The Relative Importance of Metacognitive Skills, Emotional Status, and Executive Function in Psychosocial Adjustment Following Acquired Brain Injury

2005 ◽  
Vol 20 (4) ◽  
pp. 315-332 ◽  
Author(s):  
Tamara Ownsworth ◽  
Jennifer Fleming
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Psychosocial Adjustment ◽  
Acquired Brain Injury ◽  
Relative Importance ◽  
Metacognitive Skills ◽  
Emotional Status

scholarly journals The mentalizing network and theory of mind mediate adjustment after childhood traumatic brain injury

2019 ◽  
Vol 14 (12) ◽  
pp. 1285-1295 ◽  
Author(s):  
Kristen R Hoskinson ◽  
Erin D Bigler ◽  
Tracy J Abildskov ◽  
Maureen Dennis ◽  
H Gerry Taylor ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Executive Function ◽  
Social Cognition ◽  
Brain Injury ◽  
Theory Of Mind ◽  
Psychosocial Adjustment ◽  
Right Hemisphere ◽  
Brain Networks ◽  
The United States ◽  
Severe Tbi

Abstract Childhood traumatic brain injury (TBI) affects over 600 000 children per year in the United States. Following TBI, children are vulnerable to deficits in psychosocial adjustment and neurocognition, including social cognition, which persist long-term. They are also susceptible to direct and secondary damage to related brain networks. In this study, we examine whether brain morphometry of the mentalizing network (MN) and theory of mind (ToM; one component of social cognition) mediates the effects of TBI on adjustment. Children with severe TBI (n = 15, Mage = 10.32), complicated mild/moderate TBI (n = 30, Mage = 10.81) and orthopedic injury (OI; n = 42, Mage = 10.65) completed measures of ToM and executive function and underwent MRI; parents rated children’s psychosocial adjustment. Children with severe TBI demonstrated reduced right-hemisphere MN volume, and poorer ToM, vs children with OI. Ordinary least-squares path analysis indicated that right-hemisphere MN volume and ToM mediated the association between severe TBI and adjustment. Parallel analyses substituting the central executive network and executive function were not significant, suggesting some model specificity. Children at greatest risk of poor adjustment after TBI could be identified based in part on neuroimaging of social brain networks and assessment of social cognition and thereby more effectively allocate limited intervention resources.

scholarly journals Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury

2016 ◽  
Vol 31 (6) ◽  
pp. 419-433 ◽  
Author(s):  
Yelena Bogdanova ◽  
Megan K. Yee ◽  
Vivian T. Ho ◽  
Keith D. Cicerone
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Cognitive Rehabilitation ◽  
Acquired Brain Injury

scholarly journals Executive Function Evaluation System Based on Wiping Desk Behavior in Virtual Space

2020 ◽  
Vol 9 (4) ◽  
pp. 149-159
Author(s):  
Sho Ooi ◽  
◽  
Akihito Mihara ◽  
Mutsuo Sano ◽  
Hajime Tabuchi ◽  
...  
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Real Time ◽  
Evaluation System ◽  
Brain Injuries ◽  
Acquired Brain Injury ◽  
Virtual Space ◽  
Dynamic Evaluation ◽  
Time Dynamic ◽  
Cleaning Behavior

In this study, we report the development of a virtual reality (VR) system that evaluates executive function based on cleaning behaviors in real-time. It is known that patients with acquired brain injuries present adverse symptoms such as attention, memory, and functional disorders, as well as aphasia. Current methods to evaluate acquired brain injuries include tests such as the behavioral assessment of the dysexecutive syndrome (BADS) and digital clinical assessment for attention (D-CAT) tests; however, these tests require special/specific toolkits, and the methods are rigorous when applied for real-time dynamic evaluation. Moreover, patients are often burdened by the need to undergo paper tests as required by the evaluation methods. In this context, we propose and verify the efficacy of a method that offers real-time dynamic evaluation of acquired brain injury based on daily-living activities such as cooking, cleaning, and shopping. In this study, we focus on executive function relating to acquired brain injury, and we propose a real-time dynamic evaluation method for executive functioning using VR, which enables the automatic evaluation of subjects’ table-cleaning behavior. Our results indicate that our system can automatically assess subjects’ table cleaning behavior based on BADS test, while affording a cleaning behavior maximum average accuracy of 75.5%.

scholarly journals Self-Awareness Moderates the Association Between Executive Dysfunction and Functional Independence After Acquired Brain Injury

2020 ◽  
Vol 35 (7) ◽  
pp. 1059-1068
Author(s):  
Dolores Villalobos ◽  
José M Caperos ◽  
Álvaro Bilbao ◽  
Umberto Bivona ◽  
Rita Formisano ◽  
...  
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Significant Interaction ◽  
Declarative Memory ◽  
Acquired Brain Injury ◽  
Functional Independence ◽  
Common Symptom ◽  
Self Awareness ◽  
Moderator Effect ◽  
Low Levels

Abstract Objective Impaired self-awareness (SA) is a common symptom after suffering acquired brain injury (ABI) which interferes with patient’s rehabilitation and their functional independence. SA is associated with executive function and declarative memory, two cognitive functions that are related to participants’ daily living functionality. Through this observational study, we aim to explore whether SA may play a moderator role in the relation between these two cognitive processes and functional independence. Method A sample of 69 participants with ABI completed a neuropsychological assessment focused on executive function and declarative memory which also included a measure of SA and functional independence. Two separated linear models were performed including functional independence, SA, and two neuropsychological factors (declarative memory and executive function) derived from a previous principal component analysis. Results Moderation analysis show a significant interaction between SA and executive function, reflecting an association between lower executive functioning and poorer functional outcome, only in participants with low levels of SA. Notwithstanding, declarative memory do not show a significant interaction with SA, even though higher declarative memory scores were associated with better functional independence. Conclusions SA seems to play a moderator effect between executive function, but not declarative memory, and functional independence. Accordingly, participants with executive deficits and low levels of SA might benefit from receiving specific SA interventions in the first instance, which would in turn positively impact on their functional independence.

scholarly journals Paediatric goal management training in patients with acquired brain injury: study protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029273
Author(s):  
Ruth Elizabeth Hypher ◽  
Anne Elisabeth Brandt ◽  
Kari Risnes ◽  
Torstein Baade Rø ◽  
Eva Skovlund ◽  
...  
Keyword(s):  
Executive Function ◽  
Brain Injury ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Acquired Brain Injury ◽  
Executive Dysfunction ◽  
Management Training ◽  
Goal Management ◽  
Randomised Controlled ◽  
Goal Management Training

IntroductionCompromised integrity of the brain due to paediatric acquired brain injury (pABI) has been associated with cognitive impairment, particularly executive dysfunction, in addition to somatic and emotional symptoms and reduced everyday function. Goal Management Training (GMT) is a cognitive rehabilitation intervention for improving executive function (EF) that has received empirical support in studies of adults with ABI. The purpose of the present study is to determine the efficacy of a recently developed paediatric version of GMT (pGMT) for children and adolescents with ABI and reported executive dysfunction.Methods and analysisThis study protocol describes a parallel randomised controlled trial including allocation concealment and assessor blinding. Eighty survivors after pABI, aged 10–17 years at the time of intervention, will be recruited. Participants will be randomly allocated to either pGMT (n=40) or a psychoeducative control intervention (n=40; paediatric Brain Health Workshop). Both interventions consist of seven group sessions for participants and parents, followed by external cueing and telephone counselling. The study also includes involvement of teachers. Assessments will be performed at baseline, immediately postintervention and at 6 months’ follow-up. Primary outcome measure will be changes in daily life EF as reported by parents (The Behavior Rating Inventory of Executive Function). Secondary outcomes include other assessments of EF (neuropsychological tests and questionnaires). Furthermore, we aim to assess generalisation effects of pGMT on other cognitive functions, as well as emotional, behavioural, adaptive and family function, academic performance, fatigue and quality of life.Ethics and disseminationResults from this study will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals, in addition to presentations at scientific conferences. The study will be conducted in accordance with the Helsinki declaration and the Ethical Research Involving Children (ChildWatch International and Unicef). In accordance to Good Clinical Practice our study includes safety and quality monitoring guarantees in compliance with research ethics and safety. The trial will be reported in accordance with the Consolidated Standards of Reporting Trials 2010 statement and Standard Protocol Items for Reporting in Trials recommendations, in addition to being registered at ClinicalTrials.gov. The study has been approved by the Regional Committees for Medical and Health Research Ethics Norway (2017/772).Trial registration numberNCT03215342.

591 Sleep disturbances and executive function outcomes after critical care hospitalization in children with acquired brain injury

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A233-A233
Author(s):  
Cydni Williams ◽  
Miranda Lim ◽  
Cindy McEovy ◽  
Trevor Hall ◽  
Kurt Drury ◽  
...  
Keyword(s):  
Critical Care ◽  
Executive Function ◽  
Brain Injury ◽  
Sleep Disturbances ◽  
Pediatric Population ◽  
Acquired Brain Injury ◽  
Cognitive Outcomes ◽  
Blood Institute ◽  
T Score ◽  
And Gender

Abstract Introduction Annually, over 60,000 children require critical care admission for acquired brain injury (ABI) in the US, and many face long-term cognitive morbidity. Over 50% of these children also develop sleep/wake disturbances (SWD). Given the importance of sleep to brain development and healing after injury, we hypothesized SWD in children after ABI would portend worse cognitive outcomes in domains of executive function. Methods We performed a prospective observational study of N=80 children aged 6–18 years with ABI evaluated 1–3 months after critical care hospitalization. SWD were evaluated using the Sleep Disturbances Scale for Children (SDSC). The primary outcome was the Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2) Global Executive Composite (GEC; an age and gender adjusted T-score). Secondary cognitive outcomes included age adjusted scaled scores (ss) from the Delis Kaplan Executive Function System (DKEFS), Wechsler Intelligence Scale for Children, 5th Edition (WISC-V), and Children’s Memory Scale (CMS). Relationships between the SDSC and cognitive measures were evaluated using Spearman correlation (rs). Multiple linear regression evaluated associations between SWD and GEC T-scores controlling for patient and ABI characteristics. Results Sixty-five (81%) eligible children completed evaluation, and 48% had clinically significant SWD (total SDSC ≥39). Significant correlation (p<0.05) was found between the SDSC total score and worse GEC T-score (rs=0.60), and worse ss for CMS numbers forward (rs= -0.39), WISC-V coding (rs=-0.36), DKEFS number letter switching total time (rs=-0.38), and DKEFS category fluency (rs=-0.43). Presence of SWD was significantly associated with a full standard deviation worsening in the GEC T-score (β-coefficient= 10.2, 95% Confidence Interval=1.0–19.3) when controlling for age, race, gender, admission Glasgow Coma Scale, critical care intervention, and chronic comorbidities. Conclusion Children with ABI requiring critical care have high rates of SWD after discharge that are associated with significantly worse executive function outcomes in overall function (BRIEF-2 GEC) and direct objective assessments (DKEFS, WISC-V, CMS) evaluating aspects of executive functioning including attention, processing speed, cognitive flexibility, and working memory. SWD may serve as a modifiable target to improve cognitive outcomes in this vulnerable pediatric population. Support (if any) This work is supported by the National Heart Lung and Blood Institute (K23HL150229-01)

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