Arnould Annabelle, Rochat Lucien, Azouvi Philippe, van der Linden Martial
a Cognitive Psychopathology and Neuropsychology Unit , University of Geneva , Geneva , Switzerland.
b AP-HP, Department of Physical Medicine and Rehabilitation , Raymond Poincaré Hospital , Garches , France.
J Clin Exp Neuropsychol. 2018 Sep;40(7):650-662. doi: 10.1080/13803395.2017.1411468. Epub 2018 Jan 9.
Apathy is a core feature in patients with traumatic brain injury (TBI). The psychological processes underlying apathy are still unclear, and the few studies conducted on this subject have essentially focused on cognitive processes and informant reports of apathetic manifestations. The aims of the present study were to examine self-reports versus informant reports of diminished initiative/interest, as well as their relationship with different cognitive factors (attention/executive mechanisms, episodic memory, and multitasking) and personal identity factors (self-esteem and self-efficacy beliefs).
To this end, 74 participants (38 patients with severe TBI matched with 36 control participants) were given three questionnaires to assess self-esteem, general self-efficacy beliefs, and anxio-depressive symptoms and five tasks to assess cognitive processes, including real-life multitasking. In addition, a questionnaire that assessed self-awareness of functional competencies and a questionnaire that assessed lack of initiative/interest were administered to each participant and their relatives.
The main results showed that patients demonstrated an awareness of their lack of initiative/interest and that self-reported lack of initiative/interest was best predicted by low general self-efficacy beliefs and self-esteem, whereas informant-reported lack of initiative/interest was predicted by episodic memory difficulties.
These results shed new light on the psychological processes related to apathetic manifestations, as well as the differing perspectives and lived experiences of patients and external observers in the TBI population, which opens interesting prospects for psychological interventions.
冷漠是创伤性脑损伤（TBI）患者的核心特征。冷漠背后的心理过程仍不清楚，针对该主题进行的少数研究主要集中在认知过程和冷漠表现的 informant 报告上。本研究的目的是检验主动/兴趣减退的自我报告与 informant 报告，以及它们与不同认知因素（注意力/执行机制、情景记忆和多任务处理）和个人身份因素（自尊和自我效能信念）之间的关系。
为此，74 名参与者（38 名重度 TBI 患者与 36 名对照参与者匹配）被给予三份问卷以评估自尊、一般自我效能信念和焦虑抑郁症状，并给予五项任务以评估认知过程，包括现实生活中的多任务处理。此外，还向每位参与者及其亲属发放了一份评估功能能力自我意识的问卷和一份评估缺乏主动性/兴趣的问卷。
主要结果表明，患者意识到自己缺乏主动性/兴趣，自我报告的缺乏主动性/兴趣最好由低一般自我效能信念和自尊来预测，而 informant 报告的缺乏主动性/兴趣则由情景记忆困难来预测。
这些结果为与冷漠表现相关的心理过程以及 TBI 人群中患者和外部观察者的不同观点和生活经历提供了新的见解，这为心理干预开辟了有趣的前景。
