PHYSIOLOGICAL PREDICTORS OF BEHAVIORAL DYSREGULATION IN ADULTS WITH TRAUMATIC BRAIN INJURY: A NOVEL ECOLOGICAL MOMENTARY ASSESSMENT METHOD

摘要

Each year in the United States 2.5 million people sustain a traumatic brain injury (TBI), making TBI one of the leading causes of death and disability. Difficulty self-regulating behavior is considered a hallmark deficit of TBI and can impede positive rehabilitation outcomes. Traditional clinic-based assessments with TBI cohorts are often compromised due to inaccurate self-reporting caused by self-awareness and/or memory challenges. This project developed out of the need for more adequate and objective assessment methods of behavior after TBI. The aim of this study was to identify physiological states that may serve as real world, real-time prodromes of behavioral dysregulation when compared to direct behavioral observation during task performance. Adults with TBI (N=14) were asked to complete a protocol of challenging, problem-solving tasks selected due to their potential to elicit negative responses believed to be indicative of dysregulation and result in task breakdown behaviors. Participants wore a portable biosensor band throughout the completion of all research tasks, which allowed for continuous physiological recordings of heart rate, breathing rate, and heart rate variability. Physiology was then synchronized with post hoc behavioral ratings conducted by trained clinicians from video recordings and analyzed through hierarchical linear mixed model methods to assess both between- and within-subject contribution related to the outcome. Testing was conducted at ReMed of Pittsburgh, a community-based brain injury rehabilitation program. This study was funded in part through the National Science Foundation’s Integrative Graduate Education & Research Traineeship (IGERT) Program in the Department of Rehabilitation Science & Technology and the School of Health & Rehabilitation Sciences Dean’s Research Development Fund, all at the University of Pittsburgh.