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Observational themes of social behavioral disturbances in frontotemporal dementia

Published online by Cambridge University Press:  20 May 2014

Joseph P. Barsuglia ,
Frances R. Nedjat-Haiem ,
Jill S. Shapira ,
Christina Velasco ,
Elvira E. Jimenez ,
Michelle J. Mather  and
Mario F. Mendez
Joseph P. Barsuglia*
Affiliation:
Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA
Frances R. Nedjat-Haiem
Affiliation:
Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA
Jill S. Shapira
Affiliation:
Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California
Christina Velasco
Affiliation:
Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California
Elvira E. Jimenez
Affiliation:
Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California
Michelle J. Mather
Affiliation:
Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California
Mario F. Mendez
Affiliation:
Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California
*
Correspondence should be addressed to: Joseph P. Barsuglia, PhD, Neurobehavior Service (116AF), West Los Angeles VA Healthcare Center; 11301 Wilshire Blvd, Los Angeles, CA 90073, USA. Phone: +(310) 478-3711; Ext.: 42393; Fax: +(310) 268-4181. Email:joseph.barsuglia@va.gov.
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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.

Keywords

Behavioral variant frontotemporal dementiasocial behavior in dementiaobservational studyintersubjectivity in dementiaearly onset dementia
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 9 , September 2014 , pp. 1475 - 1481
Copyright
Copyright © International Psychogeriatric Association 2014 

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References

Allen, M. and Williams, G. (2011). Consciousness, plasticity, and connectomics: the role of intersubjectivity in human cognition. Frontiers in Psychology, 2, 20.CrossRefGoogle ScholarPubMed
Atzil, S., Hendler, T. and Feldman, R. (2013). The brain basis of social synchrony. Social Cognitive and Affective Neuroscience. Epublished ahead of print, doi: 10.1093/scan/nst105 Google Scholar
Bakker, C. et al. (2013). The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: a two-year follow-up study. International Psychogeriatrics. Epublished ahead of print, doi: http://dx.doi.org/10.1017/S1041610213001476 Google ScholarPubMed
Black, B. S. and Rabins, P. V. (2007). Qualitative research in psychogeriatrics. International Psychogeriatrics, 19, 167–173.CrossRefGoogle ScholarPubMed
Carleton, R. N. et al. (2013). The center for epidemiologic studies depression scale: a review with a theoretical and empirical examination of item content and factor structure. PLoS One, 8, e58067.CrossRefGoogle Scholar
Charmaz, K. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. London: Sage.Google Scholar
Corbin, J. and Strauss, A. (2007). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: SAGE Publications, Inc. Google Scholar
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Diehl-Schmid, J. et al. (2013). Caregiver burden and needs in frontotemporal dementia. Journal of Geriatric Psychiatry and Neurology, 26, 221–229.Google Scholar
Eaves, Y. D. (2001). A synthesis technique for grounded theory data analysis. Journal of Advanced Nursing, 35, 654–663.CrossRefGoogle ScholarPubMed
Ghosh, A., Dutt, A., Bhargava, P. and Snowden, J. (2013). Environmental dependency behaviours in frontotemporal dementia: have we been underrating them? Journal of Neurology, 260, 861–868.Google Scholar
Glaser, B. G. (1992). Basic of Grounded Theory Analysis. Mill Valley, CA: Sociology Press.Google Scholar
Grace, J. and Malloy, P. F. (2001). Frontal Systems Behavior Scale Professional Manual. Lutz, FL: Psychological Assessment Resources.Google Scholar
Han, S., Northoff, G., Vogeley, K., Wexler, B. E., Kitayama, S. and Varnum, M. E. (2013). A cultural neuroscience approach to the biosocial nature of the human brain. Annual Review of Psychology, 64, 335–359.Google Scholar
Joshi, A., Barsuglia, J. P., Mather, M. J., Jimenez, E. E., Shapira, J. and Mendez, M. F. (2014). Evaluation of emotional blunting in behavioral variant frontotemporal dementia compared to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 38, 79–88.Google Scholar
LoGiudice, D. and Hassett, A. (2005). Uncommon dementia and the carer's perspective. International Psychogeriatrics, 17 (Suppl 1), S223–231.Google Scholar
Magai, C. and Cohen, C. I. (1998). Attachment style and emotion regulation in dementia patients and their relation to caregiver burden. Journal of Gerontology, 53B, 147–154.Google Scholar
Mendez, M. F. and Lim, G. T. (2004). Alterations of the sense of “humanness” in right hemisphere predominant frontotemporal dementia patients. Cognitive and Behavioral Neurology, 17, 133–138.Google Scholar
Mendez, M. F. and Manes, F. (2011). The emerging impact of social neuroscience on neuropsychiatry and clinical neuroscience. Social Neuroscience, 6, 415–419.Google Scholar
Mendez, M. F. and Shapira, J. S. (2011). Loss of emotional insight in behavioral variant frontotemporal dementia or “frontal anosodiaphoria”. Consciousness and Cogniton, 20, 1690–1696.CrossRefGoogle ScholarPubMed
Mendez, M. F., Perryman, K. M., Miller, B. L. and Cummings, J. L. (1998). Behavioral differences between frontotemporal dementia and Alzheimer's disease: a comparison on the BEHAVE-AD rating scale. International Psychogeriatrics, 10, 155–162.Google Scholar
Mendez, M. F., Lauterbach, E. C., Sampson, S. M. and Research, A. C. O. (2008). An evidence-based review of the psychopathology of frontotemporal dementia: a report of the ANPA Committee on Research. Journal of Neuropsychiatry and Clinical Neuroscience, 20, 130–149.Google Scholar
Mendez, M. F. et al. (2013a). Observation of social behavior in frontotemporal dementia. American Journal of Alzheimers Disease and Other Dementias. Epublished ahead of print, doi: 10.1177/1533317513517035 Google Scholar
Mendez, M. F., Joshi, A., Tassniyom, K., Teng, E. and Shapira, J. S. (2013b). Clinicopathologic differences among patients with behavioral variant frontotemporal dementia. Neurology, 80, 561–568.Google Scholar
Nunnemann, S., Kurz, A., Leucht, S. and Diehl-Schmid, J. (2012). Caregivers of patients with frontotemporal lobar degeneration: a review of burden, problems, needs, and interventions. International Psychogeriatrics, 24, 1368–1386.CrossRefGoogle ScholarPubMed
O’Bryant, S. E. et al. (2010). Validation of the new interpretive guidelines for the clinical dementia rating scale sum of boxes score in the national Alzheimer's coordinating center database. Archives of Neurology, 67, 746–749.Google Scholar
Pardini, M. et al. (2013). Isolated theory of mind deficits and risk for frontotemporal dementia: a longitudinal pilot study. Journal of Neurology, Neurosurgery, and Psychiatry, 84, 818–821.Google Scholar
Passant, U., Elfgren, C., Englund, E. and Gustafson, L. (2005). Psychiatric symptoms and their psychosocial consequences in frontotemporal dementia. Alzheimer Disease and Associated Disorders, 19 (Suppl 1), S15–18.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H. Jr., Chance, J. M. and Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323–329.Google Scholar
Rankin, K. P., Kramer, J. H. and Miller, B. L. (2005). Patterns of cognitive and emotional empathy in frontotemporal lobar degeneration. Cognive and Behavioral Neurology, 18, 28–36.Google Scholar
Rankin, K. P., Santos-Modesitt, W., Kramer, J. H., Pavlic, D., Beckman, V. and Miller, B. L. (2008). Spontaneous social behaviors discriminate behavioral dementias from psychiatric disorders and other dementias. Journal of Clinical Psychiatry, 69, 60–73.Google Scholar
Rascovsky, K. et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134, 2456–2477.CrossRefGoogle ScholarPubMed
Rosen, H. J. et al. (2006). Neuroanatomical correlates of impaired recognition of emotion in dementia. Neuropsychologia, 44, 365–373.Google Scholar