Research Reports - Decision making after traumatic brain injury

J Int Neuropsychol Soc. 2013 Feb;19(2):181-8

Wood RL, McHugh L

A temporal discounting paradigm was used to examine decision making for
hypothetical monetary reward following traumatic brain injury (TBI). A
case-control design compared individuals following moderate or severe TBI with a
healthy control group matched for age and gender. The impact of intelligence,
impulsivity, and mood on temporal discounting performance was examined. A
within-subjects design for the TBI group determined the influence of a range of
neuropsychological tests on temporal discounting performance. Both patients and
controls demonstrated temporal discounting. However, the TBI group discounted
more than controls, suggesting that their decision making was more impulsive,
consistent with ratings on the impulsiveness questionnaire. Discounting
performance was independent of neuropsychological measures of intelligence,
memory, and executive function. There was no relationship between temporal
discounting and ratings of everyday executive function made by patients'
relatives. Low mood did not account for discounting performance. The results of
this study suggest that temporal discounting may be a useful neuropsychological
paradigm to assess decision making linked to monetary reward following TBI.
Performance was relatively independent of intelligence, memory and standard tests
of executive ability and may therefore assist when assessing a patient's mental
capacity to manage their financial affairs.

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