title: Apathetic symptom presentations in patients with severe traumatic brain injury: Assessment, heterogeneity and relationships with psychosocial functioning and caregivers' burden.
abstract: OBJECTIVE
  Apathy is frequently described following traumatic brain injury (TBI) and defined on the basis of three dimensions (emotional blunting, lack of initiative, lack of interest), which are commonly assessed by the Apathy Inventory (AI). The aims were (1) to explore the psychometric properties of this scale in the TBI population and the relationships between the dimensions; and (2) to determine whether sub-groups of patients differing with respect to the three AI dimensions could be identified and to examine their differences on psychosocial functioning and caregivers' burden.
  
  
  METHODS
  Close relatives of 68 patients with severe TBI were given the AI and two questionnaires to assess their subjective burden and patients' changes in psychosocial functioning.
  
  
  RESULTS
  The scores distribution and the sensitivity of each sub-scale showed that the AI can be used as a screening tool in the TBI population. Four clusters were identified: one group with high scores on each dimension, one group with low scores on each dimension, one group with high emotional blunting alone and another with elevated lack of initiative/interest. The high apathetic group and the lack of initiative/interest group were associated with poorer psychosocial functioning and the high apathetic group was related to subjective burden.
  
  
  CONCLUSIONS
  These results shed new light on the concept of apathy in patients with TBI and underline the necessity to take into account the various profiles of symptoms of apathy.
authors.affiliation: a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Geneva , Switzerland .|b AP-HP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation , Garches , France .|c EA 4047, HANDIReSP, Université de Versailles Saint Quentin , France .
authors.forename: Annabelle
authors.initials: A
authors.lastname: Arnould
authors.affiliation: a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Geneva , Switzerland .|d Swiss Centre for Affective Sciences, University of Geneva , Geneva , Switzerland , and.
authors.forename: Lucien
authors.initials: L
authors.lastname: Rochat
authors.affiliation: b AP-HP, Hôpital Raymond Poincaré, Service de Médecine Physique et de Réadaptation , Garches , France .|c EA 4047, HANDIReSP, Université de Versailles Saint Quentin , France .
authors.forename: Philippe
authors.initials: P
authors.lastname: Azouvi
authors.affiliation: a Cognitive Psychopathology and Neuropsychology Unit, University of Geneva , Geneva , Switzerland .|d Swiss Centre for Affective Sciences, University of Geneva , Geneva , Switzerland , and.|e Cognitive Psychopathology Unit, University of Liège , Belgium.
authors.forename: Martial
authors.initials: M
authors.lastname: Van der Linden
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D057565:Apathy; D001930:Brain Injuries / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000523:psychology; D010555:Personality Inventory; D011594:Psychometrics; D011795:Surveys and Questionnaires
keywords: Apathy; burden; heterogeneity; psychosocial changes; traumatic brain injury