title: Neurobehavioral and self-awareness changes after traumatic brain injury: Towards new multidimensional approaches.
abstract: Neurobehavioral and self-awareness changes are frequently observed following traumatic brain injury (TBI). These disturbances have been related to negative consequences on functional outcomes, caregiver distress and social reintegration, representing therefore a challenge for clinical research. Some studies have recently been conducted to specifically explore apathetic and impulsive manifestations, as well as self-awareness impairments in patients with TBI. These findings underlined the heterogeneity of clinical manifestations for each behavioral disturbance and the diversity of psychological processes involved. In this context, new multidimensional approaches taking into account the various processes at play have been proposed to better understand and apprehend the complexity and dynamic nature of these problematic behaviors. In addition, the involvement of social and environmental factors as well as premorbid personality traits have increasingly been addressed. These new multidimensional frameworks have the potential to ensure targeted and effective rehabilitation by allowing a better identification and therefore consideration of the various mechanisms involved in the onset of problematic behaviors. In this context, the main objective of this position paper was to demonstrate the interest of multidimensional approaches in the understanding and rehabilitation of problematic behaviors in patients with TBI.
authors.affiliation: Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; Unité de psychopathologie et de neuropsychologie cognitive, université de Genève, Genève, Switzerland; EA 4047, HANDIReSP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France. Electronic address: annabelle.arnould@rpc.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Arnould
authors.affiliation: Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047, HANDIReSP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
authors.forename: E
authors.initials: E
authors.lastname: Dromer
authors.affiliation: Unité de psychopathologie et de neuropsychologie cognitive, université de Genève, Genève, Switzerland; Swiss centre for affective sciences, université de Genève, Genève, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Rochat
authors.affiliation: Unité de psychopathologie et de neuropsychologie cognitive, université de Genève, Genève, Switzerland; Swiss centre for affective sciences, université de Genève, Genève, Switzerland; Unité de psychopathologie cognitive, université de Liège, Liège, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Van der Linden
authors.affiliation: Service de médecine physique et de réadaptation, hôpital Raymond-Poincaré, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France; EA 4047, HANDIReSP, université de Versailles-Saint-Quentin-en-Yvelines, 78000 Versailles, France.
authors.forename: P
authors.initials: P
authors.lastname: Azouvi
mesh_terms: D000377:Agnosia / Q000209:etiology / Q000523:psychology*; D057565:Apathy; D001930:Brain Injuries / Q000523:psychology*; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology / Q000523:psychology*; D006801:Humans; D007175:Impulsive Behavior
keywords: Anosognosia; Apathy; Impulsivity; Multidimensional approach; Traumatic brain injury