Arnould Annabelle, Rochat Lucien, Azouvi Philippe, Van der Linden Martial
a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Geneva , Switzerland .
b AP-HP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation , Garches , France .
Brain Inj. 2015;29(13-14):1597-603. doi: 10.3109/02699052.2015.1075156. Epub 2015 Oct 9.
Apathy is frequently described following traumatic brain injury (TBI) and defined on the basis of three dimensions (emotional blunting, lack of initiative, lack of interest), which are commonly assessed by the Apathy Inventory (AI). The aims were (1) to explore the psychometric properties of this scale in the TBI population and the relationships between the dimensions; and (2) to determine whether sub-groups of patients differing with respect to the three AI dimensions could be identified and to examine their differences on psychosocial functioning and caregivers' burden.
Close relatives of 68 patients with severe TBI were given the AI and two questionnaires to assess their subjective burden and patients' changes in psychosocial functioning.
The scores distribution and the sensitivity of each sub-scale showed that the AI can be used as a screening tool in the TBI population. Four clusters were identified: one group with high scores on each dimension, one group with low scores on each dimension, one group with high emotional blunting alone and another with elevated lack of initiative/interest. The high apathetic group and the lack of initiative/interest group were associated with poorer psychosocial functioning and the high apathetic group was related to subjective burden.
These results shed new light on the concept of apathy in patients with TBI and underline the necessity to take into account the various profiles of symptoms of apathy.
创伤性脑损伤（TBI）后常出现冷漠症状，且根据三个维度（情感迟钝、缺乏主动性、缺乏兴趣）进行定义，这三个维度通常由冷漠量表（AI）进行评估。本研究旨在（1）探讨该量表在TBI患者群体中的心理测量特性以及各维度之间的关系；（2）确定是否可以识别出在AI三个维度上存在差异的患者亚组，并研究他们在心理社会功能和照顾者负担方面的差异。
对68例重度TBI患者的近亲发放AI量表以及两份问卷，以评估他们的主观负担和患者心理社会功能的变化。
各子量表的得分分布和敏感性表明，AI量表可作为TBI患者群体的筛查工具。识别出四个聚类：一个在每个维度上得分都高的组，一个在每个维度上得分都低的组，一个仅情感迟钝得分高的组，以及另一个缺乏主动性/兴趣得分高的组。高度冷漠组和缺乏主动性/兴趣组与较差的心理社会功能相关，高度冷漠组与主观负担相关。
这些结果为TBI患者的冷漠概念提供了新的见解，并强调了考虑冷漠症状各种表现形式的必要性。
