Factors triggering relatives’ judgements of personality change after traumatic brain injury

Abstract

Objective: This study assesses neuropsychological and psychosocial determinants of judgements of personality change (PC) after traumatic brain injury (TBI).

Design: Cross-sectional data from 87 participants with TBI analysed using hierarchical binary regression.

Methods: Interview of participants assessed, injury severity (post-traumatic amnesia), degree of cognitive impairment (IQ and memory), presence of orbitofrontal and/or medial temporal damage (olfaction) and emotional reactions (anger, depression and anxiety questionnaires). Separate interview of relatives assessed their own response to the injury (emotional reactions and critical comments from the Expressed Emotion index) and their judgements of participants’ behavioural change.

Results: As expected, memory loss and impaired olfaction predicted relatives’ PC judgements. However, the most striking and novel result was that social-emotional factors (participants’ and relatives’ reactions) predicted PC judgements best.

Conclusions: This study emphasizes the need (a) for future studies measuring social behaviours (e.g. impulsivity and emotional perception) (b) to explore the differing determinants of relatives’ and participants’ PC judgements and (c) to develop and to tailor clinical responses to the various psychosocial determinants of PC.

• Traumatic brain injury
• frontal lobes
• stress
• expressed emotion
• personality change