Neuropsychological Rehabilitation最新文献

Stigma represents a major obstacle in rehabilitation and community reintegration after brain injury. However, appropriate tools to measure stigma in Spanish-speaking countries are lacking. This study examined the psychometric properties of the Spanish version of the Anticipated Stigma and Concealment Questionnaire (ASCQ). An observational cross-sectional study was conducted with 103 participants who completed the ASCQ and other measures. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to assess the scale's structure. Associations between the ASCQ and other mental health measures were explored to establish its nomological validity. All ASCQ items loaded significantly onto a single factor, with factor loadings ranging from .7 to .84. While χ² (35) = 56.282, p < .05, some fit indices indicated excellent model fit (CFI = .997 and TLI = .996), while others suggested a good fit (RMSEA = .077, 90% CI [.036, .113], and SRMR = .060). Significant associations were found between the ASCQ and measures of loneliness, depressive symptoms, quality of life, and self-esteem. The ASCQ is a valid and reliable tool for assessing anticipated stigma and the motivation to conceal information after acquired brain injury. It can aid rehabilitation professionals in identifying individuals with interpersonal difficulties during community reintegration.

Mental health difficulties are common post-stroke and developing support for psychological adjustment is a research priority. Wellbeing After Stroke (WAterS) is a nine-week, online, group-based Acceptance and Commitment Therapy (ACT)-informed intervention, delivered by trained third-sector practitioners, supervised by a clinical neuropsychologist. This study aimed to explore the acceptability of WAterS from the stroke survivors' perspective.Semi-structured interviews were conducted with twelve stroke survivors who received WAterS. The interview schedule was informed by theorised components of acceptability, including understanding, burden and perception of effectiveness. The data were analysed inductively and deductively using Template Analysis.Six qualitative themes were generated. Results indicate the intervention was mostly understandable and participants were able to engage with ACT and apply it to life. Online delivery reduced burden in accessing the intervention, and was acceptable when supported by live facilitation and a physical handbook. Group cohesion and understanding was facilitated by practitioners. The social aspect of the group was beneficial. Attending WAterS supported some participants to seek further support; others were left feeling unsupported when the intervention ended.Stroke survivors valued attending an online, group ACT-informed intervention, delivered by practitioners. This is a promising avenue in increasing the reach of interventions to support wellbeing.

Objective: The purpose of this study was to examine correlations between injury- and child-factors and participation and quality of life (QoL) after childhood traumatic brain injury (TBI).

Method: Cross-sectional data was analysed on 59 children with TBI included in a larger survey study. These children experienced their TBI at 12.2 years old and were 2.1 years post-injury, on average.

Results: On average, children's executive functioning, family functioning, and psychosocial QoL were within typical limits based on parent-reported standardized measures, yet participation was within the limited/somewhat limited range and physical QoL below the average for the U.S.

Population: Bivariate analyses revealed significant correlations between age at injury, executive functioning summary and subscale scores, and family functioning with participation and psychosocial QoL.

Conclusions: The results of this study support the understanding of risk and protective factors and the interaction amongst these factors for children with TBI. These findings highlight the need for professionals to monitor and provide direct and indirect interventions, as needed, for all components of the ICF framework for children with TBI and their families.

The Strategy Use Measure (SUM) was developed as a systematic tool to assess cognitive, behavioural and emotional strategy use by clients and carers after acquired brain injury. Comprehensive content development was undertaken across four clinical service sites via expert clinician consultation and consensus, file review of strategies used in clinical practice, and consumer consultation. Statistical analysis was undertaken to evaluate items and assess reliability, validity and factor structure. Two final versions of the SUM were developed, for use with clients (SUM-ABI; 14 items) and carers (SUM-C; 24 items). Internal consistency for the total scales was sound (SUM-ABI = .90; SUM-C = .96) as was test-retest reliability (SUM-ABI = .87; SUM-C = .90). Meaningful factors were identified for both scales (SUM-ABI: Memory and Planning, Emotion and Mood, Cognitive Load; SUM-C: Executive Support, Emotion/Behaviour Support, Enhancing Task Performance, Motivation Support) with all subscales demonstrating strong internal consistency (≥.80). Construct validity for both scales was explored using validated measures. The SUM versions were evaluated against COSMIN instrument design standards and found overall to be reliable and valid, with promising utility in rehabilitation for clinicians and researchers.

Objectives: This single-blind, parallel groups, randomized controlled trial examined whether (1) mnemonic strategy training (MST) improved memory for face-name associations relative to vanishing cue training (VCT) and (2) the interventions modulated blood oxygen level dependent (BOLD) signal in a training-specific manner.

Methods: We randomized 30 cognitively intact older adults to either MST or VCT (1:1 basis). Memory for face-name associations (primary outcome) was evaluated at baseline and post-training using functional magnetic resonance imaging (fMRI) and again at 1-month follow-up (memory test only). During training sessions, MST participants applied a 3-step strategy while those receiving VCT recalled the targeted name across trials with letters subtracted (correct trials) or added (incorrect trials) as appropriate.

Results: There were no adverse events and excellent retention. The magnitude of memory test improvement was significantly greater after MST at both post-training and 1-month relative to VCT. The MST group also showed significantly greater BOLD signal changes in multiple brain regions as well as increased functional connectivity between networks relative to the VCT group.

Conclusions: MST is superior to VCT for enhancing long-term retention of face-name associations in cognitively intact older adults and appears to enhance use of lateral frontoparietal regions and networks involved in top-down processing.

Prosopagnosia is a neurological disorder; characterized by an impairment in facial recognition. It can occur from acquired prosopagnosia (occurring in approximately 5.6% of the population), or from developmental prosopagnosia (occurring in approximately 2% of the population). Despite the relatively high prevalence of prosopagnosia, there has been limited research into intervention for this condition. The current systematic review aimed to review the evidence base to aid the development of practice guidelines for clinicians working with impacted individuals. A systemic search identified 14 studies, 10 of which involved participants with developmental prosopagnosia, while the remaining studies involved participants with acquired prosopagnosia. Overall, the findings identified two strategies which produced significant improvement in face recognition in prosopagnosics. The first strategy involved a perceptual learning strategy (a restorative approach). While this strategy improved face processing abilities, the intervention was time-consuming and relied on specific software. The second strategy involved learned association of distinguishable facial features (a compensatory approach). This intervention produced improvements in face recognition and was quick to administer, however, the gains made were not generalisable to untrained faces. The current review identified a number of limitations in the existing literature, such as the lack of single-case experimental designs and randomized controlled trials, limited control for practice effects, and no consensus with regard to the assessment and diagnosis of prosopagnosia. This review highlighted the need for further research to inform practice guidelines.

Individuals living with neurological conditions often face chronic issues including motor and sensory impairments and cognitive deficits. These challenges can lead to significant psychological difficulties, including anxiety, depression, and post-traumatic stress. Acceptance and Commitment Therapy (ACT) is a psychotherapeutic approach which aims to enhance psychological flexibility and acceptance while promoting behavioural change. Although ACT groups have shown promise in supporting individuals with neurological conditions, the evidence on patients' experiences of attending them is sparse. This project explored the experiences of individuals with a range of neurological conditions who had attended ACT group sessions as part of routine clinical practice, with the aim to refine future iterations of the intervention and enhancing patient care. Ten individual qualitative semi-structured interviews were carried out and the data were analysed thematically. Three overarching themes emerged from the analysis: (1) Initial Barriers to Group Attendance and Engagement; (2) Building an Environment of Acceptance; (3) Developing an ACT toolkit. Overall, the results showed that the ACT group intervention led participants to develop stronger emotional connectedness, better knowledge of their difficulties, more effective psychological skills, and different mindsets regarding their condition. Implications for the refinement of future ACT groups, neuropsychological service development, and clinical practice are discussed.

Self-discrepancy, i.e., negative changes in self-concept, is a common post-stroke phenomenon which is closely associated with depression and quality of life. In earlier research, self-discrepancy has been measured with the 18-item seven-stepped Head Injury Semantic Differential Scale (HISDS-III), by comparing pre- and post-morbid self-concepts. As completing this scale may be demanding especially for cognitively impaired stroke survivors, a straightforward instrument is desirable. Therefore, the validity of the Inclusion of the Other in the Self Scale (IOSS), which measures self-discrepancy with a single visualized item, was cross-sectionally examined in 123 individuals three years after stroke. Results revealed a substantial correlation between the IOSS and the established HISDS-III (r = .47, p < .001) and a Gini Index corresponding to an AUC of 0.74, both indicating convergent validity. Both measures showed similar correlations with relevant covariates. Prediction of depressive symptoms using established predictors was significantly improved by the inclusion of the IOSS (ΔR² = .07, p < .001). The findings indicate the high validity of the IOSS as an economic measure of global self-discrepancy after stroke. In addition, the results confirm self-discrepancy as a relevant determinant of post-stroke depression and thus as a potential target for psychological interventions in stroke patients.

We aimed to evaluate the acceptability, feasibility, preliminary effectiveness and costs of two eHealth maintenance interventions to sustain the longer-term effects of post-stroke memory rehabilitation compared to usual care. An observer-blinded pilot randomized controlled trial was conducted with community-dwelling stroke survivors experiencing everyday memory problems. Following a 6-week memory skills group, participants were randomly allocated to Telehealth Booster sessions, Electronic Reminders prompting strategy use, or Usual Care control (no active maintenance). Outcomes were acceptability ratings, recruitment and attrition rates, nine efficacy measures (e.g., Goal Attainment Scaling), intervention delivery costs and total costs (including service utilization). Efficacy outcomes were assessed post-memory-group (T1), post-waiting-period-1 (T2), post-maintenance-intervention (T3), and post-waiting-period-2 (T4). 38 participants were randomized (median_age 53 years, median_{time-since-stroke} 13 months). Acceptability was high across conditions, and feasibility thresholds were mostly met. Post-memory-group gains were maintained over time across all conditions. Participants receiving usual care also unexpectedly sustained gains, possibly due to regular monitoring across four trial assessments. Within-group effect sizes were largest for Telehealth Booster sessions for most outcomes. Intervention delivery costs were greatest for Telehealth Boosters, but total costs greatest for Electronic Reminders due to more service utilization. Therefore, booster sessions may have the greatest maintenance effect without increasing total costs.

Background: Recent research has shown the effectiveness of computerized therapy in the treatment of anomia in patients with aphasia. Multisensory stimulation, the use of various types of aids for lexical access, and immediate feedback favor this type of therapy. In the present study, the Computer-assisted Anomia Rehabilitation Program (CARP2) was applied.Aims: This study was designed to verify the efficacy of CARP2 in naming, to analyze the changes in terms of correct responses and types of errors according to the type of anomia, and to verify whether changes were generalized to the processes and skills involved in naming.Methods & Procedures: Ten people with aphasia were treated for 25 weeks; four had lexical anomia, two phonological anomia, and four semantic anomia. Neuropsychological assessment was conducted pre- and post-treatment.Outcomes & Results: The patients increased their effectiveness in naming, reducing, or modifying the type of error. Generalization effect of benefits is predominant.Conclusions: The study's findings suggest the potential efficacy of the CARP2 program. This therapy might be beneficial across anomia types, although generalization of treatment gains appears somewhat restricted in the case of semantic anomia.