Self-awareness following acquired brain injury is linked with depression and executive function

The current study aimed to examine the potential relationship between selfawareness, executive function and depression in post-acute acquired brain injury. 25 participants prospectively recruited from a community brain injury rehabilitation service completed the Awareness Questionnaire (AQ), the Hospital Anxiety and Depression Scale (HADS), the Trail Making Task (TMT) and the Wisconsin Card Sorting Test (WCST). Each participant’s treating clinician also completed the Awareness Questionnaire (clinician form) for comparison. Hierarchical multiple regression revealed that depression (HADS) and set shifting (TMT) were significant predictors of level of self-awareness (AQ) following acquired brain injury. Contrary to previous research, the Wisconsin Card Sorting Test was not predictive of self-awareness. Consistent with previous research, reduced self-awareness appears to be protective against symptoms of depression even after the acute stages of recovery. Clinical implications include the importance of monitoring levels of self-awareness even in post-acute ABI, including neuropsychological and psychological factors that might be contributing to and maintaining varying levels of self-awareness.O presente estudo buscou examinar a relação potencial entre a autoconsciência, função executiva e a depressão com a lesão cerebral adquirida na fase pós-aguda. Os 25 participantes recrutados prospectivamente de um serviço comunitário de reabilitação cerebral completaram o Awareness Questionnaire (AQ), a Escala Hospitalar de Ansiedade e Depressão (HADS), o Teste de Trilhas (TMT) e o Teste Wisconsin de Classificação de Cartas (WCST). O clínico de cada participante também respondeu o Awareness Questionnaire para comparação. As múltiplas regressões hierárquicas revelaram que a depressão (HADS) e a mudança de configuração (TMT) foram preditores significantes de um nível de autoconsciência (AQ) seguido da lesão cerebral adquirida. Ao contrário das pesquisas anteriores, o Teste Wisconsin de Classificação de Cartas não foi preditivo de autoconsciência. Consistente com as pesquisas anteriores, a autoconsciência reduzida parece ser uma proteção contra os sintomas de depressão mesmo após atingir níveis agudos de recuperação. As implicações clínicas incluem a importância do monitoramento dos níveis de autoconsciência, mesmo na lesão cerebral adquirida pós-aguda, incluindo os fatores neuropsicológicos e psicológicos que podem contribuir e manter a variação dos níveis de autoconsciênciaEl presente estudio buscó analizar la relación potencial entre la autoconsciencia, la función ejecutiva y la depresión con lesión cerebral adquirida en la fase post-aguda. Los 25 participantes reclutados prospectivamente desde un servicio comunitario de rehabilitación cerebral completaron el o Awareness Questionnaire (AQ), a Hospital Anxiety and Depression Scale (HADS), el Trail Masking Test (TMT) y el Wisconsin Card Sorting Test (WCST). El clínico de cada participante también respondió el Awareness Questionnaire para comparación. Las múltiples regresiones jerárquicas han revelado que la depresión (HADS) y la transformación de la configuración (TMT) fueron los predictores significativos de un nivel de autoconsciencia (AQ) seguido de la lesión cerebral adquirida. A lo contrario de las investigaciones anteriores, él no fue predictivo de autoconsciencia. Consistente con las investigaciones anteriores, la autoconsciencia reducida parece ser una protección en contra de los síntomas de la depresión mismo después de atingir niveles agudos de recuperación. Las implicaciones clínicas incluyen la importancia del monitoreo de los niveles de autoconciencia, mismo en la lesión cerebral adquirida post-aguda, incluyendo los factores neuropsicológicos y psicológicos que pueden contribuir y mantener la variación de los niveles de autoconciencia

The challenges and opportunities of delivering clinical neuropsychology services during the Covid-19 crisis of 2020.

Este breve artigo descreve os efeitos que o Covid-19 teve na organização e no atendimento a pacientes de um serviço comunitário de reabilitação de lesões cerebrais do Reino Unido (Reino Unido). O artigo foi escrito sob a perspectiva da neuropsicologia e reflete sobre as experiências pessoais dos autores de trabalhar com pacientes com lesões cerebrais, alguns dos quais foram positivos para Covid-19, durante a crise de 2020.This short paper describes the effects Covid-19 had on the organization and patient care of a United Kingdom (UK) community brain injury rehabilitation service. The paper is written from a neuropsychology perspective and reflects on the authors’ personal experiences of working with brain-injured patients, some of whom were Covid-19 positive, during the crisis of 2020

“We can all relate": patient experience of an emotion-oriented group intervention

Introduction: Group interventions are carried out routinely acrossneuropsychological rehabilitation services, to improve understanding of braininjury and aspects of impairment. Treatment provided in a group modality canbring additional perceived benefits, such as co-operative learning. However, there are very few studies which explore patient perceptions and experiences of such interventions. In the present study we investigated the experience of attending a group-based educational intervention for the consequences of acquired brain injury (ABI), which had a strong focus on emotion and emotion regulation.Methods: Using qualitative semi-structured interviews (approximately 20minutes), the study explores the lived experience of participating in the sevensession programme, the better to identify the perceived efficacy, salienceand value of individual elements. Twenty participants with ABI took part inindividual interviews, after completion of the group programme (the Brain InjurySolutions and Emotions Programme, BISEP). The study adopted a descriptivephenomenological philosophy, which focuses on lived experience to explorea phenomenon (i.e. the experience of BISEP). As regards methods, the studyemployed thematic analysis to cluster experiences into themes of meaning.Results: Five themes were identified: (1) ‘Long term consequences and psychological needs’, which related to the persistent nature of direct consequences of injury and adjustment, and how these result in a need for interventions such as BISEP. (2) ‘Positive experiences of participating in the programme’, referred to participants’ overall experience of the programme and valued elements within it. The remaining themes referred to the programme as (3) a social milieu; (4) a place to learn; and (5) a place to promote positive emotional experiences.Discussion: Similar to previous studies, many people reported high acceptabilityand perceived value of the group programme, and its role in facilitatingadjustment and understanding of injury. Of particular importance was theopportunity to socialise with people who “can all relate”, in line with a growingemphasis on social rehabilitation. The findings especially highlight the relevanceof emotion-focused group programmes for ABI, promoting emotion regulation,and practical tools that are delivered optimistically. Further implications forpractice and future research include to focus on long term rehabilitation, asocial milieu, and strategies to support adjustment