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关于创伤性脑损伤恢复与康复的积极心理学视角。

Positive psychology perspective on traumatic brain injury recovery and rehabilitation.

作者信息

Rabinowitz Amanda R, Arnett Peter A

机构信息

a Moss Rehabilitation Research Institute, MossRehab , Elkins Park , Pennsylvania , USA.

b Department of Psychology , The Pennsylvania State University , University Park , Pennsylvania , USA.

出版信息

Appl Neuropsychol Adult. 2018 Jul-Aug;25(4):295-303. doi: 10.1080/23279095.2018.1458514.

Abstract

Recovery from traumatic brain injury (TBI) is heterogeneous, with injury characteristics and neuropathological findings accounting for a relatively modest proportion of the variance in clinical outcome. Furthermore, premorbid personality traits and psychological characteristics may moderate psychosocial recovery. Constructs from the field of positive psychology have been examined in multiple illness populations and are increasingly gaining attention as factors that may influence recovery from TBI. Positive affect, hope, optimism, adaptive coping style, and resilience have all been examined in the context of TBI. These phenomena are of particular interest because they may inform treatment, either by reducing psychological distress and promoting better adjustment, or by augmenting existing therapies to improve engagement. In general, research suggests that higher levels of these factors predict better psychosocial functioning after injury. However, brain injury itself is associated with reduced levels of many of these positive traits, either relative to uninjured control samples or preinjury functioning. There have been proposals for targeting these positive traits in the context of TBI rehabilitation. Although more research is needed, the few controlled trials aimed at improving adaptive coping skills have shown promising results. Other positive psychological phenomena, such as grit, optimism, and positive affect are deserving of further study as potential intervention targets.

摘要

创伤性脑损伤(TBI)的恢复情况因人而异,损伤特征和神经病理学发现仅占临床结果差异的相对较小比例。此外,病前人格特质和心理特征可能会影响心理社会功能的恢复。积极心理学领域的概念已在多种疾病人群中得到研究,并越来越受到关注,被视为可能影响TBI恢复的因素。积极情绪、希望、乐观、适应性应对方式和心理韧性都已在TBI的背景下进行了研究。这些现象特别令人感兴趣,因为它们可能为治疗提供信息,要么通过减轻心理困扰和促进更好的适应,要么通过增强现有疗法来提高参与度。一般来说,研究表明这些因素水平越高,受伤后心理社会功能恢复得越好。然而,脑损伤本身与这些积极特质中的许多特质水平降低有关,无论是相对于未受伤的对照样本还是伤前功能而言。有人提议在TBI康复中针对这些积极特质。尽管还需要更多研究,但少数旨在提高适应性应对技能的对照试验已显示出有希望的结果。其他积极心理现象,如毅力、乐观和积极情绪,作为潜在的干预目标值得进一步研究。

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