Cognitive rehabilitation treatment for mental slowness in conversion disorder : A case report

Cognitive rehabilitation treatment (CRT) has been described in patients with brain injury, but it has not been attempted in cases of cognitive dysfunction without organic cause. This case report describes CRT of neurocognitive impairment in a 54-year-old female patient with conversion disorder (CD). She experienced difficulties with regard to speaking, motor function, and pain symptoms, which developed after stressful life circumstances. Baseline neuropsychological assessment (NPA) showed mental slowness and impaired (working) memory. Time Pressure Management (TPM) was used as CRT to teach the patient a compensatory strategy to overcome mental slowness in 12 sessions. During treatment, physical symptoms were monitored with the Physical Symptom Questionnaire (LKV), and mental slowness with the Mental Slowness Questionnaire (MSQ). After treatment, the LKV score dropped from 85 to 47, indicating 54% treatment response. Mental slowness showed improvement based on the MSQ and was confirmed by an NPA after treatment. Other neurocognitive functions improved as well and the motoric CD symptoms subsided. This case report suggests that improvement of mental slowness, as well as motor CD symptoms, can be achieved by TPM in non-organic neurocognitive impairment in CD. This finding has not been described in the literature. Further research is warranted to explore the efficacy of TPM in CD.Keywords: conversion disorder, neurocognitive impairment, cognitive rehabilitation treatment, time pressure management, pai

Social cure and social curse: social identity resources and adjustment to acquired brain injury

.There is increasing evidence that identification with social groups can protect and enhance health, establishing a kind of ‘social cure’. However, for those affected by chronic or disabling conditions such as acquired brain injury (ABI), their identity may also represent a burden, a form of ‘social curse’. The present study explored the identity benefits and burdens available to 15 participants living with ABI using semi‐structured interviews. The qualitative data was then analysed systematically using thematic analysis. The findings highlight social identity changes as central to the experience of brain injury. Participants reported changes in their social networks and social group memberships after injury. Identity loss and reduced social support were described as disabling. Engagement in meaningful group activity with others affected by ABI and access to affected peers enabled new group‐based resources such as social support. In this way, group activity can be seen as a form of identity enactment that can drive social cure effects. Similarly, adaptation to life after injury was demonstrably linked to social identity processes pointing to the importance of a social cure approach to rehabilitatio