Exploring domains of ‘frontal dysfunction’ relevant to everyday life following acquired brain injury.

Gracey, Fergus (2019) Exploring domains of ‘frontal dysfunction’ relevant to everyday life following acquired brain injury. Doctoral thesis, University of East Anglia.

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Damage to the frontal areas of the brain is associated with alterations in cognitive, social, and emotional regulation abilities. These neuropsychological consequences present challenges to ecologically valid assessment (difficulties in everyday life being poorly predicted by traditional neuropsychological test performance) and far transfer of rehabilitation gains to everyday life. In this thesis, the literature on ‘cold’ and ‘hot’ cognitive, social and emotional frontal functions is discussed in relation to these challenges. Gaps in the research are identified relating to 1. Associations between specific ‘hot’ and ‘cold’ cognitive processes, 2. Association of ‘hot’ and ‘cold’ cognitive processes with everyday outcomes. Four studies are presented each addressing a different aspect of these gaps: ‘cold’ executive and ‘hot’ emotion regulation abilities and peer relationships following paediatric acquired brain injury (ABI); patterns and predictors of performance of people with traumatic brain injury (TBI) on a modified gamble task compared with healthy controls; interaction between coping style and specific executive functions in association with emotional outcomes after ABI; and the effect of brief goal management training (GMT) and periodic alerts on achievement of everyday intentions following ABI. Results indicate variation in the extent to which ‘hot’ and ‘cold’ frontal functions are associated with each other and everyday outcomes. A ‘frontal-contextual system’ model in which performance characteristics arise from the dynamic interaction between ‘hot’ and ‘cold’ frontal systems and everyday practical and social contexts is presented as a way of understanding everyday difficulties. Application of novel methodologies that can sample the interactions between system components and are sensitive to inter-individual variability may be useful for advancing understanding of the links between frontal dysfunction and everyday life. Implications for intervention that are similarly focused on the interactions between components and facilitation of social or physiological conditions that give rise to optimal adaptation in everyday life are discussed.

Item Type: Thesis (Doctoral)
Uncontrolled Keywords: Publication
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: James Tweddle
Date Deposited: 21 Aug 2019 11:16
Last Modified: 21 Aug 2019 11:16
URI: https://ueaeprints.uea.ac.uk/id/eprint/72023

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