Emotional Regulation Following Acquired Brain Injury: Associations With Executive Functioning in Daily Life and Symptoms of Anxiety and Depression.

Jan Stubberud,Marianne Løvstad,Sveinung Tornås,Anne-Kristin Solbakk,Anne-Kristine Schanke

doi:10.3389/fneur.2020.01011

Abstract

Objective: To examine whether a questionnaire measuring emotional regulation after acquired brain injury adds clinical information beyond what can be obtained with a comprehensive executive function questionnaire and an anxiety and depression measure.Method: Seventy adult persons (age 19–66 years, Mage = 43, SDage = 13) with acquired brain injury in the chronic phase and executive function complaints. All were recruited to participate in a randomized controlled trial (NCT02692352) evaluating the effects of cognitive rehabilitation. Traumatic brain injury was the dominant cause of injury (64%), and mean time since injury was 8 years. Emotional regulation was assessed with the Brain Injury Trust Regulation of Emotions Questionnaire (BREQ). Executive function was assessed with the Behavior Rating Inventory of Executive Function Adult Version (BRIEF-A). The Hopkins Symptom Checklist 25 (HCSL-25) was employed to measure anxiety and depression symptoms.Results: Overall, significant correlations were found between reports of emotional regulation (BREQ) and executive function in daily life (BRIEF-A). Furthermore, our analyses revealed a significant relationship between self-reported scores of emotional regulation (BREQ) and symptoms of anxiety and depression (HSCL-25).Conclusion: The significant associations between the BREQ and most of the other clinical measures indicate that, for patients with acquired brain injury, the BREQ does not add substantial information beyond what can be assessed with the BRIEF-A and the HSCL-25.

Highlights

Difficulties in emotional regulation are among the most common and debilitating consequences of acquired brain injury (ABI), such as traumatic brain injury (TBI) and cerebrovascular accidents (CVA), with potential deleterious effects in all life domains [e.g., [1,2,3,4]]
A score equal to or above recommended clinical cut-off was self-reported for 52% (n = 36) on the Global Executive Composite (GEC), 38% on the Behavioral Regulation Index (BRI) (n = 26), 54% (n = 37) on the Metacognition Index (MCI), and 41% (n = 28) on the Emotional Control scale
A clinical score was reported for 25% (n = 14) on the GEC, 18% (n = 10) on the BRI, 38% (n = 21) on the MCI, and 13% (n = 9) on the Emotional Control scale

Summary

Introduction

Difficulties in emotional regulation are among the most common and debilitating consequences of acquired brain injury (ABI), such as traumatic brain injury (TBI) and cerebrovascular accidents (CVA), with potential deleterious effects in all life domains [e.g., [1,2,3,4]]. In ABI, there may be impairments in self-monitoring and control, in addition to the ability to differentiate emotions, that are revealed through various symptoms of emotional dysregulation, including disinhibited emotion/behavior, and reduced emotional awareness and expression [8, 11]. The experience of cognitive deficits after ABI has been described as having a “disordered” mind [16], a situation that can be emotionally experienced as a disorganized inner state. Pre- and comorbid emotional problems may influence symptom presentation after ABI. The reactions to the psychosocial and cognitive changes associated with having an ABI makes it challenging to conceptualize and measure problems with emotional regulation [17]

Methods

Results

Discussion

Conclusion