The aim of the study was to develop and validate a short questionnaire assessing four dimensions of impulsivity (urgency, lack of premeditation, lack of perseverance, sensation seeking) in patients with traumatic brain injury (TBI). To this end, 82 patients with TBI and their caregivers completed a short questionnaire adapted from the UPPS Impulsive Behavior Scale designed to assess impulsivity changes after TBI. Confirmatory factor analyses (CFAs) performed on the version of the scale completed by the relatives revealed that a hierarchical model holding that lack of premeditation and lack of perseverance are facets of a higher order construct (lack of conscientiousness), with urgency and sensation seeking as separate correlated factors, fit the data best. Urgency, lack of premeditation, and lack of perseverance increased after the TBI, whereas sensation seeking decreased. CFA failed to reveal a satisfactory model in the version of the scale completed by the patients. The psychological processes related to these impulsivity changes and the discrepancy observed between self-report and informant-report are discussed. This short questionnaire opens up interesting prospects for better comprehension and assessment of behavioural symptoms of TBI.

Impulsive behaviors and poor inhibition performances are frequently described in patients with traumatic brain injury (TBI). However, few studies have examined impulsivity and associated inhibition impairments in these patients. Twenty-eight patients with moderate to severe TBI and 27 matched controls performed a stop-signal task designed to assess prepotent response inhibition (the ability to inhibit a dominant or automatic motor response) in a neutral or emotional context and a recent negative task to assess resistance to proactive interference (the ability to resist the intrusion into memory of information that was previously relevant but has since become irrelevant). Informants of each patient completed a short questionnaire designed to assess impulsivity. Patients showed a significant increase in current urgency, lack of premeditation, and lack of perseverance when retrospectively compared with the preinjury condition. Group comparisons revealed poorer prepotent response inhibition and resistance to proactive interference performances in patients with TBI. Finally, correlation analyses revealed a significant positive correlation between urgency (the tendency to act rashly when distressed) and prepotent response inhibition in patients with TBI. This study sheds new light on the construct of impulsivity after a TBI, its related cognitive mechanisms, and its potential role in problematic behaviors described after a TBI. (JINS, 2013, 19, 890-898)

Background: Impulsivity is a core feature in patients with traumatic brain injury (TBI). The aim of the study is to investigate how a specific dimension of impulsivity, namely urgency (the tendency to act rashly when distressed), might shed new light on the aetiology of compulsive buying proneness in patients with TBI and to explore how urgency and compulsive buying relate to the burden perceived by the caregivers. Sampling and Methods: Caregivers of 74 patients with TBI were given 3 questionnaires in order to assess their subjective burden as well as patients’ impulsivity and compulsive buying proneness. Results: Both urgency and compulsive buying tendencies significantly increased after TBI. Furthermore, path analyses revealed that current urgency was both directly and indirectly related to the subjective burden perceived by the caregivers, and this indirect pathway was mediated by compulsive buying. Conclusion: Urgency plays a central role in understanding specific problematic behaviours after TBI and their impact on caregivers. These findings are discussed in light of the cognitive processes underlying the urgency component of impulsivity in relation to the occurrence of compulsive buying behaviours after TBI.

Les problèmes émotionnels et comportementaux après un traumatisme crânio-cérébral (TCC) sont fréquents et souvent associés à des difficultés familiales, sociales et professionnelles. Ils constituent ainsi un enjeu important de l’évaluation et de la prise en charge des personnes ayant subi un TCC. Cependant, les outils d’évaluation des troubles du comportement socio-émotionnel après un TCC présentent de nombreuses failles sur les plans méthodologique, théorique et statistique. Dans ce contexte, l’objectif de ce travail était d’élaborer et de valider un nouveau questionnaire en français reposant sur des critères théoriques et méthodologiques solides : l’Échelle des changements de comportements socio-émotionnels de Genève (ECCSEG). Ce questionnaire à 15 items a été administré à 117 proches de personnes victimes d’un TCC. Les analyses factorielles exploratoires ont permis de dégager une structure factorielle à trois facteurs ayant chacun une consistance interne satisfaisante à élevée : problèmes externalisés, motivationnels et internalisés. En outre, les résultats indiquent non seulement une augmentation significative des scores sur chacun des trois facteurs par rapport à la condition pré-traumatique, mais aussi des liens significatifs entre ces trois facteurs et différentes dimensions de l’impulsivité, attestant d’une bonne validité externe de l’échelle. Enfin, les trois facteurs de l’ECCSEG sont significativement associés au fardeau subjectif des proches et à des répercussions psychosociales, témoignant d’une bonne validité prédictive. Ces résultats indiquent que l’ECCSEG constitue un outil valide et pertinent en français pour l’évaluation des problèmes socio-émotionnels pouvant être utilisés dans un contexte clinique ou de recherche auprès de personnes ayant subi un TCC.

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