Tratamiento neuropsicológico de problemas de control de impulsos en un caso de traumatismo craneoencefélico frontalestudio de un caso

  1. Blázquez Alisente, Juan Luis
  2. Ríos Lago, Marcos
  3. Paúl Lapedriza, Nuria
  4. González Rodríguez, Begoña
  5. Muñoz Céspedes, Juan Manuel
Journal:
Acción psicológica

ISSN: 1578-908X

Year of publication: 2004

Volume: 3

Issue: 3

Pages: 225-244

Type: Article

DOI: 10.5944/AP.3.3.515 DIALNET GOOGLE SCHOLAR

More publications in: Acción psicológica

Abstract

Patients with brain injury suffer cognitive, physical and emotional impairments that interfere with their everyday activities. However, behavioural problems such as aggressiveness and irritability affect the normal integration of the patient in the family, and in social and vocational contexts. Given this, it is important to add a functional assessment to the classical neuropsychological assessment, in order to identify the main difficulties and to guide the intervention. Traditionally, behavioural disabilities are associated with executive function impairments. The intervention implies the compensation and restitution of the function using a wide variety of tools and methodologies. The complexity of emotions is relevant to completely understand the executive functions. The present article reviews the main changes in cognitive, functional and behavioural abilities during neuropsychological rehabilitation. In this purpose, a neuropsychological evaluation was carried out to decide the objectives of the rehabilitation and a second evaluation aimed to investigate the treatment effects. The lenght of the rehabilitation program was 18 weeks, with two one-hour sessions per week. The results show a good recovery on behavioural and cognitive domains, what constitutes a higher evidence of the effectiveness of neuropsychological rehabilitation after traumatic brain injury.

Bibliographic References

  • Bechara, A., Damasio, A. R., Damasio, H., y Anderson, S. W. (1994). Insensitivity to future consequences following damage to human prefrontal cortex. Cognition, 50(1-3), 7-15.
  • Bigler, E. D. (2001). The lesion(s) in traumatic brain injury: implications for clinical neuropsychology. Archives of Clinical Neuropsychology, 16, 95-131.
  • Botvinick, M., Nystrom, L. E., Fissell, K., Carter, C. S., y Cohen, J. D. (1999). Conflict monitoring versus selection-for-action in anterior cingulate cortex. Nature, 402(6758), 179-181.
  • Burgess, P. W. (1997). Theory and methodology in executive function research. En P. Rabbit (Ed.), Methodology of frontal and executive function (pp. 81-116). Hove, U.K: Psychology Press.
  • Callahan, C. D. (2001). The assessment and rehabilita- tion of executive functions disorders. En B. Johnston y H. Stonnington (Eds.), Rehabilitation of neuropsychological disorders. Hove: Psychology Press.
  • Cassidy, J. W. (1999). Neuropharmacological contri- butions to the rehabilitation of patients with traumatic brain injury. En D. T. Stuss, G. Winocur y I. H. Robertson (Eds.), Cognitive neurorehabilitation. Cambridge: Cambridge University Press.
  • Damasio, A. R. (1996). El error de Descartes. Barcelona: Crítica.
  • Delis, D. C., Kramer, J. H., Fridland, A. J., y Kaplan, E. A. (1990). Cognitive science approach to neuropsychological assessment. En P. Mc Reynolds, J. C. Rosen y G. J. Chelune (Eds.), Advances in psychological assessment (Vol. 7). New Cork: Plenum Press.
  • Delis, D. C., Squire, L. R., Bihrle, A., y Massman, P. (1992). Componential analysis of problem-solving ability: performance of patients with frontal lobe damage and amnesic patients on a new sorting test. Neuropsychologia, 30(8), 683-697.
  • Dixon, R. A., y Backman, L. (1999). Principles of compensation in cognitive neurorehabilitation. En D. T. Stuss, G. Winocur y I. H. Robertson (Eds.), Cognitive neurorehabilitation. Cambridge: Cambridge University Press.
  • D’Zurilla, T. J., y Goldfried, M. R. (1971). Problem solving and behavior modification. J Abnorm Psychol, 78, 107-126.
  • Fisher, S., Ganggel, S., y Trexler, L. E. (2004). Awareness of activity limitations, goal setting and rehabilitation outcome in patients with brain injuries. Brain Injury, 18(6), 547-562.
  • Franulic, A., Horta, E., Maturana, R., Scherpenisse, J., y Carbonell, C. (2000). Organic personality disorder after traumatic brain injury: cognitive, anatomic and psychosocial factors. A 6 month follow-up. Brain Inj, 14(5), 431-439.
  • Garavan, H., Ross, T. J., y Stein, E. A. (1999). Right hemispheric dominance of inhibitory control: an event-related functional MRI study. Proc Natl Acad Sci U S A, 96(14), 8301-8306.
  • Gilford, A. (2002). Emotion and self control. Journal of Economic Behaviour and organization, 49, 113-130.
  • Godfrey, H. P., Knight, R. G., y Bishara, S. N. (1991). The relationship between social skill and family problem-solving following very severe closed head injury. Brain Inj, 5(2), 207-211.
  • Goldberg, E. (2002). El cerebro ejecutivo. Barcelona: Crítica.
  • Greenberg, L. S., y Paivio, S. C. (2000). Trabajar las emociones en psicoterapia. Barcelona: Paidos.
  • Harmsen, M., Geurts, A., Fasotti, L., y Behart, B. (2004). Positive behaviour disturbances in the rehabilitation phase alter severe traumatic brain injury: An historic review. Brain Inj, 18(8), 787- 796.
  • Johnston, B., y Stonnington, H. (1984). Rehabilitation of neuropsychological disorders: A practical guide for rehabilitation professionals. Hove: Psychology Press.
  • Junqué, C. (1999). Secuelas neuropsicológicas de los traumatismos craneoencefálicos. Revista de Neurología, 28(4), 423-429.
  • Kalsbeek, W. D., McLaurin, R. L., Harris, B. S., y Miller, J. D. (1980). The National Head and Spinal Cord Injury Survey: major findings. J Neurosurg, Suppl, S19-31.
  • Kristensen, O. O. (2004). Changing goals and intentions among participants in a neuropsychological rehabilitation programme: An explorative case study evaluation. Brain Inj, 18(10), 1049-1062.
  • Larsen, R. J., Diener, E., y Emmons, R. A. (1986). Affect intensity and reactions to daily life events. Journal of personality and social psychology, 51, 803-814.
  • Leclercq, M., y Azouvi, P. (2002). Attention after trau- matic brain injury. En M. Leclercq y P. Zimmermann (Eds.), Applied neuropsychology of attention: Theory, diagnosis and rehabilitation (pp. 257-279). London: Psychology Press.
  • Mapou, R. L., y Spector, J. (1995). Clinical neuropsychological assessment: A cognitive approach. New Cork: Plenum Press.
  • Mateer, C. A., y Mapou, R. L. (1996). Understanding, evaluating, and managing attention disorders following traumatic brain injury. Journal of Head Trauma Rehabilitation, 11(2), 1-16.
  • Moreno Gea, P., y Blanco Sánchez, M. C. (1997). Clasificación y epidemiología de los traumatismos craneoencefálicos. En C. Pelgrín, J. M. M. Céspedes y J. I. Quemada (Eds.), Neuropsiquiatría del daño cerebral traumático (pp. 11-33). Barcelona: Prous Science.
  • Muñoz-Céspedes, J. M., Ríos, M., Ruano, A., y Moreno, F. (1998). Déficit cognitivo e integración laboral de las personas con daño cerebral traumático. Polibea, 48, 38-43.
  • Muñoz Céspedes, J. M., Ríos, M., Ruano, A., y Moreno, F. (1999). Las alteraciones emocionales y la integración laboral de las personas con daño cerebral traumático. Polibea, 50, 10-18.
  • Muñoz-Céspedes, J. M., y Tirapu Ustarroz, J. (2004). Rehabilitación de las funciones ejecutivas. Rev Neurol, 38(07), 656-.
  • Nissen, M. J. (1986). Neuropsychology of attention and memory. Journal of Head Trauma Rehabilitation, 1(3), 13-21.
  • Ortony, A., L., C. G., y Collins, A. (1996). The cognitive motivational analysis of anxiety. Behavior Research and Therapy, 36, 809-848.
  • Pelegrín, C., y Gómez-Hernández, R. (1996). Trastor- nos neuropsiquiátricos en traumatismos craneales de menor gravedad. En C. Pelegrín, J. M. Muñoz-Céspedes y I. Quemada (Eds.), Neuropsiquiatría del daño cerebral traumático (pp. 71-95). Barcelona: Prous Science.
  • Prigatano, G. P. (1992). Personality disturbances associated with traumatic brain injury. Journal of Consulting and Clinical Psychology, 60, 360-368.
  • Prigatano, G. (1999). Principles of neuropsychological rehabilitation. New York: Oxford University Press.
  • Prigatano, G. (1999). Motivation and awareness in cognitive neurorehabilitation. En D. T. Stuss, G. Winocur y I. H. Robertson (Eds.), Cognitive neurorehabilitation. Cambridge: Cambridge University Press.
  • Prigatano, G., y Wong, J. L. (1999). Cognitive and effective improvement in brain disfunctional patients who achieve inpatient rehabilitation goals. Arch Phys Med Rehabil, 80, 77-84.
  • Ríos, M., y Muñoz-Céspedes, J. M. (2004). La Aten- ción y el control ejecutivo después de un traumatismo craneoencefálico. Madrid: Fundación Mapfre Medicina.
  • Ríos, M., Paúl, N., Muñoz-Céspedes, J. M., Maestú, F., Álvarez-Linera, J., y Ortiz, T. (2004). Aplicación de la neuroimagen funcional al estudio de la rehabilitación neuropsicológica. Rev Neurol, 38(4), 366- 373.
  • Sohlberg, M. M., y Mateer, C. A. (2001). Cognitive rehabilitation: an integrative neuropsychological approach (1. ed.). New York: The Guilford Press.
  • Stuss, D. T., Gow, C. A., y Hetherington, C. R. (1992). «No longer Gage»: frontal lobe dysfunction and emotional changes. J Consult Clin Psychol, 60(3), 349-359.
  • Stuss, D. T., y Levine, B. (2002). Adult clinical neuropsychology: lessons from studies of the frontal lobes. Annu Rev Psychol, 53, 401-433.
  • Tirapu, J., Casi, A., Ugarteburu, I., y Albéniz, A. (1997). Aplicación de las técnicas de modifica- ción de conducta al daño cerebral. En C. Pelegrín, J. M. M. Céspedes y J. I. Quemada (Eds.), Neuropsiquiatría del daño cerebral traumático: Aspectos clínicos y terapéuticos. Barcelona: Prous Science.
  • Van Zomeren, A. H., Brouwer, W. H., y Deelman, B. G. (1984). Attentional deficits: The riddles of selectivity, speed, and alerteness. En N. Brooks (Ed.), Closed head injury: Psychological, social, and family consequences. (pp. 74-107). New York: Oxford University Press.
  • Wilson, B. A. (2002). Towards a comprehensive model of cognitive rehabilitation. Neuropsychological Rehabilitation, 12(2), 97-110.
  • Wilson, B., Evans, J., Alderman, N., Burgess, P., y Emslie, H. (1997). Behavioural assessment of the dysexecutive syndrome. En P. Rabbit (Ed.), Methodology of frontal and executive function. East Sussex: Psychology Press.
  • Wood, R. L. (1984). Behaviour disorders following severe brain injury: their presentation and psychological management. En N. Brooks (Ed.), Closed head injury: psychological, social and familiy consequences. Oxford: University Press.
  • Wood, R. L. (1990). Cognitive rehabiltiation in perspective. London: Psychology Press.
  • Wood, R. L., y Mc Millan, T. M. (2001). Neurobe- havioral disability and social handicap following traumatic brain injury. Hove: Psychology Press.
  • Zabala Rabadán, A., Muñoz Céspedes, J. M., y Quemada, J. I. (2003). Efectividad de la rehabilitación neuropsicológica en pacientes con daño cerebral adquirido: fundamentos y dificultades metodológicas en la investigación. Rehabilitación, 37(2), 103-112.
Data source: Dialnet