Neuropsychology Review

, Volume 23, Issue 3, pp 210–233 | Cite as

A Multidimensional Approach to Apathy after Traumatic Brain Injury

  • Annabelle Arnould
  • Lucien Rochat
  • Philippe Azouvi
  • Martial Van der Linden
Review

Abstract

Apathy is commonly described following traumatic brain injury (TBI) and is associated with serious consequences, notably for patients’ participation in rehabilitation, family life and later social reintegration. There is strong evidence in the literature of the multidimensional nature of apathy (behavioural, cognitive and emotional), but the processes underlying each dimension are still unclear. The purpose of this article is first, to provide a critical review of the current definitions and instruments used to measure apathy in neurological and psychiatric disorders, and second, to review the prevalence, characteristics, neuroanatomical correlates, relationships with other neurobehavioural disorders and mechanisms of apathy in the TBI population. In this context, we propose a new multidimensional framework that takes into account the various mechanisms at play in the facets of apathy, including not only cognitive factors, especially executive, but also affective factors (e.g., negative mood), motivational variables (e.g., anticipatory pleasure) and aspects related to personal identity (e.g., self-esteem). Future investigations that consider these various factors will help improve the understanding of apathy. This theoretical framework opens up relevant prospects for better clinical assessment and rehabilitation of these frequently described motivational disorders in patients with brain injury.

Keywords

Apathy Traumatic brain injury Motivation Depression Executive functions Self-esteem 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Annabelle Arnould
    • 1
    • 2
    • 3
  • Lucien Rochat
    • 1
    • 4
  • Philippe Azouvi
    • 2
    • 3
    • 5
  • Martial Van der Linden
    • 1
    • 4
    • 6
  1. 1.Cognitive Psychopathology and Neuropsychology UnitUniversity of GenevaGenevaSwitzerland
  2. 2.AP-HP, Department of Physical Medicine and RehabilitationRaymond Poincaré HospitalGarchesFrance
  3. 3.University of Versailles-Saint-Quentin-en-YvelinesVersaillesFrance
  4. 4.Swiss Centre for Affective SciencesUniversity of GenevaGenevaSwitzerland
  5. 5.ER 6, UPMCParisFrance
  6. 6.Cognitive Psychopathology UnitUniversity of LiègeLiègeBelgium

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