Perceived Social Support and Its Impact on Mental Fatigue in Patients with Mild Traumatic Brain Injury

Lesions and reduced working memory impair emotion recognition in self and others

ABSTRACTEmotion recognition (ER) can be conceived of as an integration of affective cues in working memory. We examined whether reduced working memory capacity and brain lesions in neural networks involved in emotion processing interactively impair ER of both one's own and another person's emotions. To assess the recognition of one's own and other's emotions, pictures from the International Affective Picture System (IAPS) and facial expressions from the Karolinska Directed Emotional Faces (KDEF) database representing fear, anger, disgust, and sadness were presented to 40 lesioned patients and 40 healthy students. To manipulate working memory, a math task was imposed between exposure to the stimuli and collection of responses. Participants indicated the intensity of each of the four emotions for each picture. ER was computed as the difference between trials where the elicited emotion matched the requested emotion and trials where the elicited and requested emotions did not match. Whereas lesions impaired ER in both self and others, working memory load exclusively decreased recognition of other persons' emotions.

Dissecting the fatigue experience: A scoping review of fatigue definitions, dimensions, and measures in non-oncologic medical conditions

Introduction

Fatigue is a prevalent and potentially debilitating symptom that impacts the health-related quality-of-life of individuals diagnosed with acute and chronic medical conditions. Yet, its etiologic mechanism is not fully understood. Additionally, the assessment and determination of the clinical meaning of fatigue and its multidimensionality may vary by medical condition.

Methods

A scoping literature review was conducted to investigate how fatigue is defined and measured, including its dimensions, in non-oncologic medical conditions. The PubMed database was searched using keywords.

Results

Overall, 8376 articles were screened at the title/abstract levels, where 293 articles were chosen for full-text review that mentioned fatigue or included fatigue measures. The review of the full text excluded 246 articles that did not assess at least one fatigue dimension using validated questionnaires and clinical tests. The final set included 47 articles. Physical fatigue was the most assessed fatigue dimension and the Multidimensional Fatigue Inventory was the most widely used questionnaire to assess fatigue in this review.

Limitations

This review was limited by including only English-language publications and using PubMed as the sole database for the search.

Conclusions

This review affirms that fatigue is a multidimensional construct, agnostic of medical condition, and that individual fatigue dimensions can be measured by validated clinical measures. Future research should focus on expanding the repertoire of clinical measures to assess specific fatigue dimensions.

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The 27 different validated clinical measures used to assess fatigue and its dimensions; 20 instruments assessed the physical, 8 for mental, 7 cognitive, 5 for motivational, 2 for emotional, 1 peripheral, 1 for central, 1 psychosocial.

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Physical was the most measured dimension, as assessed in 42 of 47 included articles.

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This review affirms that fatigue is a multidimensional construct, agnostic of medical condition, and that individual fatigue dimensions can be measured by validate clinical measures.

From Provider to Advocate: The Complexities of Traumatic Brain Injury Prompt the Evolution of Provider Engagement

Treating a patient with traumatic brain injury requires an interdisciplinary approach because of the pervasive, profound and protean manifestations of this condition. In this review, key aspects of the medical history and review of systems will be described in order to highlight how the role of any provider must evolve to become a better patient advocate. Although this review is written from the vantage point of a vision care provider, it is hoped that patients, caregivers and providers will recognize the need for a team approach.

The effect of severe traumatic brain injury on social cognition, emotion regulation, and mood

This chapter provides a review of the emotional and psychosocial consequences of moderate to severe traumatic brain injury (TBI). Many of the disorders affecting socioemotional function arise from damage to frontotemporal systems, exacerbated by white matter injury. They include disorders of social cognition, such as the ability to recognize emotions in others, the ability to attribute mental states to others, and the ability to experience empathy. Patients with TBI also often have disorders of emotion regulation. Disorders of drive or apathy can manifest across cognitive, emotional, and behavioral domains. Likewise, disorders of control can lead to dysregulated emotions and behavior. Other disorders, such as loss of self-awareness, are also implicated in poor psychosocial recovery. Finally, this chapter overviews psychiatric disorders associated with TBI, especially anxiety and depression. For each kind of disorder, the nature of the disorder and its prevalence, as well as theoretical considerations and impact on every day functions, are reviewed.

Mid-Task Physical Exercise Keeps Your Mind Vigilant: Evidences From Behavioral Performance and EEG Functional Connectivity

Accumulating efforts have been made to discover effective solutions for fatigue recovery with the ultimate aim of reducing adverse consequences of mental fatigue in real life. The previously-reported behavioral benefits of physical exercise on mental fatigue recovery prompted us to investigate the restorative effect and reveal the underlying neural mechanisms. Specifically, we introduced an empirical method to investigate the beneficial effect of physical exercise on the reorganization of EEG functional connectivity (FC) in a two-session experiment where one session including a successive 30-min psychomotor vigilance task (PVT) (No-intervention session) compared to an insertion of a mid-task 15-min cycling exercise (Intervention session). EEG FC was obtained from 21 participants and quantitatively assessed via graph theoretical analysis and a classification framework. The findings demonstrated the effectiveness of exercise intervention on behavioral performance as shown in improved reaction time and response accuracy. Although we found significantly altered network alterations towards the end of experiment in both sessions, no significant differences between the two sessions and no interaction between session and time were found in EEG network topology. Further interrogation of functional connectivity through classification analysis showed decreased FC in distributed brain areas, which may lead to the significant reduction of network efficiency in both sessions. Moreover, we showed distinct patterns of FC alterations between the two sessions, indicating different information processing strategies adopted in the intervention session. In sum, these results provide some of the first quantitative insights into the complex neural mechanism of exercise intervention for fatigue recovery and lead a new direction for further application research in real-world situations.

Mediators of quality of life in brain injury

PRIMARY OBJECTIVE

This study examined the mediating role of perceived social support and mastery on quality of life (QOL) among adults with brain injury.

RESEARCH DESIGN

An a priori structural model hypothesizing the relationships among symptom severity, mastery, social support, and QOL variables were tested.

METHODS AND PROCEDURES

Individuals with brain injury across the United States participated in an online survey (N = 183). Structural equation modeling (SEM) was used to examine the model fit.

MAIN OUTCOMES AND RESULTS

The model fit the data well (χ² ₍₁₅₎ = 13.68). The Normed Bentler-Bonnet Fit Index (NFI) was.97; Goodness-of-Fit Statistic (GFI) was .98; Adjusted-Goodness-of-Fit (AGFI) was.96; and the Comparative Fit Index (CFI) was 1.00. The direct effects supported all expected relationships among the study variables. Social support and mastery fully mediated the relationship between symptom severity and QOL. Mastery partially mediated the relationship between social support and QOL.

CONCLUSIONS

These findings underscore the importance of incorporating psychosocial factors into interventions, with attention on increasing levels of perceived social support and mastery skills to foster greater QOL.

Unraveling the Biopsychosocial Factors of Fatigue and Sleep Problems After Traumatic Brain Injury: Protocol for a Multicenter Longitudinal Cohort Study

Background

Fatigue and sleep problems are common after a traumatic brain injury (TBI) and are experienced as highly distressing symptoms, playing a significant role in the recovery trajectory, and they can drastically impact the quality of life and societal participation of the patient and their family and friends. However, the etiology and development of these symptoms are still uncertain.

Objective

The aim of this study is to examine the development of fatigue and sleep problems following moderate to severe TBI and to explore the changes in underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors across time.

Methods

This study is a longitudinal multicenter observational cohort study with 4 measurement points (3, 6, 12, and 18 months postinjury) including subjective questionnaires and cognitive tasks, preceded by 7 nights of actigraphy combined with a sleep diary. Recruitment of 137 moderate to severe TBI patients presenting at emergency and neurology departments or rehabilitation centers across the Netherlands is anticipated. The evolution of fatigue and sleep problems following TBI and their association with possible underlying biological (pain, brain damage), psychological (emotional state), and social (support family, participation) factors will be examined.

Results

Recruitment of participants for this longitudinal cohort study started in October 2017, and the enrollment of participants is ongoing. The first results are expected at the end of 2020.

Conclusions

To the authors’ knowledge, this is the first study that examines the development of both post-TBI fatigue and sleep longitudinally within a biopsychosocial model in moderate to severe TBI using both subjective and objective measures. Identification of modifiable factors such as mood and psychosocial stressors may give direction to the development of interventions for fatigue and sleep problems post-TBI.

Trial Registration

Netherlands Trial Register NTR7162; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=7162 (Archived by WebCite at http://www.webcitation.org/6z3mvNLuy)

International Registered Report Identifier (IRRID)

RR1-10.2196/11295

A systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS)

BACKGROUND

Social support (SS) has been identified as an essential buffer to stressful life events. Consequently, there has been a surge in the evaluation of SS as a wellbeing indicator. The Multidimensional Perceived Social Support Scale (MSPSS) has evolved as one of the most extensively translated and validated social support outcome measures. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, there is a paucity of systematic evidence of the psychometrics of adapted and translated versions of the MSPSS across settings.

OBJECTIVES

To understand the psychometric properties of the MSPSS for non-English speaking populations by conducting a systematic review of studies that examine the psychometric properties of non-English versions of the MSPSS.

METHODS

We searched Africa-Wide Information, CINAHL, Medline and PsycINFO, for articles published in English on the translation and or validation of the MSPSS. Methodological quality and quality of psychometric properties of the retrieved translations were assessed using the COSMIN checklist and a validated quality assessment criterion, respectively. The two assessments were combined to produce the best level of evidence per language/translation.

RESULTS

Seventy articles evaluating the MSPSS in 22 languages were retrieved. Most translations [16/22] were not rigorously translated (only solitary backward-forward translations were performed, reconciliation was poorly described, or were not pretested). There was poor evidence for structural validity, as confirmatory factor analysis was performed in only nine studies. Internal consistency was reported in all studies. Most attained a Cronbach's alpha of at least 0.70 against a backdrop of fair methodological quality. There was poor evidence for construct validity.

CONCLUSION

There is limited evidence supporting the psychometric robustness of the translated versions of the MSPSS, and given the variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error and cut-off values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions of the MSPSS.

TRIAL REGISTRATION

PROSPERO - CRD42016052394.

Facebook as communication support for persons with potential mild acquired cognitive impairment: A content and social network analysis study

INTRODUCTION

Social media has the potential to increase social participation and support for the well-being of individuals with chronic medical conditions. To date, Facebook is the most popular social medium for different types of communication. However, there is a lack of knowledge about the potential use of Facebook as a means of communication for persons with potential Mild Acquired Cognitive Impairment (MACI), a non-progressive mild cognitive impairment after an acquired brain injury. The aim of this study was to explore how persons with potential MACI, specifically persons with perceived brain fatigue after brain injury, communicate through Facebook, to classify the content of the communication and to visualize the frequency and types of interactions.

METHODS AND MATERIALS

A social network analysis of the interactions between members' and a qualitative content analysis of a whole year's communication of a public Facebook group for Swedish speaking persons (1310 members) with perceived brain fatigue after an illness or injury to the brain were performed.

RESULTS

The results showed how members use social media technology and Facebook as a means for communication and support for their condition. Individual group members showed very different patterns of communication and interactions. However, for the group as a whole, the most frequent topics in their communication were related to informational support and banter in posts, and socialization in comments. The findings also showed that the majority of members only communicated with few other members and had few direct communications. The most used communication feature of Facebook was likes in form of "thumbs-up".

CONCLUSIONS

This study indicated that social media and in this case Facebook is used for communication and social support by persons with potential MACI, and revealed that their communication behavior is similar to the healthy population. Further studies relating specific cognitive problems of the participants to the use of social media would provide more reliable results for this specific group.