Observational themes of social behavioral disturbances in frontotemporal dementia

Abstract

Background Caregivers report early disturbances in social behavior among patients with behavioral variant frontotemporal dementia (bvFTD); however, there are few direct observational studies of these social behavioral disturbances. This study aimed to identify social behavioral themes in bvFTD by direct observation in naturalistic interactions. The identification of these themes can help caregivers and clinicians manage the social behavioral disturbances of this disease. Methods Researchers observed 13 bvFTD patients in their homes and community-based settings and recorded field notes on their interpersonal interactions. A qualitative analysis of their social behavior was then conducted using ATLAS.ti application and a constant comparison method. Results Qualitative analysis revealed the following themes: (1) diminished relational interest and initiation, indicating failure to seek social interactions; (2) lack of social synchrony/intersubjectivity, indicating an inability to establish and maintain interpersonal relationships; and (3) poor awareness and adherence to social boundaries and norms. These themes corresponded with changes from caregiver reports and behavioral scales. Conclusion This analysis indicates that real-world observation validates the diagnostic criteria for bvFTD and increases understanding of social behavioral disturbances in this disorder. The results of this and future observational studies can highlight key areas for clinical assessment, caregiver education, and targeted interventions that enhance the management of social behavioral disturbances in bvFTD.

Humour processing in frontotemporal lobar degeneration: A behavioural and neuroanatomical analysis

“…Our findings resonate with the complaints of caregivers of patients with FTLD, frequently indicating that they have lost the ability to appreciate more subtle comedy, that their tastes in comedy have coarsened or that they have become humourless or more inclined to find humour in inappropriate contexts. Altered humour sensibility may constitute a distinct domain of social cognitive function that is not well captured by standard neuropsychological instruments, and impaired humour processing may contribute importantly to behavioural difficulties more generally, including the flouting of social norms ( Barsuglia et al., 2014 ). While bvFTD and SD were both associated with extensive abnormalities of humour processing, our findings suggest that relatively greater affinity for more fatuous or childlike humour may be a marker of bvFTD while SD produces a more general impairment of humour processing, opening up avenues for assessing these syndromes that could be further explored at the bedside.…”

What is known about the subjective needs of people with behavioural variant frontotemporal dementia? A scoping review

“…social behaviour instead of needs and demands (Barsuglia et al . , Mendez et al . ) or subsumed people with FTD in the group of early‐onset dementia (Harris , Alzheimer's Australia , Armari et al .…”

“…, Barsuglia et al . , Mendez et al . ) demonstrate that it is possible to analyse self‐expressions from people with FTD.…”

“…Based on the mentioned studies about the social behaviour of people with FTD (Barsuglia et al . , Mendez et al . ), a secondary analysis could determine whether unmet needs could be the trigger for this behaviour.…”

“…More detailed information could not be received by contacting the authors. Two other research projects identified in the updated search of electronic database using video‐based observation (Barsuglia et al . , Mendez et al . ) were closely related to our question but did not fit exactly because of the focus on social behaviour instead of needs.…”