Using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) to determine prevalence and predictors of neurobehavioural disability amongst survivors with traumatic brain injury in the community.

Studies using the St Andrew's - Swansea Neurobehavioural Outcome Scale (SASNOS) confirm neurobehavioural disability (NBD) is highly prevalent in inpatient Neurobehavioural Rehabilitation and Stroke samples. However, a recent study amongst a Danish community sample of acquired brain injury survivors found a relative paucity of NBD symptoms; and when symptoms were present, they tended to be of mild severity. The current observational study employed the SASNOS to explore prevalence of NBD in survivors with traumatic brain injury (TBI) living in the community, the extent of survivors' self-awareness of NBD symptoms, and constructed prediction models of NBD.

Lacking Pace but Not Precision: Age-Related Information Processing Changes in Response to a Dynamic Attentional Control Task.

Age-related decline in information processing can have a substantial impact on activities such as driving. However, the assessment of these changes is often carried out using cognitive tasks that do not adequately represent the dynamic process of updating environmental stimuli. Equally, traditional tests are often static in their approach to task complexity, and do not assess difficulty within the bounds of an individual's capability.

The Psychosocial Impact of Neurobehavioral Disability.

Neurobehavioral disability (NBD) comprises elements of executive and attentional dysfunction, poor insight, problems of awareness and social judgement, labile mood, altered emotional expression, and poor impulse control, any or all of which can have a serious impact upon a person's decision-making and capacity for social independence. The aim of this narrative review is to explore some of the more intrusive forms of NBD that act as obstacles to psychosocial outcome to act as a frame of reference for developing effective rehabilitation interventions. Special consideration is given to the psychosocial impact of three core forms of NBD: a failure of social cognition, aggressive behavior, and problems of drive/motivation.

Measuring Neurobehavioral Disabilities Among Severe Brain Injury Survivors: Reports of Survivors and Proxies in the Chronic Phase.

Neurobehavioral disability (NBD) has a major influence on long-term psychosocial outcome following acquired brain injury, as it affects not only the survivor of the brain injury, but the whole family. To investigate (1) the frequency of NBD among survivors of severe brain injury measured by the Danish version of the St Andrew's-Swansea Neurobehavioural Outcome Scale (SASNOS) rated by patients and proxies, (2) factors associated with NBD, and (3) concordance between reports of NBD completed by patients and proxies. SASNOS was administered at an outpatient unit as a part of a follow-up assessment after discharge from intensive neurorehabilitation.

Alexithymia is associated with aggressive tendencies following traumatic brain injury.

Objective: Aggressive behavior is a frequent legacy of traumatic brain injury (TBI). This study explores the question of how alexithymia, which is associated with deficits in social cognition and empathy, may predispose individuals to aggressive tendencies after head trauma.

Method: A total of 47 individuals referred for routine neuropsychological assessment and advice on the management of long-term neuropsychological sequelae after TBI and 72 demographically matched controls completed the 20-Item Toronto Alexithymia Scale (TAS-20) and Buss Perry Aggression Questionnaire (BPAQ; self and proxy).

Apathy following traumatic brain injury: A review.

Apathy is a common problem after traumatic brain injury (TBI) and can have a major impact on cognitive function, psychosocial outcome and engagement in rehabilitation. For scientists and clinicians it remains one of the least understood aspects of brain-behaviour relationships encompassing disturbances of cognition, motivation, emotion and action, and is variously an indication of organic brain disease or psychiatric disorder. Apathy can be both sign and symptom and has been proposed as a diagnosis in its own right as well as a secondary feature of other conditions.

Perceived personality change after traumatic brain injury II: comparing participant and informant perspectives.

Objective: The objective of this paper was to correlate informant personality change (PC) judgements following moderate-severe traumatic brain injury with quantitative neurobehavioural measures and to contrast the neurobehavioural correlates of informant and participant judgements of PC.

Participants: Informant-participant pairs were recruited from a medico-legal clinic passing effort tests (N = 31) and a National Health Service clinic (N = 40).

Measures: Participants were assessed on Wechsler tests of general ability, tests of executive functioning (Zoo Map and Fluency) and emotional distress (Beck Depression Inventory-FastScreen, Hospital Anxiety and Depression Scale and State-Trait Anger Expression Inventory-II).

When normal scores don't equate to independence: Recalibrating ratings of neurobehavioural disability from the 'St Andrew's - Swansea Neurobehavioural Outcome Scale' to reflect context-dependent support.

Primary Objective: Context is critical to the interpretation of measurement instruments that capture acquired brain injury (ABI) outcomes. Ratings reflect behaviours and abilities observed in a particular setting; it cannot be assumed that results are generalizable beyond these. This study explored the utility of a method to convey the impact of context-dependent support given on ratings of neurobehavioural disability (NBD) using the St Andrews-Swansea Neurobehavioural Outcome Scale (SASNOS).

Neurobehavioral Abnormalities Associated with Executive Dysfunction after Traumatic Brain Injury.

: This article will address how anomalies of executive function after traumatic brain injury (TBI) can translate into altered social behavior that has an impact on a person's capacity to live safely and independently in the community. : Review of literature on executive and neurobehavioral function linked to cognitive ageing in neurologically healthy populations and late neurocognitive effects of serious TBI. Information was collated from internet searches involving MEDLINE, PubMed, PyscINFO and Google Scholar as well as the authors' own catalogs.

Accelerated cognitive aging following severe traumatic brain injury: A review.

Objective: The primary objective of this review was to examine relevant clinical and experimental literatures for information on the long-term cognitive impact of serious traumatic brain injury (TBI) with regard to the process of cognitive aging.

Method: Online journal databases were queried for studies pertaining to cognitive aging in neurologically healthy populations, as well as the late cognitive effects of serious TBI. Additional studies were identified through searching bibliographies of related publications and using Google search engine.

Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale.

Objective: Neurobehavioural disability (NBD) after acquired brain injury (ABI) is often associated with poor outcome. The "St Andrew's-Swansea Neurobehavioural Outcome Scale" (SASNOS) was developed to measure NBD in a range of applications. Two of the "holy trinity" of psychometric properties, reliability and validity, have been comprehensively mapped, but the extent to which SASNOS meets the third, responsiveness, has not been investigated.

Unsupervised categorization with individuals diagnosed as having moderate traumatic brain injury: Over-selective responding.

Primary Objective: This study explored over-selectivity (executive dysfunction) using a standard unsupervised categorization task. Over-selectivity has been demonstrated using supervised categorization procedures (where training is given); however, little has been done in the way of unsupervised categorization (without training).

Methods And Procedure: A standard unsupervised categorization task was used to assess levels of over-selectivity in a traumatic brain injury (TBI) population.

Exploration of correlates of self-reported personality change after moderate-severe traumatic brain injury.

Objective: Individuals with traumatic brain injury (TBI) often express concern that their personality has changed. Factors generating that conclusion are rarely explored quantitatively. Accordingly, this study examines neurobehavioural correlates of self-reported personality change.

The development of a measure of social cognition following acquired brain injury.

Deficits in social cognition following acquired brain injury (ABI) have been found to be both prevalent and disabling. Despite this, relatively little attention has been given to identifying the characteristics of such deficits in a systematic way. We describe the development of self and informant versions of a new questionnaire designed to measure the changes in social cognition that may occur following ABI, the Brain Injury Rehabilitation Trust (BIRT) Social Cognition Questionnaire (BSCQ).

The impact of alexithymia on burnout amongst relatives of people who suffer from traumatic brain injury.

Background: Although previous research has provided some indication of the association of alexithymia and burnout, this is the first study exploring the association of these two variables in a sample of relatives of individuals who have sustained traumatic brain injury (TBI).

Objective: To explore the degree to which relatives experience burnout and the extent to which alexithymia acts as a pre-disposing factor, controlling for depression and coping strategies.

Method: Toronto Alexithymia Scale-20, Maslach Burnout Inventory-Human Services, Estonian COPE Dispositional Inventory and Beck Depression Inventory-II were completed by 60 relatives of patients with TBI drawn from a tertiary head injury clinic population.

Stimulus over-selectivity in temporal brain injury: mindfulness as a potential intervention.

Objective: The current study aimed to investigate the impact of brief mindfulness training on the performance of a sample of patients with TBI in an over-selectivity task.

Participants: Twenty-four patients who had suffered TBI and reported problems with focused or sustained attention.

Method: The study was a between-subjects design (mindfulness intervention vs control) with difference between number of most and least chosen stimulus selections on an over-selectivity task as the dependent measure.

Neurobehavioural approaches to the rehabilitation of challenging behaviour.

Background: Neurobehavioural disability (NBD) following acquired brain injury undermines capacity for independent social behaviour and results in serious long-term social handicap. The presence of challenging behaviour as a feature of NBD has obvious implications for rehabilitation and community reintegration.

Objectives: Behavioural approaches are seen by many as fundamental to the successful rehabilitation of challenging behaviour.

Recognising and assessing neurobehavioural disability after traumatic brain injury.

Background: Neurobehavioural disability often leads to serious social handicap. Many individuals never recover full social independence and will remain largely dependent upon family support, imposing a significant and potentially life-long psychological burden on those who care for injured relatives. Close relationships are at risk and many partnerships break down, increasing the risk of social isolation and subsequent psychological distress to the survivor.

The costs of traumatic brain injury: a literature review.

Objective: The purpose of this study was to review the literature relating to the psychosocial costs associated with traumatic brain injury (TBI).

Methods: Nine online journal databases, including MEDLINE, CINAHL, PsychINFO, and PUBMED, were queried for studies between July 2010 and May 2012 pertaining to the economic burden of head injuries. Additional studies were identified through searching bibliographies of related publications and using Google internet search engine.

Impulsive and episodic disorders of aggressive behaviour following traumatic brain injury.

Background: Aggressive behaviour is a frequent legacy of traumatic brain injury (TBI) and a major obstacle to psychosocial recovery. Aggression can take many forms and there is currently no uniform method of assessment that distinguishes aggressive sub-types in a way that can assist decisions for treatment.

Review: This paper attempts to provide a framework that will help distinguish two primary sub-types of aggression following TBI, impulsive and episodic aggression, based on their most prominent clinical characteristics.

Anxiety sensitivity and alexithymia as mediators of postconcussion syndrome following mild traumatic brain injury.

Objective: To examine the influence of anxiety sensitivity (AS) and alexithymia as potential mediators for the development of psychological distress and postconcussion syndrome after mild traumatic brain injury (mTBI).

Participants: Sixty-one patients with mTBI assessed at a mean of 2.38 weeks after injury and demographically matched healthy controls (n = 61).

Decision making after traumatic brain injury: a temporal discounting paradigm.

A temporal discounting paradigm was used to examine decision making for hypothetical monetary reward following traumatic brain injury (TBI). A case-control design compared individuals following moderate or severe TBI with a healthy control group matched for age and gender. The impact of intelligence, impulsivity, and mood on temporal discounting performance was examined.

The impact of alexithymia on relationship quality and satisfaction following traumatic brain injury.

Objectives: To explore relationship quality and satisfaction in couples following traumatic brain injury (TBI), obtaining the perspective of both patients with TBI and their noninjured partner; to examine the impact of alexithymia on ratings of relationship quality and satisfaction following TBI.

Participants: A total of 47 patients with TBI and their noninjured partners.

Measures: Twenty-item Toronto Alexithymia Scale; Index of Marital Satisfaction; and Dyadic Adjustment Scale.

Affective modulation of the startle reflex following traumatic brain injury.

Diminished emotional recognition, expression, and responsivity are frequent legacies of traumatic brain injury (TBI) that can have an adverse impact on relationships and psychosocial recovery. However, assessment of emotion responsivity is often difficult because many patients lack insight into their altered personality. To overcome this obstacle, we used a physiological measure of emotion responsivity, the startle reflex, to examine how this can vary according to the affective valence of stimuli by comparing a TBI group with a matched control group.