ABSTRACT
Anger outbursts constitute a frequent behavioural issue after a traumatic brain injury (TBI) and have a strong negative impact on the social outcomes resulting from the TBI. However, few studies have examined the efficacy of specific intervention strategies to reduce the frequency and intensity of anger outbursts. We therefore performed a single-case study on this topic by administering two successive and complementary psychological interventions with an AB design with maintenance (first intervention) and an AC design with maintenance plus a one-month follow-up (second intervention) to a patient with a severe TBI. Whereas the first intervention focused on improving the recognition and expression of basic emotions, the second consisted of a self-regulation programme, including various features such as psychoeducation about self-control strategies, relaxation and assertiveness training that aimed to establish adequate behaviours, which were further promoted by an implementation intentions strategy in the patient's daily life. The results indicated that all interventions resulted in a reduced frequency and intensity of anger outbursts, and the data upheld the specificity of these effects. In addition, a meta-analytic integration of the effects of both interventions on the outcomes indicated a medium effect size. Further research is needed on other patients who experience long-standing anger outbursts to examine whether the observed gains can be replicated, sustained on a longer-term basis and improved.
Subject(s)
Anger/physiology , Brain Injuries, Traumatic/complications , Cognitive Behavioral Therapy/methods , Mood Disorders/etiology , Mood Disorders/rehabilitation , Brain Injuries, Traumatic/psychology , Humans , Male , Meta-Analysis as Topic , Middle Aged , Neuropsychological Tests , Recognition, PsychologyABSTRACT
Difficulties in the execution of goal-directed behaviours, and particularly their prospective memory component, can arise in ageing and have important consequences for autonomy. The first objective of this article is to present an intervention that trained older individuals who reported prospective memory or goal-directed behaviour problems to use "implementation intentions". This technique, which has been shown to improve different aspects of goal-directed behaviour enactment, consists of establishing a mental (verbal and/or visual) link between the action that must be performed and the situation in which it must be performed. Our programme proposes exercises of progressively increasing difficulty that are targeted at daily life situations. Our second objective was to test the programme in small groups of older adults. Preliminary data regarding the programme's feasibility and its initial efficacy show a significant improvement in the main outcome measure, a questionnaire assessing goal-directed behaviours in everyday life. The participants also reported being significantly less bothered by their difficulties, although there were no significant changes in quality of life, self-esteem, anxiety or depression. Two participants with different psychological profiles, who benefited differently from the intervention, are then presented in more detail.
Subject(s)
Aging/physiology , Cognition Disorders/therapy , Goals , Memory Disorders/therapy , Memory, Episodic , Psychotherapy/methods , Activities of Daily Living/psychology , Aged , Cognition Disorders/etiology , Feasibility Studies , Female , Humans , Male , Memory Disorders/etiology , Pilot Projects , Program Development/methods , Treatment OutcomeABSTRACT
Implementation intentions, a strategy in which a strong link is created between a cue and a to-be-performed action, have been shown to be efficacious in improving self-regulation. The relative efficacy of verbal and visual implementation intentions, however, has yet to be determined. Implementation intentions have also been shown to be inefficacious in participants with high impulsivity, specifically in individuals who reported having a high tendency to commit rash or regrettable actions as a result of intense affect (high urgency). Nevertheless, previous studies did not assess whether the individuals were in an emotional context at the time of the experiment. In the current study, we compared different forms of implementation intentions (verbal/visual/combined verbal-visual) on a computerized inhibition task while assessing impulsivity and emotional activation. The results showed that all types of implementation intentions improved inhibition performances significantly in participants with high urgency, but only when their emotional activation was low. There was no difference between the three types of implementation intentions.
