INTIMASY-TBI Guideline: Optimization of INTIMAcy, SexualitY, and Relationships Among Adults With Traumatic Brain Injury.

INTRODUCTION: Traumatic brain injury (TBI) can negatively impact intimacy, relationships, and sexual functioning through changes in physical, endocrine, cognitive, behavioral, and emotional function. Without intervention, diminished intimacy and/or sexual functioning in individuals with TBI may persist. Although most health care professionals agree that sexuality and intimacy in relationships are significant concerns and should be addressed in rehabilitation, these concerns are not typically discussed during rehabilitation and discharge planning for people with TBI. To address this gap, an expert panel of North American clinicians and researchers convened to develop evidence-informed recommendations to assist clinicians in providing a framework and guidance on how clinicians can support individuals after TBI. METHODS: A systematic search of multiple databases was conducted to identify relevant evidence published from 2010 to 2023. The INTIMASY-TBI Expert Panel developed recommendations for optimizing discussions and interventions related to intimacy and sexuality for people with TBI in rehabilitation and community-based programs. For each recommendation, the experts evaluated the evidence by examining the study design and quality to determine the level of evidence. RESULTS: A total of 12 recommendations were developed that address the following topic areas: (1) interprofessional team training, (2) early education on the effects of TBI on intimacy, relationships, and sexuality, (3) creating individualized interventions, (4) education, assessment, and management of the causes of sexual dysfunction, and (5) providing written materials and relationship coaching to persons with TBI and their partners. Two recommendations were supported by Level A evidence, 1 was supported by Level B evidence, and 9 were supported by Level C (consensus of the INTIMASY-TBI Expert Panel) evidence. A decision algorithm was developed to assist clinicians in navigating through the recommendations. CONCLUSION: The INTIMASY-TBI Guideline is one of the first comprehensive clinical practice guidelines to offer strategies to trained clinicians to discuss the physical, psychosocial, behavioral, and emotional aspects of intimacy and sexuality with persons with TBI.

Relationships between risky sexual behaviour, dysexecutive problems, and mental health in the years following interdisciplinary TBI rehabilitation.

Little is known about the long-term consequences of traumatic brain injury (TBI) regarding risky sexual behaviour. The objectives of the study were (1) to compare risky sexual behaviour in a sample of individuals with TBI having received interdisciplinary rehabilitation with that of healthy controls, and (2) to explore the relationships between risky sexual behaviour, executive functions, and mental health in individuals with TBI. The study group consisted of 42 individuals with TBI with a mean age of 37.9 years (SD = 9.7), 12.8 years of education (SD = 3.3), and 3.3 years post-injury (SD = 4.3). Healthy controls consisted of 47 participants, with a mean age of 37.6 years (SD = 10.7), and 13 years of education (SD = 3). Risky sexual behaviour was measured with the Sexual Risk Survey and executive function with the Dysexecutive Questionnaire. Mental health measures included the Generalised Anxiety Disorder Scale, and the Patient Health Questionnaire for depression. Compared to healthy controls, individuals with TBI reported more dysexecutive and mental health problems, without differences in risky sexual behaviour. In individuals with TBI, risky sexual behaviour was associated with behavioural, cognitive and emotional dysexecutive problems, but not with anxiety or depression. It was concluded that special attention should be given to individuals with TBI showing difficulties in executive functions given their association with risky sexual behaviour.

Caregiving in Dementia and its Impact on Psychological Functioning and Health-Related Quality of Life: Findings from a Colombian Sample.

Existing published studies about health-related quality of life (HRQOL) in caregivers of dementia patients living in Latin American countries are very limited. However, cultural aspects, personal values, and social structure may affect the way caregivers experience their role in different societies. The current study investigated the relationship between HRQOL and psychological factors using a cross-sectional design. The sample consisted of 102 informal caregivers of patients with dementia from Bogotá, Colombia, South America. Measures included the Patient Health Questionnaire (PHQ-9) for depression, the Satisfaction with Life Scale (SWLS), the Zarit Burden Interview, and the Short Health Questionnaire (SF36) for HRQOL. Canonical correlations revealed that there was a significant relationship between caregivers' mental health and HRQOL, such that caregivers with better satisfaction with life and less symptoms of depression had more vitality and better general health. There is a strong relationship between mental health and health-related quality of life in Colombian caregivers of dementia patients living in their country of origin. Specific aspects of mental health, including satisfaction with life and depression, need to be addressed in order to improve caregivers' quality of life. Given that mental health care resources may be scarce in Latin American countries, culturally appropriate interventions should focus on preventing/treating depression and promote life satisfaction, as a way to improve their quality of life.

Corrigendum: Neurocognitive health in LGBTQIA+ older adults: current state of research and recommendations.

[This corrects the article DOI: 10.3389/fnhum.2024.1394374.].

Towards a taxonomy of sexuality following traumatic brain injury: A pilot exploratory study using cluster analysis.

INTRODUCTION: Clinicians need to understand the heterogeneity of sexual problems following traumatic brain injury (TBI) for their adequate identification and treatment. OBJECTIVE: To systematically identify groups of individuals with TBI showing similar patterns of sexual functioning. METHODS: Forty-two individuals with TBI with a mean age of 37.9 years (SD = 9.7) and an average of 3.3 years post-injury (SD = 4.3). We included four primary measures in the cluster analysis (sexual quality of life questionnaire, sexual desire inventory, generalized anxiety disorder scale, and the patient health questionnaire for depression) and two secondary measures for cluster validation (post-concussion symptom scale and dysexecutive questionnaire). RESULTS: A hierarchical cluster analysis using the Ward method revealed the existence of two groups of individuals with TBI: a) with sexual problems who were older, showed lower levels of sexual quality of life and sexual desire, with significant symptoms of anxiety and depression, and b) without sexual problems who were younger, showed high levels of sexual quality of life and sexual desire, as well as low complaints of anxiety and depression. CONCLUSIONS: Clinicians must be more proactive in assessing sexual concerns, mostly when emotional and cognitive difficulties are present in older individuals with TBI, regardless of gender, chronicity and injury severity.

Differences according to Sex in Sociosexuality and Infidelity after Traumatic Brain Injury.

OBJECTIVE: To explore differences according to sex in sociosexuality and infidelity in individuals with TBI and in healthy controls. PARTICIPANTS: Forty-two individuals with mild, moderate, and severe TBI having completed a postacute TBI rehabilitation program, at least six months after injury, and 47 healthy controls. MAIN MEASURES: Sociosexual Orientation Inventory-Revised (SOI-R) and Attitudes toward Infidelity Scale. RESULTS: Overall, men score significantly higher than women in sociosexuality. However, there was a nonsignificant trend towards a reduction of sociosexuality levels in men with TBI. Infidelity levels were comparable in healthy controls and individuals with TBI. In individuals with TBI, less acceptance of infidelity was significantly associated with an unrestricted sociosexual orientation, but not in healthy controls. CONCLUSIONS: As documented in previous cross-cultural studies, men have higher levels of sociosexuality than women. However, men with TBI showed a tendency towards the reduction of sociosexuality. The possibility of a latent explanatory variable is suggested (e.g., post-TBI neuroendocrinological changes). TBI does not seem to have an impact on infidelity, but individuals with TBI who express less acceptance of infidelity also report a more promiscuous mating strategy regarding their behavior, attitudes, and desire. Theoretical implications are discussed in terms of evolutionary theories of human sexuality and neuropsychology.

Sexuality after traumatic brain injury: a critical review.

Brain injury can directly and indirectly affect important aspects related to sexuality and sexual function. In this critical review of the literature, traumatic brain injury (TBI) and sexuality are examined. A general review of the concept of sexuality and the neurological correlates of sexual function are proposed as a framework to understand the cognitive, behavioral and physical effects of TBI on sexuality and sexual function. Studies are then classified according to the participants enrolled and findings are presented from the professional's, the survivor's, the patient/partner's, and the non-injured spouse's perspectives. Results are discussed taking into account methodological limitations and knowledge gaps. Next, implications for sexual rehabilitation for individuals with TBI are discussed. Finally, suggestions for future research and their pertinence for improving rehabilitation outcomes are considered.

Necesidades familiares y su relación con las características psicosociales que presentan los cuidadores de personas con demencia / Family needs and their relationship with psicosocial functioning in caregivers of people with dementia

El objetivo de este estudio consiste en: 1) Conocer las necesidades más y menos importantes que reportan un grupo de 73 cuidadores de personas con demencia que asisten a la Clínica de la Memoria del Hospital Central de la Policía en Bogotá, Colombia, 2) Describir las principales características psicosociales y 3) Determinar si existe una relación entre dichas necesidades y las características psicosociales. Se administró un cuestionario de necesidades familiares, el cuestionario de depresión PHQ-9, el cuestionario de sobrecarga de Zarit, la escala de apoyo social, y la escala de satisfacción con la vida. Se encontró que las necesidades más importantes para los cuidadores fueron la necesidad de recibir información sobre la enfermedad, la necesidad de recibir apoyo emocional y la necesidad de recibir apoyo de la comunidad. La mayoría de cuidadores reportaron tener altos niveles de sobrecarga, depresión y problemas de salud. La necesidad de ayuda para mejorar la salud física fue la que mejor predijo la depresión y la sobrecarga en los cuidadores de personas con demencia. Las necesidades de tiempo para descansar y de apoyo psicológico fueron las que mejor predijeron la satisfacción con la vida.

The aim of this study as to: 1) To determine the most and least important family needs of 73 dementia family member caregivers from the Memory Clinic of the Central Police Hospital in Bogotá, Colombia, 2) To describe caregivers’ psychosocial functioning and 3) To determine which type of family needs best predict caregiver psychosocial functioning. Family member caregivers were administered a 27-item Caregiver Needs Questionnaire, the Patient Health Questionnaire (PHQ-9) to measure depression, Zarit Burden Interview (ZBI), the Interpersonal Support Evaluation List Short Version (ISEL-12) to evaluate social support, and The Satisfaction with Life Scale (SWLS). The three most important needs reported by the family member caregivers were the need for information about the disease, need for emotional support, and need for community support. The majority of caregivers reported high levels of burden, depression, and health problems. The need to improve physical health was the best predictor of depression and burden. The need for respite and for psychological assistance best predicted satisfaction with life.