Search

Acquired Brain Injury (ABI), an important cause of long-term disability, is associated with increased rates of depression in addition to common cognitive and physical consequences. Past research has linked post-ABI depression to injury severity (e.g., extent of physical or cognitive impairment) and premorbid mood problems. In the general (non-ABI) population, depression is associated with cognitive vulnerabilities that have informed the development of psychological interventions. In this observational study in a heterogeneous sample of individuals with chronic stage ABI, we examine two cognitive vulnerabilities – dysfunctional attitudes (DAs) and autobiographical memory specificity – and explore whether these are linked to depression symptoms and ongoing cognitive difficulties as in the general population. Compared to control participants, individuals with an ABI demonstrated increased endorsement of DAs and reduced specificity of autobiographical memory recall. Within the ABI group, cognitive vulnerability–depression symptom correlations were detected for an explicit measure of DAs, but not for a more implicit DA measure or for autobiographical memory specificity. While individual differences in injury severity and other factors likely obscured subtle relationships between mood and cognitive vulnerabilities, evidence of these vulnerabilities may be relevant to changes in identity and psychological interventions that target low mood in ABI. [ABSTRACT FROM AUTHOR]

Intolerance of uncertainty (IU) is a risk factor for poor mental health. Acquired brain injury (ABI; for example, stroke, traumatic brain injury) often brings considerable uncertainty and increased mood disorder vulnerability. The Intolerance of Uncertainty Scale–Short Form (IUS-12) is a brief, well-validated IU measure in non-ABI samples, comprising two subscales, namely, Prospective Anxiety and Inhibitory Anxiety. Here, for the first time, we investigated its reliability and validity (N = 118), and factor structure (N = 176), in ABI. Both subscales had high test–retest reliability (intraclass correlation coefficients [ICCs] of.75 and.86) and were significantly associated with mood disorder symptoms. The two-factor model was superior to a one-factor IU model fit. Some fit statistics were less than optimal (standardized root mean square residual [SRMR] = 0.06, root mean square error of approximation [RMSEA] = 0.09); hence, exploration of other factor structures in other ABI samples may be warranted. Nonetheless, the IUS-12 appears suitable in ABI. [ABSTRACT FROM AUTHOR]

Cognitive difficulties are common following stroke and can have widespread impacts on everyday functioning. Technological advances offer the possibility of individualized cognitive training for patients at home, potentially providing a low-cost, low-intensity adjunct to rehabilitation services. Using this approach, we have previously demonstrated post-training improvements in attention and everyday functioning in fronto-parietal stroke patients. Here we examine whether these benefits are observed more broadly in a community stroke sample. Eighty patients were randomized to either 4 weeks of online adaptive attention training (SAT), working memory training (WMT) or waitlist (WL). Cognitive and everyday function measures were collected before and after the intervention, and after 3 months. During training, weekly measures of patients' subjective functioning were collected. The training was well received and compliance good. No differences in our primary end-point, spatial bias, or other cognitive functions were observed. However, on patient-reported outcomes, SAT participants showed greater levels of improvement in everyday functioning than WMT or WL participants. In line with our previous work, everyday functioning improvements were greatest for patients with spatial impairments and those who received SAT training. Whether attention training can be recommended for stroke survivors depends on whether cognitive test performance or everyday functioning is considered more relevant. [ABSTRACT FROM AUTHOR]

Difficulties with attention are common following stroke, particularly in patients with frontal and parietal damage, and are associated with poor outcome. Home-based online cognitive training may have the potential to provide an efficient and effective way to improve attentional functions in such patients. Little work has been carried out to assess the efficacy of this approach in stroke patients, and the lack of studies with active control conditions and rigorous evaluations of cognitive functioning pre and post-training means understanding is limited as to whether and how such interventions may be effective. Here, in a feasibility pilot study, we compare the effects of 20 days of cognitive training using either novel Selective Attention Training (SAT) or commercial Working Memory Training (WMT) programme, versus a waitlist control on a range of attentional and working memory tasks. We demonstrate separable effects of each training condition, with SAT leading to improvements in spatial and non-spatial aspects of attention and WMT leading to improvements on closely related working memory tasks. In addition, both training groups reported improvements in everyday functioning, which were associated with improvements in attention, suggesting that improving attention may be of particular importance in maximising functional improvements in this patient group. [ABSTRACT FROM AUTHOR]

Objectives: Depression, which is common following acquired brain injury (ABI), has been shown to predict cognitive impairment, rehabilitation outcome, and quality of life. Whilst many studies have examined links between depression and cognitive–affective processing in the non‐ABI population, their applicability to this important clinical group, where cognitive difficulties can be marked, remains unknown. Here, we investigated biases in prospective cognition, which is known to be disrupted in (non‐ABI) depression yet important for well‐being. Design: Cross‐sectional design with three groups (depressed ABI, non‐depressed ABI, and non‐ABI control participants). Continuous data were additionally analysed in correlation analyses. Methods: Individuals with ABI varying in extent of self‐reported depression and matched non‐ABI control participants completed assessments of mood and prospective cognition (anticipating and imagining future events), alongside background tests of executive function and fluid intelligence. Results: Relative to non‐depressed ABI and control participants, depressed ABI individuals demonstrated a reduced positive bias in prospective cognition: whereas non‐depressed ABI and control participants generated more examples of likely or possible positive versus negative future events, there was no evidence for such a positive bias in depressed ABI participants. Non‐depressed ABI and control participants also reported more vivid mental imagery for positive versus negative future scenarios, whereas such a pattern was not evident in depressed ABI participants. This pattern emerged despite background impairments in fluid intelligence and executive function associated with ABI. Conclusions: These findings (1) elucidate depression‐linked cognitive–affective processes following ABI, where cognitive difficulties are common, and (2) highlight psychological processes associated with depression that are common to ABI and non‐ABI populations. Practitioner points: Clinical implicationsA relative negative bias in future‐directed cognition is associated with depressed mood in individuals with chronic ABI.Such processes may contribute to the onset and maintenance of depression following ABI.These findings suggest it may be important to consider a role for prospective cognition in psychological interventions for depression following ABI. Limitations of the studyThe extent to which depressed mood following ABI is associated with biases in other cognitive domains remains unclear.Whether similar patterns would be observed in acute patients with more profound cognitive difficulties requires further investigation.Despite large effect sizes, our sample size is modest; these effects thus require replication in larger groups. [ABSTRACT FROM AUTHOR]