Impulsivity and Risk-Taking in Adolescent Young Offenders: Does Traumatic Brain Injury Play a Role?

Objective: To investigate whether traumatic brain injury (TBI) plays a role in impulsivity, risk-taking, aggression and other behaviour problems in young offenders. Setting: Youth Offending Teams in the South West of England. Participants: Participants were 21 young offenders with community sentences, aged between 14 and 18 years old. Design: A cross-sectional correlational design. Main measures: A background questionnaire gathered information about the frequency and severity of TBIs, which was used to calculate the “TBI dose”. The Stoplight task and the Stroop test provided behavioural measures of risk-taking and interference control respectively. Self-report questionnaires provided measures of impulsivity (UPPS Impulsivity Scale), aggression (Reactive and Proactive Aggression Questionnaire) and behaviour (Strength and Difficulties Questionnaire). Results: Seventy-six per cent of the sample reported at least one TBI. TBI was not significantly correlated with either any of the other variables. Impulsivity was significantly positively correlated with reactive aggression. Conclusion: This exploratory study concludes that, in the current sample, TBI is not associated with impulsivity or risk-taking. Therefore, it is equally possible that impulsivity and reactive aggression pre-exist TBI. Future research should use a longitudinal design and a larger sample

Working with older adults on the cochlear implant (CI) programme within the University of Southampton Auditory Implant Service (USAIS)

Background: as one gets older the chances of experiencing hearing loss increases, with around 65% of people aged over 60 experiencing disabling hearing loss (Chadha et al., 2021). Many of the people USAIS see are over 60. Hearing loss in older age has been associated with a poorer quality of life and social isolation (Lawrence et al, 2020) as well as dementia (Livingston et al., 2020). Providing support to older adults with their hearing can greatly reduce these chances and can increase one’s quality of life (Cuda et al., 2024). Aims: the study wanted to explore the practicalities of working with older adults and whether as a service we were aware of the difficulties older adults might face alongside their hearing loss. We wanted to see whether staff had any concerns working with older adults and whether older adults were being given the support they needed whilst accessing the service.Method: an online questionnaire was sent via Teams to all staff members within USAIS who worked with older adults, including audiologists, psychologists, rehabilitation, speech and language therapists and administration staff. Staff were asked to state their job role and to define who they considered to be an “older adult”. They were asked about the practicalities of working with older adults and whether they had any concerns when working with an older person. They were asked whether they made adaptions to their practice, the frequency of those adaptations and what those adaptions were. They were then asked what changes and support they needed, including whether training was needed, to help them to feel more confident working with older adults. Finally, staff were asked what they needed from the service to be able to meet the needs of older adults to provide safe care and what this support would look like.Results: 38% of staff responded. Majority of staff defined “older adults” as being over 70, however many were unsure and said it depended on the person. Common concerns staff had were around social isolation, mobility, communicating information and involving family/caregivers. Most staff made adaptations to their practice at least once a month. Adaptions included simplifying their language, using more visual/tactile stimuli, and allowing for breaks. Staff said they lacked knowledge with difficulties including dementia, capacity/consent, age related changes to auditory processes and involving family/carers. They were also unsure around how to communicate information so that it was understood. Conclusions: the study highlighted current practices with USAIS and gaps in staff knowledge around how to best meet the needs of older adults within the service. It demonstrated that staff training is needed to build staff confidence to provide better support to older adults within USAIS so that their needs are met

Characteristics of 698 patients with dissociative seizures: a UK multicenter study

Objective We aimed to characterize the demographics of adults with dissociative (nonepileptic) seizures, placing emphasis on distribution of age at onset, male:female ratio, levels of deprivation, and dissociative seizure semiology. Methods We collected demographic and clinical data from 698 adults with dissociative seizures recruited to the screening phase of the CODES (Cognitive Behavioural Therapy vs Standardised Medical Care for Adults With Dissociative Non‐Epileptic Seizures) trial from 27 neurology/specialist epilepsy clinics in the UK. We described the cohort in terms of age, age at onset of dissociative seizures, duration of seizure disorder, level of socioeconomic deprivation, and other social and clinical demographic characteristics and their associations. Results In what is, to date, the largest study of adults with dissociative seizures, the overall modal age at dissociative seizure onset was 19 years; median age at onset was 28 years. Although 74% of the sample was female, importantly the male:female ratio varied with age at onset, with 77% of female but only 59% of male participants developing dissociative seizures by the age of 40 years. The frequency of self‐reported previous epilepsy was 27%; nearly half of these epilepsy diagnoses were retrospectively considered erroneous by clinicians. Patients with predominantly hyperkinetic dissociative seizures had a shorter disorder duration prior to diagnosis in this study than patients with hypokinetic seizures (P < .001); dissociative seizure type was not associated with gender. Predominantly hyperkinetic seizures were most commonly seen in patients with symptom onset in their late teens. Thirty percent of the sample reported taking antiepileptic drugs; this was more common in men. More than 50% of the sample lived in areas characterized by the highest levels of deprivation, and more than two‐thirds were unemployed. Significance Females with dissociative seizures were more common at all ages, whereas the proportion of males increased with age at onset. This disorder was associated with socioeconomic deprivation. Those with hypokinetic dissociative seizures may be at risk for delayed diagnosis and treatment