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Igoe A, Twomey DM, Allen N, Carton S, Brady N, O'Keeffe F. A longitudinal analysis of factors associated with post traumatic growth after acquired brain injury. Neuropsychol Rehabil 2024; 34:430-452. [PMID: 37022203 DOI: 10.1080/09602011.2023.2195190] [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: 11/01/2022] [Accepted: 03/20/2023] [Indexed: 04/07/2023]
Abstract
ABSTRACTPost-Traumatic Growth (PTG) is a form of positive psychological change that occurs for some individuals following traumatic experiences. High levels of PTG have been reported among survivors of acquired brain injury (ABI). Yet it remains unclear why some survivors of ABI develop PTG and others do not. The present study investigated early and late factors that are associated with long-term PTG in people with moderate to severe ABIs. Participants (n = 32, Mage = 50.59, SD = 12.28) completed self-report outcome measures at two time-points seven years apart (one-year and eight-years post-ABI). Outcome measures assessed emotional distress, coping, quality of life and ongoing symptoms of brain injury, as well as PTG at the later timepoint. Multiple regression analyses indicated that one-year post-ABI, fewer symptoms of depression, more symptoms of anxiety, and use of adaptive coping strategies accounted for a significant amount of variance in later PTG. At eight years post-ABI, fewer symptoms of depression, fewer ongoing symptoms of brain injury, better psychological quality of life and use of adaptive coping strategies explained a substantial amount of variance in PTG. For individuals with ABIs, PTG may be promoted by implementing long-term neuropsychological support which aims to facilitate use of adaptive coping strategies, supports psychological wellbeing and allows individuals to find meaning post-ABI.
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Affiliation(s)
- Anna Igoe
- University College Dublin, Dublin, Ireland
| | | | | | - Simone Carton
- National Rehabilitation Hospital, Dun Laoghaire, Ireland
| | | | - Fiadhnait O'Keeffe
- University College Dublin, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
- National Rehabilitation Hospital, Dun Laoghaire, Ireland
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Alam AM, Easton A, Bavikatte G, Mahendran S, Michael BD. Sequelae of neurological infection: management in primary care. TRENDS IN UROLOGY & MEN'S HEALTH 2023. [DOI: 10.1002/tre.894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Ali M Alam
- Institute of Infection, Veterinary and Ecological Science University of Liverpool UK
- Barts Health NHS Trust London UK
| | | | | | | | - Benedict D Michael
- Institute of Infection, Veterinary and Ecological Science University of Liverpool UK
- The Walton Centre NHS Foundation Trust Liverpool UK
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Van Bost G, Van Damme S, Crombez G. Goal adjustment and well-being after an acquired brain injury: the role of cognitive flexibility and personality traits. PeerJ 2022; 10:e13531. [PMID: 35669954 PMCID: PMC9165594 DOI: 10.7717/peerj.13531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/12/2022] [Indexed: 01/17/2023] Open
Abstract
Objective The tendency to flexibly adjust goals that are hindered by chronic illness is related to indicators of wellbeing. However, cognitive flexibility is often impaired in persons with an acquired brain injury (ABI), possibly affecting the ability to flexibly adjust goals. In this study we examined whether cognitive flexibility is positively related with the ability to disengage from goals to reengage with goals in persons with ABI. Second, we explored whether goal adjustment abilities are predictive of a unique proportion of the variance inabilities are predictive of quality of life and life satisfaction after controlling for personality traits. Method Seventy-eight persons with an ABI completed a set of questionnaires. Goal disengagement and goal reengagement were assessed using the Wrosch Goal Adjustment Scale (GAS). Indicators of wellbeing were measured with the European Brain Injury Questionnaire (EBIQ) and the Satisfaction with Life Scale (SWLS). The percentage of perseverative errors on the Wisconsin Card Sorting Test (WCST) was used as an indicator of cognitive inflexibility. Big Five personality traits were assessed via the NEO Five Factor Inventory (NEO-FFI). Four hierarchical multiple regression analyses were then conducted. The first two analyses tested the effect of cognitive flexibility on goal adjustment tendencies. The second two analyses tested whether goal adjustment has a predictive value for life satisfaction and QOL beyond personality. Results Cognitive flexibility was positively related to goal reengagement, but not to goal disengagement. Goal reengagement was positively associated with both quality of life and life satisfaction after controlling for demographic, illness characteristics and personality factors. Goal disengagement was negatively related to life satisfaction. Conclusion Flexible goal adjustment abilities have a unique explanatory value for indicators of wellbeing, beyond personality traits. The findings indicate that in persons with lower cognitive flexibility, goal reengagement ability might be negatively affected, and should be taking into account during rehabilitation.
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Affiliation(s)
- Gunther Van Bost
- Department of Experimental Clinical and Health Psychology, Universiteit Gent, Ghent, Belgium,Unit Acquired Brain Injury, Centrum voor Ambulante Revalidatie Ter Kouter, Deinze, Belgium
| | - Stefaan Van Damme
- Department of Experimental Clinical and Health Psychology, Universiteit Gent, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental Clinical and Health Psychology, Universiteit Gent, Ghent, Belgium
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Sathananthan N, Morris EMJ, Gillanders D, Knox L, Dimech-Betancourt B, Wright BJ, das Nair R, Wong D. Does Integrating Cognitive and Psychological Interventions Enhance Wellbeing After Acquired Brain Injury? Study Protocol for a Phase II Randomized Controlled Trial of the VaLiANT (Valued Living After Neurological Trauma) Group Program. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:815111. [PMID: 36188858 PMCID: PMC9397748 DOI: 10.3389/fresc.2021.815111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022]
Abstract
Background and Objectives Cognitive and emotional changes affect the majority of individuals with acquired brain injury (ABI) and are associated with poorer outcomes. The evidence for “siloed” rehabilitation approaches targeting cognition and mood separately remains mixed. Valued living (i.e., acting consistently with personal values) is associated with better psychological functioning and participation in work and other productive activities. Rehabilitation interventions that concurrently address cognitive and emotional barriers to valued living may therefore result in improved outcomes. VaLiANT (Valued Living After Neurological Trauma) is an 8-week group intervention developed by our team, which uniquely combines cognitive rehabilitation and psychological therapy to improve wellbeing and meaningful participation (i.e., valued living) following ABI. Method This protocol describes the design and implementation of a Phase II parallel-group randomized controlled trial with blinded outcome assessors, to evaluate the potential efficacy of VaLiANT and the feasibility of a Phase III trial. Participants are adults with a history of ABI at least 3 months prior to study entry, who experience cognitive and/or emotional difficulties and associated reduced participation in valued activities. Random allocation to the treatment condition (8-week VaLiANT group program) or a usual care waitlist control condition occurs at a 2:1 treatment: control ratio. The primary outcome is wellbeing, measured by the Warwick-Edinburgh Mental Wellbeing Scale. Secondary outcomes include measures of valued living, mood, cognitive complaints, quality of life, community participation, post-traumatic growth, and self-efficacy. All measures are collected across three time points by blinded assessors (baseline, 8-week follow-up, 16-week follow-up). Trial feasibility will be evaluated against recruitment rates, drop-out rates, intervention acceptability, and treatment fidelity (manual adherence and therapist competence). Discussion This trial will extend current knowledge on how to improve long-term outcomes following ABI by evaluating an innovative integrated, multi-domain approach to rehabilitation concurrently addressing cognitive and emotional barriers to participation in meaningful life roles.
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Affiliation(s)
- Nick Sathananthan
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Eric M. J. Morris
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - David Gillanders
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Lucy Knox
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | | | - Bradley J. Wright
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Roshan das Nair
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- *Correspondence: Dana Wong
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Fatigue after acquired brain injury impacts health-related quality of life: an exploratory cohort study. Sci Rep 2021; 11:22153. [PMID: 34773047 PMCID: PMC8590006 DOI: 10.1038/s41598-021-01617-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/28/2021] [Indexed: 01/08/2023] Open
Abstract
This study aimed to identify the consequences of fatigue, fatigability, cognitive and executive functioning, and emotional state on health-related quality of life (HRQoL) in a clinical group of outpatients after acquired brain injury (ABI). This cross-sectional retrospective study included assessing outpatients at a rehabilitation clinic with WAIS-III working memory and coding subtests, and self-rating scales (Fatigue Impact Scale, Dysexecutive Questionnaire, Hospital Anxiety and Depression Scale, and the dimension of health-related quality of life from EQ-5D-3L). The predictive variables were investigated using a binary logistic regression with HRQoL as the dependent variable. Descriptive statistics and correlations were analyzed. Participants reported a lower than average HRQoL (95%), fatigue (90%), and executive dysfunction (75%). Fatigue had a significant impact and explained 20–33% of the variance in HRQoL with a moderate significance on depression (p = 0.579) and executive dysfunction (p = 0.555). Cognitive and executive function and emotional state showed no association with HRQoL. A lower HRQoL, as well as fatigue and cognitive and executive dysfunctions, are common after ABI, with fatigue is a partial explanation of a lower HRQoL.
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Knight E, Norman A, Simpson GK. Living with suicidality following traumatic brain injury: a qualitative study. Brain Inj 2020; 34:1010-1019. [PMID: 32529858 DOI: 10.1080/02699052.2020.1763463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Numbers of traumatic brain injury (TBI) are increasing, and with suicidality post-injury presenting at 3-4 times higher than in the general population, understanding this is crucial in reducing a devastating outcome. Given the lack of literature, this study investigated the experiences of living with suicidality after TBI. METHODS Interview data from nineteen participants with TBI from a Brain Injury Rehabilitation Unit (BIRU) in New South Wales (NSW), Australia were collected and thematically analyzed. FINDINGS The participants (predominantly male) sustained extremely severe injuries (median PTA 60 [IQR 81.0] days) and were in the chronic phase post-injury (median 8.0 [IQR 9.0] years). Six main themes were identified; Loss of sense of self, TBI as a hidden disability, Chronic but transient suicidality, Reliance, Protective factors, and Hope. Tentative relationships between themes and subthemes were identified. CONCLUSION Chronic suicidality after TBI was demonstrated consistently regardless of receiving long-term support. However, their engagement with protective factors such as social support, spirituality and positive personal qualities was identified. Implementing these as coping strategies during long-term rehabilitation may reduce the levels of suicidal distress. Implications, methodological considerations and future research were discussed, with the aim of improving experiences of individuals with TBI to reduce suicidality.
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Affiliation(s)
- Ellie Knight
- Department of Psychology, Hywel Dda University Health Board , Wales, UK
| | - Alyson Norman
- School of Psychology, University of Plymouth , Plymouth, UK
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research , Sydney, Australia
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Van Bost G, Van Damme S, Crombez G. Goal reengagement is related to mental well-being, life satisfaction and acceptance in people with an acquired brain injury. Neuropsychol Rehabil 2019; 30:1814-1828. [PMID: 31030643 DOI: 10.1080/09602011.2019.1608265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE After an acquired brain injury (ABI), the achievement of previous life goals may no longer be feasible. This study examined whether self-reported disengagement from previous goals and reengagement towards new, more feasible goals, are associated with higher quality of life (QOL) and life satisfaction. We also examined whether acceptance mediated these relationships. METHODS Eighty-two individuals (18-68 years of age) with an ABI completed a battery of questionnaires. We investigated the relations between goal disengagement and reengagement on the one hand, and general QOL, disease-specific QOL, life satisfaction and acceptance, on the other hand. Rehabilitation psychologists provided estimates of self-awareness and the extent of motor, communicative and cognitive impairment. RESULTS Goal reengagement, but not goal disengagement, was positively associated with mental QOL and life satisfaction, after statistically controlling for demographic and impairments. Acceptance mediated the relationship between goal reengagement on the one hand, and mental QOL and life satisfaction, on the other hand. CONCLUSION After an ABI, reengagement in feasible goals is more important in explaining mental well-being and life satisfaction than disengagement from unattainable goals. Interventions aimed at identifying and pursuing new, feasible goals may be more helpful than strategies focusing on the loss of blocked goals.
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Affiliation(s)
- Gunther Van Bost
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium.,CAR Ter Kouter Deinze, Deinze, Belgium
| | - Stefaan Van Damme
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Geert Crombez
- Department of Experimental-Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Bonfils NA, Grall-Bronnec M, Caillon J, Limosin F, Benyamina A, Aubin HJ, Luquiens A. Giving room to subjectivity in understanding and assessing problem gambling: A patient-centered approach focused on quality of life. J Behav Addict 2019; 8:103-113. [PMID: 30663328 PMCID: PMC7044609 DOI: 10.1556/2006.7.2018.137] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND AIMS Problem gambling is characterized by high stigma and self-stigma, making relevant measurement of the burden of the disorder complex. The aim of our qualitative study was to describe health-related quality of life (HRQOL) impacted by problem gambling from the patients' perspective. METHODS We conducted 6 focus groups with 25 current or lifetime at-risk problem gamblers to identify key domains of quality of life impacted by problem gambling. A content analysis from the focus groups data was conducted using Alceste© software, using descendant hierarchical classification analysis, to obtain stable classes and the significant presences of reduced forms. The class of interest, detailing the core of impacted quality of life, was described using a cluster analysis. RESULTS Thematic content analysis identified three stable classes. Class 1 contained the interviewers' speech. Class 3 was composed of the vocabulary related to gambling practice, games and gambling venues (casino, horse betting, etc.). Class 2 described the core of impact of gambling on quality of life and corresponded to 43% of the analyzed elementary context units. This analysis revealed seven key domains of impact of problem gambling: loneliness, financial pressure, relationships deterioration, feeling of incomprehension, preoccupation with gambling, negative emotions, and avoidance of helping relationships. CONCLUSIONS We identified, beyond objective damage, the subjective distress felt by problem gamblers over the course of the disorder and in the helping process, marked in particular by stigma and self-stigma. Four impacted HRQOL areas were new and gambling-specific: loneliness, feeling of incomprehension, avoidance of helping relationships, and preoccupation with gambling. These results support the relevance of developing, in a next step, a specific HRQOL scale in the context of gambling.
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Affiliation(s)
- Nicolas A. Bonfils
- CESP, UVSQ, INSERM, University Paris-Sud, Université Paris-Saclay, Villejuif, France,Inserm U894, Centre Psychiatrie et Neurosciences, Paris, France,AP-HP, Department of Psychiatry and Addictology, Hôpitaux Universitaires Paris Ouest, Paris, France,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France,Corresponding author: Nicolas A. Bonfils; Inserm U894, Centre Psychiatrie et Neurosciences, Issy-Les-Moulineaux, Paris 92130, France; Phone: +33 6 37 29 40 15; Fax: +33 1 71 19 63 72; E-mail:
| | - Marie Grall-Bronnec
- Addictology and Psychiatry Department, CHU Nantes, Nantes, France,Université de Tours, Inserm U1246, Université de Nantes, Nantes, France
| | - Julie Caillon
- Addictology and Psychiatry Department, CHU Nantes, Nantes, France,Université de Tours, Inserm U1246, Université de Nantes, Nantes, France
| | - Frédéric Limosin
- Inserm U894, Centre Psychiatrie et Neurosciences, Paris, France,AP-HP, Department of Psychiatry and Addictology, Hôpitaux Universitaires Paris Ouest, Paris, France,Sorbonne Paris Cité, Faculté de Médecine, Université Paris Descartes, Paris, France
| | - Amine Benyamina
- CESP, UVSQ, INSERM, University Paris-Sud, Université Paris-Saclay, Villejuif, France,APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France,Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
| | - Henri-Jean Aubin
- CESP, UVSQ, INSERM, University Paris-Sud, Université Paris-Saclay, Villejuif, France,APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France,Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
| | - Amandine Luquiens
- CESP, UVSQ, INSERM, University Paris-Sud, Université Paris-Saclay, Villejuif, France,APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France,Faculté de Médecine Paris Sud, Université Paris XI, Paris, France
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