Research Reports - Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment

Neuropsychol Rehabil. 2015 Jul 9:1-37

Whiting DL(1), Deane FP, Simpson GK, McLeod HJ, Ciarrochi J

This paper provides a selective review of cognitive and psychological flexibility
in the context of treatment for psychological distress after traumatic brain
injury, with a focus on acceptance-based therapies. Cognitive flexibility is a
component of executive function that is referred to mostly in the context of
neuropsychological research and practice. Psychological flexibility, from a
clinical psychology perspective, is linked to health and well-being and is an
identified treatment outcome for therapies such as acceptance and commitment
therapy (ACT). There are a number of overlaps between the constructs. They both
manifest in the ability to change behaviour (either a thought or an action) in
response to environmental change, with similarities in neural substrate and
mental processes. Impairments in both show a strong association with
psychopathology. People with a traumatic brain injury (TBI) often suffer
impairments in their cognitive flexibility as a result of damage to areas
controlling executive processes but have a positive response to therapies that
promote psychological flexibility. Overall, psychological flexibility appears a
more overarching construct and cognitive flexibility may be a subcomponent of it
but not necessarily a pre-requisite. Further research into therapies which claim
to improve psychological flexibility, such as ACT, needs to be undertaken in TBI
populations in order to clarify its utility in this group.

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