title: Association between impulsivity, emotional/behavioural hyperactivation and functional outcome one year after severe traumatic brain injury.
abstract: OBJECTIVE
  To examine impulsivity changes after a severe traumatic brain injury (TBI) and to explore the relationships between impulsivity dimensions (urgency, lack of premeditation, lack of perseverance, sensation seeking), emotional/behavioural hyperactivation and 12-month outcome.
  
  
  METHODS
  Measures of emotional/behavioural hyperactivation and functional outcome were administered to 60 patients with severe TBI 12 months after the trauma. A scale designed to assess impulsivity changes after TBI was completed by the patients' significant others at the same time.
  
  
  RESULTS
  Scores on urgency and lack of perseverance were higher after the trauma, whereas the score on sensation seeking was lower and the score on lack of premeditation remained stable. Urgency was the only dimension of impulsivity related to both emotional/behavioural hyperactivation and functional outcome. The relationship between urgency and functional outcome was mediated by emotional/behavioural hyperactivation, suggesting that a high level of urgency results in emotional/behavioural hyperactivation, which in turn impacts functional outcome. Lack of perseverance was significantly associated with functional outcome, indicating that the higher the lack of perseverance, the lower the functional outcome.
  
  
  CONCLUSIONS
  The results contribute to a better understanding of the 12-month outcome in patients with severe TBI. They also open interesting perspectives on management strategies for implementing targeted psychological interventions to decrease impulsive manifestations.
authors.affiliation: a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Switzerland.|b Swiss Centre for Affective Sciences, University of Geneva , Switzerland.
authors.forename: Marie My Lien
authors.initials: MML
authors.lastname: Rebetez
authors.affiliation: a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Switzerland.|b Swiss Centre for Affective Sciences, University of Geneva , Switzerland.
authors.forename: Lucien
authors.initials: L
authors.lastname: Rochat
authors.affiliation: c Methodology and Data Analysis, University of Geneva , Switzerland.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ghisletta
authors.affiliation: d Division of Anaesthesiology , University Hospitals of Geneva , Switzerland , and.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Walder
authors.affiliation: a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Switzerland.|b Swiss Centre for Affective Sciences, University of Geneva , Switzerland.|e Cognitive Psychopathology Unit, University of Liège , Belgium.
authors.forename: Martial
authors.initials: M
authors.lastname: Van der Linden
keywords: 12-month outcome; UPPS Impulsive Behaviour Scale; neurobehavioural changes