The effect of severe traumatic brain injury on social cognition, emotion regulation, and mood

Author(s):  
Skye McDonald ◽  
Helen Genova
2019 ◽  
Vol 33 (5) ◽  
pp. 820-833 ◽  
Author(s):  
Herma J Westerhof-Evers ◽  
Annemarie C Visser-Keizer ◽  
Luciano Fasotti ◽  
Jacoba M Spikman

Background: Many patients with moderate to severe traumatic brain injury have deficits in social cognition. Social cognition refers to the ability to perceive, interpret, and act upon social information. Few studies have investigated the effectiveness of treatment for impairments of social cognition in patients with traumatic brain injury. Moreover, these studies have targeted only a single aspect of the problem. They all reported improvements, but evidence for transfer of learned skills to daily life was scarce. We evaluated a multifaceted treatment protocol for poor social cognition and emotion regulation impairments (called T-ScEmo) in patients with traumatic brain injury and found evidence for transfer to participation and quality of life. Purpose: In the current paper, we describe the theoretical underpinning, the design, and the content of our treatment of social cognition and emotion regulation (T-ScEmo). Theory into practice: The multifaceted treatment that we describe is aimed at improving social cognition, regulation of social behavior and participation in everyday life. Some of the methods taught were already evidence-based and derived from existing studies. They were combined, modified, or extended with newly developed material. Protocol design: T-ScEmo consists of 20 one-hour individual sessions and incorporates three modules: (1) emotion perception, (2) perspective taking and theory of mind, and (3) regulation of social behavior. It includes goal-setting, psycho-education, function training, compensatory strategy training, self-monitoring, role-play with participation of a significant other, and homework assignments. Recommendations: It is strongly recommended to offer all three modules, as they build upon each other. However, therapists can vary the time spent per module, in line with the patients’ individual needs and goals. In future, development of e-learning modules and virtual reality sessions might shorten the treatment.


2018 ◽  
Vol 13 (3) ◽  
pp. 819-829 ◽  
Author(s):  
Skye McDonald ◽  
Katie I. Dalton ◽  
Jacqueline A. Rushby ◽  
Ramon Landin-Romero

2013 ◽  
Vol 19 (8) ◽  
pp. 911-924 ◽  
Author(s):  
Mary R. Newsome ◽  
Randall S. Scheibel ◽  
Andrew R. Mayer ◽  
Zili D. Chu ◽  
Elisabeth A. Wilde ◽  
...  

AbstractOutcome of moderate to severe traumatic brain injury (TBI) includes impaired emotion regulation. Emotion regulation has been associated with amygdala and rostral anterior cingulate (rACC). However, functional connectivity between the two structures after injury has not been reported. A preliminary examination of functional connectivity of rACC and right amygdala was conducted in adolescents 2 to 3 years after moderate to severe TBI and in typically developing (TD) control adolescents, with the hypothesis that the TBI adolescents would demonstrate altered functional connectivity in the two regions. Functional connectivity was determined by correlating fluctuations in the blood oxygen level dependent (BOLD) signal of the rACC and right amygdala with that of other brain regions. In the TBI adolescents, the rACC was found to be significantly less functionally connected to medial prefrontal cortices and to right temporal regions near the amygdala (height threshold T = 2.5, cluster level p < .05, FDR corrected), while the right amygdala showed a trend in reduced functional connectivity with the rACC (height threshold T = 2.5, cluster level p = .06, FDR corrected). Data suggest disrupted functional connectivity in emotion regulation regions. Limitations include small sample sizes. Studies with larger sample sizes are necessary to characterize the persistent neural damage resulting from moderate to severe TBI during development. (JINS, 2013, 19, 1–14)


2013 ◽  
Vol 19 (3) ◽  
pp. 231-246 ◽  
Author(s):  
Skye McDonald

AbstractSevere traumatic brain injury (TBI) leads to physical, neuropsychological, and emotional deficits that interfere with the individual's capacity to return to his or her former lifestyle. This review focuses on social cognition, that is, the capacity to attend to, recognize and interpret interpersonal cues that guide social behavior. Social cognition entails “hot” processes, that is, emotion perception and emotional empathy and “cold” processes, that is, the ability to infer the beliefs, feelings, and intentions of others (theory of mind: ToM) to see their point of view (cognitive empathy) and what they mean when communicating (pragmatic inference). This review critically examines research attesting to deficits in each of these domains and also examines evidence for theorized mechanisms including specific neural networks, the role of simulation, and non-social cognition. Current research is hampered by small, heterogeneous samples and the inherent complexity of TBI pathology. Nevertheless, there is evidence that facets of social cognition are impaired in this population. New assessment tools to measure social cognition following TBI are required that predict everyday social functioning. In addition, research into remediation needs to be guided by the growing empirical base for understanding social cognition that may yet reveal how deficits dissociate following TBI. (JINS, 2013,19, 1–16)


2017 ◽  
Vol 32 (5) ◽  
pp. 296-307 ◽  
Author(s):  
Herma J. Westerhof-Evers ◽  
Annemarie C. Visser-Keizer ◽  
Luciano Fasotti ◽  
Marleen C. Schönherr ◽  
Martie Vink ◽  
...  

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