmTBI.
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Affiliation(s)
- Francesco Tomaiuolo
- Department of Clinical and Experimental Medicine and Department BIOMORF, University of Messina, Messina, Italy
| | - Antonio Cerasa
- IRIB, National Research Council, Cosenza, Italy, and S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
| | - Jason P Lerch
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, The University of Oxford, Oxford, United Kingdom
| | | | - Giovanni Augusto Carlesimo
- IRCCS Fondazione 'Santa Lucia', Rome, Italy.,Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | | | - Giovanni Raffa
- Division of Neurosurgery, Department BIOMORF, University of Messina, Messina, Italy
| | - Marina Catena Quattropani
- Department of Clinical and Experimental Medicine and Department BIOMORF, University of Messina, Messina, Italy
| | - Antonino Germanò
- Division of Neurosurgery, Department BIOMORF, University of Messina, Messina, Italy
| | | | | | - Salvatore Nigro
- Institute of Nanotechnology (NANOTEC), National Research Council, Lecce, Italy
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22
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Bivona U, Ciurli P, Ferri G, Fontanelli T, Lucatello S, Donvito T, Villalobos D, Cellupica L, Mungiello F, Lo Sterzo P, Ferraro A, Giandotti E, Lombardi G, Azicnuda E, Caltagirone C, Formisano R, Costa A. The Self-Awareness Multilevel Assessment Scale, a New Tool for the Assessment of Self-Awareness After Severe Acquired Brain Injury: Preliminary Findings. Front Psychol 2020; 11:1732. [PMID: 32793065 PMCID: PMC7393213 DOI: 10.3389/fpsyg.2020.01732] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 06/23/2020] [Indexed: 11/21/2022] Open
Abstract
Self-awareness (SA) is frequently impaired after severe acquired brain injury (sABI) and may lead to reduced subject's compliance to treatment, worse functional outcome, and high caregiver distress. Considering the multifaceted nature of SA, a specific and effective assessment is crucial to address treatment of impairment of SA (ISA). Many tools can currently assess ISA; however, they have some important limits. In the present study, we proposed the Self-Awareness Multilevel Assessment Scale (SAMAS), a new scale for assessment of SA at different levels (i.e., declarative, emergent, and anticipatory) across all domains of functioning. The SAMAS has been designed to be administered by the cognitive/behavioral therapist with the involvement of a patient's relative. Findings showed that the SAMAS allowed specifically assessing SA at a declarative level and on all possible functional domains. More interestingly, it seems also able to assess both emergent and anticipatory SA, thus overcoming some important limits of other current assessment methods. Our findings are consistent with a holistic perspective of the patient with sABI because thanks to the combined use of assessing tools, the SAMAS can provide an accurate diagnosis of ISA, thus better addressing the neurorehabilitation treatment and, accordingly, reducing the possible occurrence of its primary and secondary implications.
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Affiliation(s)
- Umberto Bivona
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Paola Ciurli
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Giulia Ferri
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Tiziana Fontanelli
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Susanna Lucatello
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Teresa Donvito
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Dolores Villalobos
- Department of Psychology, Faculty of Health Sciences, Camilo José Cela University, Madrid, Spain
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology (Technical University of Madrid and Complutense University of Madrid), Madrid, Spain
| | - Laura Cellupica
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Fabiana Mungiello
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Paola Lo Sterzo
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Amalia Ferraro
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Eleonora Giandotti
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Giorgio Lombardi
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Eva Azicnuda
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Carlo Caltagirone
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
- Tor Vergata University, Rome, Italy
| | - Rita Formisano
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
| | - Alberto Costa
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Santa Lucia Foundation, Rome, Italy
- Università Telematica Niccolò Cusano, Rome, Italy
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23
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Calvillo M, Irimia A. Neuroimaging and Psychometric Assessment of Mild Cognitive Impairment After Traumatic Brain Injury. Front Psychol 2020; 11:1423. [PMID: 32733322 PMCID: PMC7358255 DOI: 10.3389/fpsyg.2020.01423] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 05/27/2020] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) can be serious partly due to the challenges of assessing and treating its neurocognitive and affective sequelae. The effects of a single TBI may persist for years and can limit patients’ activities due to somatic complaints (headaches, vertigo, sleep disturbances, nausea, light or sound sensitivity), affective sequelae (post-traumatic depressive symptoms, anxiety, irritability, emotional instability) and mild cognitive impairment (MCI, including social cognition disturbances, attention deficits, information processing speed decreases, memory degradation and executive dysfunction). Despite a growing amount of research, study comparison and knowledge synthesis in this field are problematic due to TBI heterogeneity and factors like injury mechanism, age at or time since injury. The relative lack of standardization in neuropsychological assessment strategies for quantifying sequelae adds to these challenges, and the proper administration of neuropsychological testing relative to the relationship between TBI, MCI and neuroimaging has not been reviewed satisfactorily. Social cognition impairments after TBI (e.g., disturbed emotion recognition, theory of mind impairment, altered self-awareness) and their neuroimaging correlates have not been explored thoroughly. This review consolidates recent findings on the cognitive and affective consequences of TBI in relation to neuropsychological testing strategies, to neurobiological and neuroimaging correlates, and to patient age at and assessment time after injury. All cognitive domains recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are reviewed, including social cognition, complex attention, learning and memory, executive function, language and perceptual-motor function. Affect and effort are additionally discussed owing to their relationships to cognition and to their potentially confounding effects. Our findings highlight non-negligible cognitive and affective impairments following TBI, their gravity often increasing with injury severity. Future research should study (A) language, executive and perceptual-motor function (whose evolution post-TBI remains under-explored), (B) the effects of age at and time since injury, and (C) cognitive impairment severity as a function of injury severity. Such efforts should aim to develop and standardize batteries for cognitive subdomains—rather than only domains—with high ecological validity. Additionally, they should utilize multivariate techniques like factor analysis and related methods to clarify which cognitive subdomains or components are indeed measured by standardized tests.
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Affiliation(s)
- Maria Calvillo
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States.,Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, United States
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24
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Venkatesan UM, Lancaster K, Lengenfelder J, Genova HM. Independent contributions of social cognition and depression to functional status after moderate or severe traumatic brain injury. Neuropsychol Rehabil 2020; 31:954-970. [PMID: 32314644 DOI: 10.1080/09602011.2020.1749675] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Impairments in cognitive processing related to social understanding and communication (i.e., "social cognition") are well documented after moderate or severe traumatic brain injury (TBI) and can contribute to negative functional outcome. Depression is also a common feature of TBI with detrimental functional consequences. We evaluated relationships between social cognition, depression symptom severity, and functional status in individuals with chronic TBI (>1 year post injury; n = 25) and healthy controls (n = 30) using objective tests of social cognition as well as self-reported depression (Beck Depression Inventory-II) and functional status (Functional Behavior Profile). Results revealed significant relationships between depression and functional status across the sample, and relationships between social cognition and functional status specific to TBI. In the TBI group only, social cognition significantly predicted both overall and social functional status above and beyond depression. Group differences in functional status were independently mediated by social cognition and, especially, depression. Our findings suggest that social cognitive impairments and depression are distinct, functionally relevant TBI sequelae. Interventions to improve social functioning in this population may be most effective when contextualized within treatments for emotional disturbances.
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Affiliation(s)
| | - Katie Lancaster
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Jean Lengenfelder
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Helen M Genova
- Kessler Foundation Research Center, West Orange, NJ, USA.,Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
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25
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Corallo F, Bonanno L, Formica C, Corallo F, De Salvo S, Lo Buono V, Di Cara M, Alagna A, Rifici C, Bramanti P, Marino S. Religious Coping in Caregiver of Patients with Acquired Brain Injuries. JOURNAL OF RELIGION AND HEALTH 2019; 58:1444-1452. [PMID: 31098828 DOI: 10.1007/s10943-019-00840-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Caregivers play a crucial role in physical and psychological management in terms of assistance. For this reason, it is important for caregivers to find better coping strategies to minimize a possible physical and emotional burden. The aim of our study is to demonstrate how the religious coping can influence the burden of caregivers about health care of patients with severe brain injuries. Caregivers were, respectively, divided into two groups: 31 religious believers and 20 unbelievers. We submitted the questionnaires to participants, which investigate the caregiver burden, presence of depressive symptoms and kind of coping strategies adopted. Our results demonstrated that participants with religious belief used avoidance strategies more frequently compared to non-believers' group. We want to improve adaptive coping strategies to upgrade the awareness of caregiver, supporting burden and distress. A problem-solving training might improve quality of life in terms of social and psychological wellness.
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Affiliation(s)
- Francesco Corallo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy.
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Caterina Formica
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
- Biomedical Department of Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Federica Corallo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Simona De Salvo
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Marcella Di Cara
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Antonella Alagna
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino Pulejo", S.S. 113, Via Palermo, C.da Casazza, 98124, Messina, Italy
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Via Consolare Valeria, Messina, Italy
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26
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Bivona U, Costa A, Contrada M, Silvestro D, Azicnuda E, Aloisi M, Catania G, Ciurli P, Guariglia C, Caltagirone C, Formisano R, Prigatano GP. Depression, apathy and impaired self-awareness following severe traumatic brain injury: a preliminary investigation. Brain Inj 2019; 33:1245-1256. [PMID: 31304792 DOI: 10.1080/02699052.2019.1641225] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Primary Objective: The primary aim of this study was to determine the frequency of severe impaired self-awareness (ISA) in patients with severe traumatic brain injury (TBI) and the correlates of selected clinical, neuropsychiatric and cognitive variables. The secondary aim of the study was to assess depression and apathy on the basis of their level of self-awareness. Methods: Thirty patients with severe TBI and 30 demographically matched healthy control subjects (HCs) were compared on measures of ISA, depression, anxiety, alexithymia, neuropsychiatric symptoms and cognitive flexibility. Results: Twenty percent of the patients demonstrated severe ISA. Severe post-acute ISA was associated with more severe cognitive inflexibility, despite the absence of differences in TBI severity, as evidenced by a Glasgow Coma Scale (GCS) score lower than 9 in all cases in the acute phase. Patients with severe ISA showed lower levels of depression and anxiety but tended to show more apathy and to have greater difficulty describing their emotional state than patients with severe TBI who showed minimal or no disturbance in self-awareness. Conclusion: These findings support the general hypothesis that severe ISA following severe TBI is typically not associated with depression and anxiety, but rather with apathy and cognitive inflexibility.
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Affiliation(s)
- U Bivona
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - A Costa
- b Unicusano University , Rome , Italy
| | - M Contrada
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - D Silvestro
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - E Azicnuda
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - M Aloisi
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - G Catania
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - P Ciurli
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - C Guariglia
- a IRCCS, Santa Lucia Foundation , Rome , Italy.,c Sapienza University , Rome , Italy
| | - C Caltagirone
- a IRCCS, Santa Lucia Foundation , Rome , Italy.,d Tor Vergata University , Rome , Italy
| | - R Formisano
- a IRCCS, Santa Lucia Foundation , Rome , Italy
| | - G P Prigatano
- e Department of Clinical Neuropsychology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix , AZ , USA
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27
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Gallant C, Good D. Examining the “reading the mind in the eyes test” as an assessment of subtle differences in affective theory of mind after concussion. Clin Neuropsychol 2019; 34:296-317. [DOI: 10.1080/13854046.2019.1612946] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Caitlyn Gallant
- Department of Psychology, Brock University, St. Catharines, ON, Canada
| | - Dawn Good
- Department of Psychology, Brock University, St. Catharines, ON, Canada
- Centre for Neuroscience, Brock University, St. Catharines, ON, Canada
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28
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Bhatti JA, Thiruchelvam D, Redelmeier DA. Traumatic brain injury as an independent risk factor for problem gambling: a matched case-control study. Soc Psychiatry Psychiatr Epidemiol 2019; 54:517-523. [PMID: 30232507 DOI: 10.1007/s00127-018-1583-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/20/2018] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess whether traumatic brain injury (TBI) increases the risks of subsequent problem gambling. METHODS We conducted a matched case-control analysis of adults in Ontario, Canada. The study included those who self-reported their gambling activities in the Canadian Community Health Survey 2007-2008. Using Problem Gambling Severity Index, we defined cases as those who were problem gamblers and controls who were recreational gamblers. Cases were matched to controls 1:2 using propensity scores based on demographics, prior mental health, and self-reported behaviours. The main predictor was prior TBI defined as requiring emergency care and identified using ICD-10 codes from administrative health databases. We estimated the likelihood of prior TBI in problem gamblers compared to controls using conditional logistic regression. RESULTS Of 30,652 survey participants, 16,002 (53%) reported gambling activity of whom 14,910 (49%) were recreational gamblers and 4% (n = 1092) were problem gamblers. A total of 1469 respondents (5%) had a prior TBI. Propensity score matching yielded 2038 matched pairs with 1019 cases matched to 2037 controls. Case-control analysis showed a significant association between prior TBI and subsequent problem gambling (odds ratio 1.27, 95% confidence interval 1.07-1.51, P = 0.007). The increased risk was mostly apparent in men aged 35 to 64 years who reported alcohol use or smoking. The relative risk of problem gambling in those with two or more TBIs equated to an odds ratio of 2.04 (95% confidence interval 1.05-3.99). CONCLUSIONS We found that a prior TBI was associated with an increased subsequent risk of problem gambling. Our findings support more awareness, screening, and treating problem gambling risks among TBI patients.
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Affiliation(s)
- Junaid A Bhatti
- Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Canada.
- Departments of Surgery and Medicine, University of Toronto, Toronto, Canada.
- Institute for Clinical Evaluative Sciences, Toronto, Canada.
- Department of Surgery, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, G106, Toronto, ON, M4N 3M5, Canada.
| | | | - Donald A Redelmeier
- Sunnybrook Research Institute, Evaluative Clinical Sciences, Toronto, Canada
- Departments of Surgery and Medicine, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
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29
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McKerral M, Moreno A, Delhomme P, Gélinas I. Driving Behaviors 2-3 Years After Traumatic Brain Injury Rehabilitation: A Multicenter Case-Control Study. Front Neurol 2019; 10:144. [PMID: 30899239 PMCID: PMC6417438 DOI: 10.3389/fneur.2019.00144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/05/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: Driving an automobile is an important activity for the social participation of individuals with traumatic brain injury (TBI). Return to safe driving is usually addressed during rehabilitation, but we know little about driving behaviors in the years following TBI rehabilitation. Objective: To explore self-reported and objective (official driving records) post-rehabilitation driving behaviors and offenses in individuals with TBI: (a) having passed a driving evaluation, (b) who did not undergo a driving evaluation, and (c) non-injured controls. Methods: Cross-sectional design with 162 adults: (a) 48 participants with mild, moderate, or severe TBI whose drivers' license was suspended and reinstated following a driving evaluation during rehabilitation (TBI-DE; M = 42.2 years of age, SD = 11.5); (b) 24 participants with TBI who maintained their driving privileges without undergoing a driving evaluation (TBI-NE; M = 36.5 years of age, SD = 9.9); (c) 90 non-injured controls (M = 43.8 years of age, SD = 11.4). Participants with TBI were recruited from seven rehabilitation centers, 2–3 years after the end of rehabilitation in the province of Quebec, Canada. During a telephone interview, data were obtained regarding self-reported driving: (a) habits; (b) self-efficacy; (c) anger expression; (d) sensation-seeking; (e) violations/errors; (f) accidents, driving offenses, and demerit points for the two-year interval predating the study. Objective data for driving offenses, accidents, and demerit points were obtained from the automobile regulatory body for the same period and for the two-year interval before the injury for the TBI groups. Results: Compared to non-injured controls, the TBI-DE group reported significantly lower scores for self-reported verbal aggressive expression of anger and driving violations/errors. Conversely, their official driving records showed significantly more demerit points for the last 2 years, and a significantly higher frequency of serious post-rehabilitation accidents (10), compared to the TBI-NE group (one) and the control group (none). Compared to pre-injury levels, individuals with TBI had significantly more demerit points post-rehabilitation. Conclusions: Individuals with TBI may underestimate risky driving behaviors even if they have been deemed fit to drive. Reduced self-awareness, memory, and dysexecutive problems following TBI could influence self-report of driving behaviors and explain discrepancies between self-reported and objective driving-related behaviors. Recommendations for research and practice are provided.
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Affiliation(s)
- Michelle McKerral
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada.,Departement of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Alexander Moreno
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - Patricia Delhomme
- French Institute of Science and Technology for Transport, Development and Networks (IFSTTAR), Versailles, France
| | - Isabelle Gélinas
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR) - CISSS de Laval, and School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
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30
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Soendergaard PL, Siert L, Poulsen I, Wood RL, Norup A. Measuring Neurobehavioral Disabilities Among Severe Brain Injury Survivors: Reports of Survivors and Proxies in the Chronic Phase. Front Neurol 2019; 10:51. [PMID: 30804873 PMCID: PMC6370614 DOI: 10.3389/fneur.2019.00051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 01/15/2019] [Indexed: 11/28/2022] Open
Abstract
Background: Neurobehavioral disability (NBD) has a major influence on long-term psychosocial outcome following acquired brain injury, as it affects not only the survivor of the brain injury, but the whole family. Objectives: To investigate (1) the frequency of NBD among survivors of severe brain injury measured by the Danish version of the St Andrew's-Swansea Neurobehavioural Outcome Scale (SASNOS) rated by patients and proxies, (2) factors associated with NBD, and (3) concordance between reports of NBD completed by patients and proxies. Methods: SASNOS was administered at an outpatient unit as a part of a follow-up assessment after discharge from intensive neurorehabilitation. SASNOS consists of five factors describing the following domains: Interpersonal Behavior, Cognition, Aggression, Inhibition and Communication, and both the patient and a proxy were asked to complete the questionnaire. Data collection was conducted over a period of 2 years, and 32 patients and 31 proxies completed the questionnaire. Mean time since injury was 19.4 months (10.0 SD). Most patients were male (68.8%), and most proxies were female (58.1%). Most of the patients had suffered a traumatic brain injury (68.8%). Results: A fourth of this patient group reported themselves below the normal range on the major domains of Interpersonal Behavior and Cognition. Significant associations between proxies' reports and time since injury, cohabitant status, and the patient's score on the Extended Glasgow Outcome Scale were found. Furthermore, significant differences were found between patient and proxy ratings. Proxies rated patients as having fewer problems on the Interpersonal Behavior domain, and more problems in relation to Cognition. Cognition was the only domain, where patients rated themselves higher indicating fewer problems, compared with their proxies. On both the Aggression and Communication domains, proxies rated patients higher indicating fewer problems than the patients themselves. Conclusion: Danish brain injury survivors experienced NBD as measured by SASNOS. Differences were found between patient and proxy ratings in relation to Cognition and Interpersonal Behavior. The NBDs identified can affect the survivor's ability to reintegrate and participate in activities of daily living, emphasizing how a systematic assessment is required.
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Affiliation(s)
- Pernille Langer Soendergaard
- Department of Neurology, Rigshospitalet, Glostrup, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Lars Siert
- RUBRIC (Research Unit on Brain Injury Rehabilitation Copenhagen), Department of Neurorehabilitation, TBI Unit, Copenhagen University Hospital, Rigshospitalet, Hvidovre, Denmark
| | - Ingrid Poulsen
- RUBRIC (Research Unit on Brain Injury Rehabilitation Copenhagen), Department of Neurorehabilitation, TBI Unit, Copenhagen University Hospital, Rigshospitalet, Hvidovre, Denmark.,Health, Section of Nursing Science, Aarhus University, Aarhus, Denmark
| | - Rodger Ll Wood
- Swansea University, Institute of Life Sciences, College of Medicine, Swansea, United Kingdom
| | - Anne Norup
- Department of Neurology, Rigshospitalet, Glostrup, Denmark.,Department of Psychology, University of Southern Denmark, Odense, Denmark
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31
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Vallat-Azouvi C, Azouvi P, Le-Bornec G, Brunet-Gouet E. Treatment of social cognition impairments in patients with traumatic brain injury: a critical review. Brain Inj 2018; 33:87-93. [PMID: 30346856 DOI: 10.1080/02699052.2018.1531309] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective: The aim of this study is to review published research on treatment of social cognition impairments in patients with traumatic brain injury (TBI).Methods: Following the PRISMA guidelines, a PubMed literature search was conducted, followed by a manual search in recently published papers. Main criteria for selection were that patients had sustained a TBI, and that social cognition was the main target of treatment. A total of 16 papers and three reviews were selected and included in the present review.Results: Five studies (including three randomized controlled trials (RCT)) addressed facial affect recognition, one study specifically addressed emotional prosody, two RCTs used a combination of treatment strategies addressing social perception deficits. Six studies, including two RCTs, addressed social communication skills or theory of mind. Finally, two RCTs reported the effectiveness of a more global approach, addressing multiple domains of social cognition, such as emotion perception, social skills training, and theory of mind.Discussion/conclusion: Although there has been much less research on treatment of social cognition in patients with TBI as compared with psychiatric conditions, the findings reported in the present review are encouraging. Further multicenter large-scale RCTs are needed, with special emphasis on the generalization of treatment effects to social skills in everyday life.
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Affiliation(s)
- Claire Vallat-Azouvi
- Laboratoire de Psychopathologie et Neuropsychologie, EA 2027, Université Paris 8, Saint-Denis.,Antenne UEROS- UGECAMIDF, Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP, Hôpital Raymond Poincaré, Garches, France.,HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Gaelle Le-Bornec
- Service de Médecine Physique et de Réadaptation, APHP, Hôpital Raymond Poincaré, Garches, France.,HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eric Brunet-Gouet
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France.,Service de Psychiatrie, Centre Hospitalier de Versailles, Le Chesnay, France
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32
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Bivona U, Formisano R, Mastrilli L, Zabberoni S, Caltagirone C, Costa A. Theory of Mind after Severe Acquired Brain Injury: Clues for Interpretation. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5205642. [PMID: 30069471 PMCID: PMC6057350 DOI: 10.1155/2018/5205642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/24/2018] [Accepted: 06/04/2018] [Indexed: 11/30/2022]
Abstract
Background. Recently, increased interest has been shown in Theory of Mind (ToM) abilities of individuals with severe acquired brain injury (sABI). ToM impairment following sABI can be associated with altered executive functioning and/or with difficulty in decoding and elaborating emotions. Two main theoretical models have been proposed to explain the mechanisms underlying ToM in the general population: Theory Theory and Simulation Theory. This review presents and discusses the literature on ToM abilities in individuals with sABI by examining whether they sustain the applicability of the Theory Theory and/or Simulation Theory to account for ToM deficits in this clinical population. We found 32 papers that are directly aimed at investigating ToM in sABI. Results did not show the univocal predominance of one model with respect to the other in explaining ToM deficits in sABI. We hypothesised that ToM processes could be explained by coinvolvement of the two models, i.e., according to personal experience, cognitive features, or the emotional resources of the persons with sABI.
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Affiliation(s)
- U. Bivona
- Fondazione Santa Lucia, IRCCS, Rome, Italy
| | | | | | - S. Zabberoni
- Fondazione Santa Lucia, IRCCS, Rome, Italy
- Università telematica Niccolò Cusano, Rome, Italy
| | - C. Caltagirone
- Fondazione Santa Lucia, IRCCS, Rome, Italy
- Università Tor Vergata, Rome, Italy
| | - A. Costa
- Fondazione Santa Lucia, IRCCS, Rome, Italy
- Università telematica Niccolò Cusano, Rome, Italy
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34
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Chesnel C, Jourdan C, Bayen E, Ghout I, Darnoux E, Azerad S, Charanton J, Aegerter P, Pradat-Diehl P, Ruet A, Azouvi P, Vallat-Azouvi C. Self-awareness four years after severe traumatic brain injury: discordance between the patient’s and relative’s complaints. Results from the PariS-TBI study. Clin Rehabil 2017; 32:692-704. [DOI: 10.1177/0269215517734294] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: To evaluate the patient’s awareness of his or her difficulties in the chronic phase of severe traumatic brain injury (TBI) and to determine the factors related to poor awareness. Design/Setting/Subjects: This study was part of a larger prospective inception cohort study of patients with severe TBI in the Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was carried out at four years and included the Brain Injury Complaint Questionnaire (BICoQ) completed by the patient and his or her relative as well as the evaluation of impairments, disability and quality of life. Results: A total of 90 patient-relative pairs were included. Lack of awareness was measured using the unawareness index that corresponded to the number of discordant results between the patient and relative in the direction of under evaluation of difficulties by the patient. The only significant relationship found with lack of awareness was the subjective burden perceived by the relative (Zarit Burden Inventory) ( r = 0.5; P < 0.00001). There was no significant relationship between lack of awareness and injury severity, pre-injury socio-demographic data, cognitive impairments, mood disorders, functional independence (Barthel index), global disability (Glasgow Outcome Scale), return to work at four years or quality of life (Quality Of Life after Brain Injury scale (QOLIBRI)). Conclusion: Lack of awareness four years post severe TBI was not related to the severity of the initial trauma, sociodemographic data, the severity of impairments, limitations of activity and participation, or the patient’s quality of life. However, poor awareness did significantly influence the weight of the burden perceived by the relative.
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Affiliation(s)
- Camille Chesnel
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Claire Jourdan
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Eleonore Bayen
- Laboratoire d’Économie et de Gestion des Organisations de Santé (LEDa-LEGOS), Université Paris-Dauphine, Paris, France
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Idir Ghout
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - Emmanuelle Darnoux
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Sylvie Azerad
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
| | - James Charanton
- Centre Ressources Francilien du Traumatisme Crânien (CRFTC), Paris, France
| | - Philippe Aegerter
- Unité de Recherche Clinique (URC), APHP – Hôpital Ambroise Paré, Boulogne, France
- UMR-S 1168, Université de Versailles Saint-Quentin, Versailles, France
| | - Pascale Pradat-Diehl
- Université Pierre et Marie Curie, Paris, France
- Service de Médecine Physique et de Réadaptation, APHP – Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Alexis Ruet
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
| | - Philippe Azouvi
- Service de Médecine Physique et de Réadaptation, APHP – Hôpital Raymond Poincaré, Garches, France
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
| | - Claire Vallat-Azouvi
- HANDIReSP EA 4047, Université de Versailles Saint-Quentin, Montigny-Le-Bretonneux, France
- Antenne UEROS-SAMSAH92-UGECAM IDF, Hôpital Raymond Poincaré, Garches, France
- EA 2027: Laboratoire de Psychopathologie et Neuropsychologie, Université Paris 8, Saint-Denis, France
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Ekhtiari H, Rezapour T, Aupperle RL, Paulus MP. Neuroscience-informed psychoeducation for addiction medicine: A neurocognitive perspective. PROGRESS IN BRAIN RESEARCH 2017; 235:239-264. [PMID: 29054291 PMCID: PMC5771228 DOI: 10.1016/bs.pbr.2017.08.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Psychoeducation (PE) is defined as an intervention with systematic, structured, and didactic knowledge transfer for an illness and its treatment, integrating emotional and motivational aspects to enable patients to cope with the illness and to improve its treatment adherence and efficacy. PE is considered an important component of treatment in both medical and psychiatric disorders, especially for mental health disorders associated with lack of insight, such as alcohol and substance use disorders (ASUDs). New advancements in neuroscience have shed light on how various aspects of ASUDs may relate to neural processes. However, the actual impact of neuroscience in the real-life clinical practice of addiction medicine is minimal. In this chapter, we provide a perspective on how PE in addiction medicine can be informed by neuroscience in two dimensions: content (knowledge we transfer in PE) and structure (methods we use to deliver PE). The content of conventional PE targets knowledge about etiology of illness, treatment process, adverse effects of prescribed medications, coping strategies, family education, and life skill training. Adding neuroscience evidence to the content of PE could be helpful in communicating not only the impact of drug use but also the beneficial impact of various treatments (i.e., on brain function), thus enhancing motivation for compliance and further destigmatizing their symptoms. PE can also be optimized in its "structure" by implicitly and explicitly engaging different neurocognitive processes, including salience/attention, memory, and self-awareness. There are many interactions between these two dimensions, structure and content, in the delivery of neuroscience-informed psychoeducation (NIPE). We explore these interactions in the development of a cartoon-based NIPE to promote brain recovery during addiction treatment as a part of the brain awareness for addiction recovery initiative.
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Affiliation(s)
- Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, United States; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tara Rezapour
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States; School of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
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Azouvi P, Arnould A, Dromer E, Vallat-Azouvi C. Neuropsychology of traumatic brain injury: An expert overview. Rev Neurol (Paris) 2017; 173:461-472. [PMID: 28847474 DOI: 10.1016/j.neurol.2017.07.006] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/13/2017] [Indexed: 01/12/2023]
Abstract
Traumatic brain injury (TBI) is a serious healthcare problem, and this report is a selective review of recent findings on the epidemiology, pathophysiology and neuropsychological impairments following TBI. Patients who survive moderate-to-severe TBI frequently suffer from a wide range of cognitive deficits and behavioral changes due to diffuse axonal injury. These deficits include slowed information-processing and impaired long-term memory, attention, working memory, executive function, social cognition and self-awareness. Mental fatigue is frequently also associated and can exacerbate the consequences of neuropsychological deficits. Personality and behavioral changes can include combinations of impulsivity and apathy. Even mild TBI raises specific problems: while most patients recover within a few weeks or months, a minority of patients may suffer from long-lasting symptoms (post-concussion syndrome). The pathophysiology of such persistent problems remains a subject of debate, but seems to be due to both injury-related and non-injury-related factors.
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Affiliation(s)
- P Azouvi
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France.
| | - A Arnould
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France
| | - E Dromer
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France
| | - C Vallat-Azouvi
- HANDIReSP EA 4047, université de Versailles Saint-Quentin, 78423 Montigny-Le-Bretonneux, France; Laboratoire de psychopathologie et neuropsychologie, EA 2027, université Paris-8-Saint-Denis, 2, rue de la Liberté, 93526 Saint-Denis, France; Antenne UEROS- UGECAMIDF, hôpital Raymond-Poincaré, 104, boulevard Raymond-Poincaré, 92380 Garches, France
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Buunk AM, Spikman JM, Veenstra WS, van Laar PJ, Metzemaekers JD, van Dijk JMC, Meiners LC, Groen RJ. Social cognition impairments after aneurysmal subarachnoid haemorrhage: Associations with deficits in interpersonal behaviour, apathy, and impaired self-awareness. Neuropsychologia 2017; 103:131-139. [DOI: 10.1016/j.neuropsychologia.2017.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 12/13/2022]
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Abstract
OBJECTIVES The negative effect of changes in social behavior following traumatic brain injury (TBI) are known, but much less is known about the neuropsychological impairments that may underlie and predict these changes. The current study investigated possible associations between post-injury behavior and neuropsychological competencies of emotion recognition, understanding intentions, and response selection, that have been proposed as important for social functioning. METHODS Forty participants with TBI and 32 matched healthy participants completed a battery of tests assessing the three functions of interest. In addition, self- and proxy reports of pre- and post-injury behavior, mood, and community integration were collected. RESULTS The TBI group performed significantly poorer than the comparison group on all tasks of emotion recognition, understanding intention, and on one task of response selection. Ratings of current behavior suggested significant changes in the TBI group relative to before the injury and showed significantly poorer community integration and interpersonal behavior than the comparison group. Of the three functions considered, emotion recognition was associated with both post-injury behavior and community integration and this association could not be fully explained by injury severity, time since injury, or education. CONCLUSIONS The current study confirmed earlier findings of associations between emotion recognition and post-TBI behavior, providing partial evidence for models proposing emotion recognition as one of the pre-requisites for adequate social functioning. (JINS, 2017, 23, 400-411).
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Formisano R, Silvestro D, Azicnuda E, Longo E, Barba C, Rigon J, D'Ippolito M, Giustini M, Bivona U. Quality of life after brain injury (QOLIBRI): Italian validation of the proxy version. Intern Emerg Med 2017; 12:187-198. [PMID: 27686362 DOI: 10.1007/s11739-016-1536-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 09/09/2016] [Indexed: 11/27/2022]
Abstract
To validate the proxy version of the Quality of Life after Brain Injury (QOLIBRI) questionnaire to utilize caregivers for comparison and to evaluate the correspondence between patients' self-perceived and caregivers' perception of patients' Health-Related Quality of Life (HRQoL). Ninety-two patients with severe TBI and their main caregivers were enrolled. Patients' and caregivers' HRQoL was assessed by the Patient-QOLIBRI (Pt-QOLIBRI) and the Proxy-QOLIBRI (Pro-QOLIBRI), respectively. The Pro-QOLIBRI is a modified version of the QOLIBRI to investigate caregivers' perception of patients' HRQoL (Pro-QOLIBRIpatient-centered), and their degree of satisfaction and botheredness (Pro-QOLIBRIcaregiver centered). The patients' disability and their social reintegration was investigated by means of Glasgow Outcome Scale Extended and Community Integration Questionnaire. Pro-QOLIBRI has good internal consistency and homogeneity. There was also positive correlation between the level of satisfaction measured by Pro-QOLIBRI but not by Pt-QOLIBRI, and the disability severity and social integration of the patients. The comparison between the Pt-QOLIBRI and Pro-QOLIBRI confirmed the usefulness of the Pro-QOLIBRI, especially the caregiver-centered version, to predict the social reintegration of survivors. To our knowledge this is the first study that correlates the HRQoL of survivors, as self-perceived and as perceived by the caregivers with social reintegration.
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Affiliation(s)
- Rita Formisano
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy.
| | - Daniela Silvestro
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Eva Azicnuda
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
| | | | - Carmen Barba
- Pediatric Neurology Unit, A. Meyer Children's Hopsital, University of Florence, Florence, Italy
| | - Jessica Rigon
- IRCCS San Camillo Hopsital Foundation, Venezia-Lido, Italy
| | - Mariagrazia D'Ippolito
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Umberto Bivona
- IRCCS, Rehabilitation Hospital Santa Lucia Foundation, Via Ardeatina 306, 00142, Rome, Italy
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Abstract
Some scholars have noted that an impressive number of self-related terms have been gradually introduced in the scientific literature. Several of these terms are either ill-defined or synonymous, creating confusion, and redundancy. In an effort to minimize this problem, I present a novel and systematic way of looking at possible relations between several key self-terms. I also propose a tentative classification scheme of self-terms as follows: (1) basic terms related to the overall process of self-perception (e.g., self-awareness), (2) non self-terms that are importantly associated to some other self-terms (e.g., consciousness and Theory of Mind), (3) processes related to the executive self and involving agency, volition, and self-control (e.g., self-regulation), and (4) self-views, that is, the content and feelings about the self (e.g., self-esteem). Three additional categories not discussed in this paper are self-biases, reactions to the self, and interpersonal style. Arguably unambiguous definitions for some of the most important and frequently used self-terms are suggested. These are presented in tables meant for the reader to search for definitions as well as related terms.
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Affiliation(s)
- Alain Morin
- Department of Psychology, Mount Royal University Calgary, AB, Canada
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Rigon J, Burro R, Guariglia C, Maini M, Marin D, Ciurli P, Bivona U, Formisano R. Self-awareness rehabilitation after Traumatic Brain Injury: A pilot study to compare two group therapies. Restor Neurol Neurosci 2017; 35:115-127. [PMID: 28059799 PMCID: PMC5302046 DOI: 10.3233/rnn-150538] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND AND PURPOSE Deficits of self-awareness (SA) are very common after severe acquired brain injury (sABI), especially in traumatic brain injury (TBI), playing an important role in the efficacy of the rehabilitation process. This pilot study provides information regarding two structured group therapies for disorders of SA. METHODS Nine patients with severe TBI were consecutively recruited and randomly assigned to one SA group therapy programme, according either to the model proposed by Ben-Yishay & Lakin (1989) (B&L Group), or by Sohlberg & Mateer (1989) (S&M Group). Neuropsychological tests and self-awareness questionnaires were administered before and after a 10 weeks group therapy. RESULTS Results showed that both SA and neuropsychological functioning significantly improved in both groups. CONCLUSION It is important to investigate and treat self-awareness, also to improve the outcome of neuropsychological disorders. The two group therapies proposed seem to be specific for impulsivity and emotional dyscontrol and for cognitive disorders.
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Affiliation(s)
- Jessica Rigon
- IRCCS Fondazione Ospedale San Camillo, Venezia Lido, Italy
| | - Roberto Burro
- Università degli Studi di Verona, Dipartimento di Scienze Umane, Verona, Italy
| | | | - Manuela Maini
- CRA Nucleo Speciale Gravissime Disabilità Virginia Grandi, Bologna, Italy
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Cassel A, McDonald S, Kelly M, Togher L. Learning from the minds of others: A review of social cognition treatments and their relevance to traumatic brain injury. Neuropsychol Rehabil 2016; 29:22-55. [DOI: 10.1080/09602011.2016.1257435] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Anneli Cassel
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Skye McDonald
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Michelle Kelly
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- School of Psychology, University of Newcastle, Newcastle, Australia
| | - Leanne Togher
- National Health and Medical Research Council Centre of Research Excellence in Brain Recovery, University of New South Wales, Sydney, Australia
- Discipline of Speech Pathology, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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43
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Quality of life in persons after traumatic brain injury as self-perceived and as perceived by the caregivers. Neurol Sci 2016; 38:279-286. [DOI: 10.1007/s10072-016-2755-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
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Bivona U, Antonucci G, Contrada M, Rizza F, Leoni F, Zasler ND, Formisano R. A biopsychosocial analysis of sexuality in adult males and their partners after severe traumatic brain injury. Brain Inj 2016; 30:1082-95. [PMID: 27260951 DOI: 10.3109/02699052.2016.1165867] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The primary aim of this study was to investigate changes in sexual function in males and their partners following severe TBI. Secondary aims of the study were to explore the relationship between selected sociodemographic, emotional/behavioural and sexual function variables. METHODS Twenty males with a history of severe TBI and 20 healthy controls (HC) and their respective partners were recruited. Sexual life was assessed with the Sexuality Evaluation Schedule Assessment Monitoring (SESAMO). Study participant level of self-awareness was evaluated by the Awareness Questionnaire, whereas their neuropsychiatric and psychopathological statuses were assessed by the NPI, the HAM-D and STAI. RESULTS A reduction in desire and frequency of sexual intercourse was found in all survivors and their partners. Moreover, higher levels of survivor depression correlated with lower partner harmony. Survivor feelings toward their partners gradually decreased over time, as did the ability to make decisions as a couple. The comparison with HC couples revealed that both survivors' and their partners' exaggerated the extent of disease. CONCLUSIONS After male severe TBI, men appear to have a reduced quality of their sexual life, which may be more a result of relationship dysfunction than a sexual performance deficit related to their brain injury history.
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Affiliation(s)
| | - Gabriella Antonucci
- a IRCCS Fondazione Santa Lucia , Rome , Italy.,b Department of Psychology , 'Sapienza' Università , Rome , Italy
| | - Marianna Contrada
- a IRCCS Fondazione Santa Lucia , Rome , Italy.,b Department of Psychology , 'Sapienza' Università , Rome , Italy
| | - Federica Rizza
- b Department of Psychology , 'Sapienza' Università , Rome , Italy
| | | | - Nathan D Zasler
- c Concussion Care Centre of Virginia, LTD.,d Tree of Life Services, Inc. , Richmond , VA , USA
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Ryan NP, Bijnen L, Catroppa C, Beauchamp MH, Crossley L, Hearps S, Anderson V. Longitudinal outcome and recovery of social problems after pediatric traumatic brain injury (TBI): Contribution of brain insult and family environment. Int J Dev Neurosci 2015; 49:23-30. [DOI: 10.1016/j.ijdevneu.2015.12.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Revised: 11/10/2015] [Accepted: 12/18/2015] [Indexed: 10/22/2022] Open
Affiliation(s)
- Nicholas P. Ryan
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Loeka Bijnen
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
| | - Cathy Catroppa
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
| | - Miriam H. Beauchamp
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Department of PsychologyUniversity of MontrealMontrealCanada
- Ste‐Justine Research CenterMontrealQuebecCanada
| | - Louise Crossley
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
| | - Stephen Hearps
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
| | - Vicki Anderson
- Australian Centre for Child Neuropsychological StudiesMurdoch Childrens Research InstituteMelbourneAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneAustralia
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Stephens JA, Williamson KNC, Berryhill ME. Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2015; 35:5-22. [PMID: 26623474 DOI: 10.1177/1539449214561765] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.
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Arnould A, Dromer E, Rochat L, Van der Linden M, Azouvi P. Neurobehavioral and self-awareness changes after traumatic brain injury: Towards new multidimensional approaches. Ann Phys Rehabil Med 2015; 59:18-22. [PMID: 26585583 DOI: 10.1016/j.rehab.2015.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 10/22/2022]
Abstract
Neurobehavioral and self-awareness changes are frequently observed following traumatic brain injury (TBI). These disturbances have been related to negative consequences on functional outcomes, caregiver distress and social reintegration, representing therefore a challenge for clinical research. Some studies have recently been conducted to specifically explore apathetic and impulsive manifestations, as well as self-awareness impairments in patients with TBI. These findings underlined the heterogeneity of clinical manifestations for each behavioral disturbance and the diversity of psychological processes involved. In this context, new multidimensional approaches taking into account the various processes at play have been proposed to better understand and apprehend the complexity and dynamic nature of these problematic behaviors. In addition, the involvement of social and environmental factors as well as premorbid personality traits have increasingly been addressed. These new multidimensional frameworks have the potential to ensure targeted and effective rehabilitation by allowing a better identification and therefore consideration of the various mechanisms involved in the onset of problematic behaviors. In this context, the main objective of this position paper was to demonstrate the interest of multidimensional approaches in the understanding and rehabilitation of problematic behaviors in patients with TBI.
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Affiliation(s)
- A Arnould
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Unité de psychopathologie et de neuropsychologie cognitive, université de Genève, Genève, Switzerland; EA 4047, HANDIReSP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
| | - E Dromer
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047, HANDIReSP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - L Rochat
- Unité de psychopathologie et de neuropsychologie cognitive, université de Genève, Genève, Switzerland; Swiss centre for affective sciences, université de Genève, Genève, Switzerland
| | - M Van der Linden
- Unité de psychopathologie et de neuropsychologie cognitive, université de Genève, Genève, Switzerland; Swiss centre for affective sciences, université de Genève, Genève, Switzerland; Unité de psychopathologie cognitive, université de Liège, Liège, Belgium
| | - P Azouvi
- Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047, HANDIReSP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France
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Bivona U, Formisano R, De Laurentiis S, Accetta N, Rita Di Cosimo M, Massicci R, Ciurli P, Azicnuda E, Silvestro D, Sabatini U, Falletta Caravasso C, Augusto Carlesimo G, Caltagirone C, Costa A. Theory of mind impairment after severe traumatic brain injury and its relationship with caregivers’ quality of life. Restor Neurol Neurosci 2015; 33:335-45. [DOI: 10.3233/rnn-140484] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Carlo Caltagirone
- Fondazione Santa Lucia – Rome, Italy
- Università di Roma Tor Vergata – Rome, Italy
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Wolfe KR, Bigler ED, Dennis M, Gerhardt CA, Rubin K, Taylor HG, Vannatta K, Yeates KO. Self-awareness of peer-rated social attributes in children with traumatic brain injury. J Pediatr Psychol 2015; 40:272-84. [PMID: 25080604 PMCID: PMC4366444 DOI: 10.1093/jpepsy/jsu060] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 07/08/2014] [Accepted: 07/10/2014] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study investigated self-awareness of peer-rated social attributes and its relations to executive function (EF), theory of mind (TOM), and psychosocial adjustment in children with traumatic brain injury (TBI). METHODS Self- and peer perceptions of classroom social behavior were assessed for 87 children 8-13 years of age: 15 with severe TBI, 40 with complicated mild/moderate TBI, and 32 with orthopedic injury. Participants completed measures of EF and TOM, and parents rated children's psychosocial adjustment. RESULTS Self-ratings of classroom social behavior did not differ between injury groups. Self- and peer ratings generally agreed, although children with severe TBI rated themselves as less rejected/victimized than did their peers. Higher EF predicted better self- and peer ratings and smaller self-peer discrepancies, which in turn predicted better adjustment. CONCLUSIONS Children with TBI show variable social self-awareness, which relates to EF and adjustment. Future studies should identify additional factors that contribute to limited insight.
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Affiliation(s)
- Kelly R Wolfe
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Erin D Bigler
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Maureen Dennis
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Cynthia A Gerhardt
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Kenneth Rubin
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - H Gerry Taylor
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Kathryn Vannatta
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
| | - Keith Owen Yeates
- Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital Department of Psychology, Nationwide Children's Hospital, Departments of Pediatrics and Psychology, The Ohio State University, Department of Psychology, Brigham Young University, Department of Psychiatry, University of Utah, Program in Neuroscience & Mental Health, The Hospital for Sick Children, Department of Surgery, University of Toronto, Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Department of Human Development and Quantitative Methodology, University of Maryland, Department of Pediatrics, Case Western Reserve University, and Department of Pediatrics, Rainbow Babies and Children's Hospital
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Ubukata S, Tanemura R, Yoshizumi M, Sugihara G, Murai T, Ueda K. Social cognition and its relationship to functional outcomes in patients with sustained acquired brain injury. Neuropsychiatr Dis Treat 2014; 10:2061-8. [PMID: 25395854 PMCID: PMC4224097 DOI: 10.2147/ndt.s68156] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Deficits in social cognition are common after traumatic brain injury (TBI). However, little is known about how such deficits affect functional outcomes. The purpose of this study was to investigate the relationship between social cognition and functional outcomes in patients with TBI. We studied this relationship in 20 patients with TBI over the course of 1 year post-injury. Patients completed neurocognitive assessments and social cognition tasks. The social cognition tasks included an emotion-perception task and three theory of mind tasks: the Faux Pas test, Reading the Mind in the Eyes (Eyes) test, and the Moving-Shapes paradigm. The Craig Handicap Assessment and Reporting Technique was used to assess functional outcomes. Compared with our database of normal subjects, patients showed impairments in all social cognition tasks. Multiple regression analysis revealed that theory of mind ability as measured by the Eyes test was the best predictor of the cognitive aspects of functional outcomes. The findings of this pilot study suggest that the degree to which a patient can predict what others are thinking is an important measure that can estimate functional outcomes over 1 year following TBI.
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Affiliation(s)
- Shiho Ubukata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan ; Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Rumi Tanemura
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Miho Yoshizumi
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Genichi Sugihara
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiya Murai
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Keita Ueda
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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