Neuropsychological Rehabilitation最新文献

Rehabilitation during community integration after acquired brain injury (ABI) focuses on supporting individuals to make sense of and manage injury-related changes in the context of occupational engagement. To improve understanding of the role of rehabilitation in facilitating early adjustment to ABI, the study aimed to understand individuals' rehabilitation priorities and expectations at hospital discharge and experiences at 3-months post-discharge. Semi-structured interviews were conducted with adults with ABI at discharge (n = 28) and 3-months post-discharge (n = 24) from a brain injury rehabilitation unit in Queensland, Australia. Data were thematically analysed using the Framework Method. Analysis identified an overarching theme of "Supporting self-continuity," comprising three interrelated themes. "Life's getting back on track" represented individuals' priority to access ongoing contextualized rehabilitation, enabling resumption of valued activities and roles. "My life on pause" reflected uncertainty about post-discharge processes for resuming occupations and feeling restricted by limitations and support gaps. "Collaborative fit: Matching my needs″, depicting the alignment between individual's mindset and expectations of life after ABI and personalization of rehabilitation services, and was central to self-continuity. Following discharge, collaborative fit between people with ABI and support systems is central to supporting self-continuity through enabling engagement in activities and roles important to self-identity.

Cognitive symptoms are common after mild traumatic brain injury (mTBI) and can interfere with return to work. Factors underlying these symptoms are poorly understood. This prospective observational study explored relationships between illness perceptions, coping style, and cognitive symptom reporting in mTBI, including when controlling for sex and psychological distress. Individuals with mTBI (n = 70) and trauma controls (n = 42) were assessed 6-10 weeks post-injury. Measures included the Brief-COPE, the Illness Perceptions Questionnaire-Revised (IPQ-R), and subjective cognitive and post-concussion symptom scales. Six of the nine IPQ-R subscales showed robust bivariate correlations with cognitive symptoms in the mTBI group (|r| = .24-.55). Illness perceptions contributed to cognitive symptom reporting over and above the effects of sex and psychological distress (F(2,64) = 4.12, p = .021); significant, robust independent predictors were psychological distress (β = .344, p = .003), and IPQ-Consequences (β = .276, p = .025). Relationships with general post-concussion symptoms, and in trauma controls, were also explored. This research demonstrates that illness perceptions have important relationships with cognitive symptoms after mTBI, which persist when controlling for pre-established predictors of these symptoms. This indicates that illness perceptions are a unique predictor of cognitive symptoms after mTBI and suggests that, alongside psychological distress, these perceptions may be a useful target for intervention in individuals with prolonged recovery.

Background: Despite the profound impact of "brain fog" and/or cognitive impairment in relatively young people with Long COVID, no interventions with demonstrated efficacy are currently available. We conducted a pilot randomized controlled trial investigating the preliminary outcomes of a cognitive rehabilitation (CR) intervention adapted for persons with post-COVID cognitive impairment.

Methods: Participants were ≥18 years of age, English-speaking, had history of SARS-CoV-2, and had cognitive impairment on objective measures. Eligible participants were randomized to a 12-week CR intervention or a time - and attention-matched control arm. Objective and subjective cognitive functioning was assessed at pre - and within 2-weeks post-intervention, utilizing validated neuropsychological measures across multiple domains. We compared pre vs. post intervention changes in cognitive scores in intervention vs. control groups.

Results: The mean change in the intervention group compared to the controls in measures of processing speed, learning, memory, language, and of executive function did not reach the threshold for futility. In comparison to controls, the intervention group self-reported significant improvements in cognitive functioning.

Conclusions: We found that an adapted CR intervention for Long COVID may improve post-COVID cognitive impairment in comparison to a time - and attention-matched control group and should be evaluated in a larger trial.

Trial registration: ClinicalTrials.gov identifier: NCT05498493. Registered on 08/10/2022.

The Depression Intensity Scale Circles (DISCs) is a visual self-report depression screening tool that has been designed specifically for people with moderate-to-severe cognitive or communicative impairment. This scoping review aimed to systematically map research on the DISCs, drawing conclusions about its reliability, validity, and utilization in research and clinical practice. A literature search from 2004 - July 2024 was conducted using 9 databases. Thirty-six sources met inclusion criteria of mentioning "Depression Intensity Scale Circles" in their abstract or full text (15 published literature, 12 grey literature, and 9 social media posts). Only three sources formally studied the psychometric properties of the DISCs. Taken together, their results suggested that the DISCs has stronger predictive validity than reported in previous systematic reviews. While promising, these results should be interpreted cautiously due to the limited research available. Despite limited research, we found that the DISCs continues to be recommended and included into guidelines for depression screening, especially in in-patient stroke settings in the UK. The need for further research into the psychometric properties of the DISCs is identified. The trade-off in clinical settings between psychometric validity and clinical utility when working with individuals with cognitive and communication impairments is highlighted.

Research on social support following sport-related concussion (SRC) has largely been examined from the athlete perspective. This qualitative study explored social support interactions during recovery following SRC. We conducted semi-structured interviews with six athletes and 16 individuals who were identified as being part of the athletes' social support network (e.g., teammates, friends, or family members). All 22 participants in this study completed a timeline mapping activity, which allowed participants to share details about the athletes' SRC recovery, including the type and timing of support provided and received. Using thematic analysis, we found three themes. First, we found that social support was optimal when perceptions of social support were aligned (e.g., delivery and perceived impact on recovery). Second, we found several instances where challenges arose in the social support relationships, often stemming from incongruent perspectives (e.g., expectations and perceptions of support differed). Third, members of the support network described some of the barriers they faced when attempting to provide social support to athletes. Overall, these results add to the literature by demonstrating the good (aligned perspectives), the bad (incoherent perspectives), and the challenges with the social support relationships following SRC from the perspective of athletes and members of their support network.

To establish reliability and construct validity of a Norwegian version of the social cognition test, the Awareness of Social Inference Test (N-TASIT). Participants with traumatic brain injury (TBI; n = 101) and 50 matched healthy controls performed either a virtual reality (VR) or 2D version of N-TASIT at baseline and 16 weeks later. Reliability measures were test-retest reliability and internal consistency. Intraclass correlation (ICC) and Cronbach's alpha (α) were calculated for the overall sample and both groups separately. Construct validity was tested with known groups validity, convergent and discriminant validity. Known groups analysis was conducted for both versions separately and combined. Convergent and discriminant validity were determined by associations between N-TASIT and established measures of social cognition and with measures of cognition, emotional distress and fatigue. ICC for the total sample was 0.63 (95% CI 0.49-0.73), and α was 0.88, when presentation modes (VR and 2D) were combined. The healthy control group outperformed the TBI group in both presentation modes. Medium-to-large associations were found between N-TASIT performance and social cognitive measures, and mostly weak or no significant correlations with non-social domains. N-TASIT appears psychometrically sound and comparable to the original. The influence of presentation mode on performance remains unclear.

More research is needed on suicidal ideation (SI) and self-harm (SH) following moderate-severe traumatic brain injury (TBI). Previous studies have shown limited, inconsistent associations with demographic and injury factors and relied on diagnosis-specific analyses of psychiatric factors. This cross-sectional survey included 387 individuals with moderate-severe TBI and examined correlations between SI, SH, and 35 other variables, including a series of transdiagnostic internalizing symptom dimensions. In the previous two weeks, 21% of participants reported SI and 5% reported SH, both generally at mild levels. While demographic and injury factors showed minimal associations, SI and SH were significantly correlated with higher internalizing symptoms, greater disability, and lower life satisfaction. Elastic net regression was used to select the most important correlates, including core negative affect (e.g., depressed mood), post-traumatic intrusion, obsessive-compulsive, and low positive affect symptoms. While each significantly explained only a small amount of unique variance (<1-7%), their combination accounted for 50% and 31% of the variance in SI and SH, respectively. We identified a transdiagnostic profile that may help guide assessment and treatment of SI and SH in individuals with moderate-severe TBI. Future research should aim to distinguish SH with and without suicidal intent and incorporate a control group.

For some, post-concussion symptoms following a mild traumatic brain injury (mTBI) are prolonged in nature, lasting for a minimum of 12 months and up to many years. There remains limited insight into the effectiveness of psychological interventions for the treatment of prolonged post-concussion symptoms (PrPCS). This systematic review aimed to evaluate the effectiveness of psychological interventions for PrPCS (>12 months post mTBI). A search was performed across five databases (PsychINFO, Medline, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), & PubMed). Two independent researchers assessed the studies against pre-defined eligibility criteria and completed quality appraisals. Ten studies were included in the review and underwent narrative synthesis. Four psychological interventions for PrPCS were found (i.e., Cognitive Behavioural Therapy (CBT), Neurofeedback Therapy, Psychoeducation, & Mindfulness-based therapy). Emerging empirical data tends to support the assertion that psychological interventions can improve PrPCS and quality of life. CBT appears to have the strongest evidence base to date and to be the most effective in improving anxiety, anger, and overall mental well-being. However, the evidence base is still very much in its infancy and requires research with more robust methodological designs to be conducted before any conclusions can be reliably asserted.

Recent studies have demonstrated a possible association between cognitive impairments and traumatic upper limb injuries. This study aims to track the cognitive changes in individuals with such injuries. In this longitudinal study, 36 participants with traumatic upper limb injuries and 36 uninjured participants were enrolled. Cognitive functions were assessed using the Rey Auditory Verbal Learning Test (RAVLT) and the Stroop Color and Word Test (SCWT) over a period of 6 months, with evaluations conducted on three occasions: 1 month (T1), 3 months (T2), and 6 months (T3). The results revealed that participants with nerve injuries exhibited significantly lower RAVLT scores overall and at each time point (Overall: Wald χ² = 7.99, P < .05; T1: Wald χ² = 7.61, P < .05; T2: Wald χ² = 5.95, P < .05; T3: Wald χ² = 5.76, P < .05). In contrast, no significant impairment in RAVLT performance was observed in participants without nerve injuries. Additionally, the SCWT showed no significant differences between injured and uninjured participants over the six-month period (P > .05). In conclusion, traumatic nerve injuries to the upper limbs negatively affect memory, and this impairment does not spontaneously recover within six months.