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行为支持干预能否成功治疗社区环境中获得性脑损伤后的不当性行为?一项病例系列研究(=24例)。

Can behaviour support interventions successfully treat inappropriate sexual behaviour after acquired brain injury in community settings? A case series (= 24).

作者信息

Kelly Glenn, Brown Suzanne, Gillett Lauren, Descallar Joseph, Simpson Grahame K

机构信息

Private practice, Melbourne Australia.

Concept Psychology, Melbourne Australia.

出版信息

Neuropsychol Rehabil. 2022 Apr;32(3):407-428. doi: 10.1080/09602011.2020.1830807. Epub 2020 Oct 20.

Abstract

Inappropriate sexual behaviours (ISX) are challenging clinical sequelae of acquired brain injury (ABI). Limited evidence exists about treatment approaches, with few case studies published to date. This study reports an exploratory clinical trial of community-based behaviour support interventions as a treatment approach to ISX after ABI. From routine referrals to a state-wide service specializing in challenging behaviours after ABI, a cohort ( = 24) displaying ISXs were selected. The interventions addressed multiple behavioural domains, and used a variety of approaches including environmental change, psychoeducation, and specific behavioural techniques. These approaches targetted change in the person with ABI, support personnel, or other environmental domains. Behaviour data were collected using the Overt Behaviour Scale (OBS) at baseline, closure and follow-up. Visual inspection and multilevel models were used to analyse the data. For the sample as a whole, there was a significant decline in ISXs from baseline to closure that was maintained at follow-up. Results at an individual level are also presented. Specificity of the intervention was demonstrated by comparison with concurrent challenging behaviours (aggression, perseveration, absconding) which showed no significant change over the same three time points. The results demonstrate the potential efficacy of community-based behaviour support interventions in treating ISXs after ABI.

摘要

不适当性行为(ISX)是获得性脑损伤(ABI)具有挑战性的临床后遗症。关于治疗方法的证据有限,迄今为止发表的案例研究很少。本研究报告了一项基于社区的行为支持干预的探索性临床试验,作为ABI后ISX的一种治疗方法。从常规转诊到一个全州范围内专门处理ABI后挑战性行为的服务机构,选取了一组(n = 24)表现出ISX的患者。干预措施涉及多个行为领域,并采用了多种方法,包括环境改变、心理教育和特定行为技术。这些方法针对ABI患者、支持人员或其他环境领域的改变。在基线、结束时和随访时使用公开行为量表(OBS)收集行为数据。使用视觉检查和多层次模型分析数据。对于整个样本,从基线到结束时ISX有显著下降,并在随访时保持。还呈现了个体水平的结果。通过与同期挑战性行为(攻击、持续行为、逃跑)比较证明了干预的特异性,这些行为在相同的三个时间点没有显著变化。结果表明基于社区的行为支持干预在治疗ABI后ISX方面具有潜在疗效。

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