Lynch, Jessica;
(2025)
Apathy After Traumatic Brain Injury: Prevalence, 12-Month Trajectory, and Clinical Implications.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Overview: This thesis contributes to the growing recognition of apathy as a clinically meaningful outcome following traumatic brain injury (TBI). The thesis consists of three parts: Part one presents a systematic review and meta-analysis estimating the prevalence of apathy after TBI. Eighteen studies were included, and the pooled prevalence was over one-third. Subgroup and meta-regression analyses identified moderators of prevalence, including cause of injury, injury severity, population type, and sex. These findings reinforce the importance of routine apathy screening. Part two reports an empirical study using data from the TRACK-TBI cohort. The study compared apathy trajectories in individuals with TBI versus orthopaedic injuries over 12-months and explored whether early apathy was associated with long-term functional outcomes. Apathy scores were higher in the TBI group and remained higher throughout the 12-months. However, this association was reduced when the model was adjusted for co-occurring mental health difficulties. Early apathy was associated with poorer functioning at 12 months, particularly in social and interpersonal domains. These findings support the clinical relevance of apathy as an early marker of long-term outcomes. Part three is a critical appraisal that reflects on the evolving understanding of apathy, highlighting the challenges of capturing its complexity within existing frameworks. It explores key methodological decisions, including the use of secondary data and the development of an ad-hoc apathy scale, and considers how open-science principles and clinical experience shaped the research process. The appraisal also discusses the clinical relevance of apathy following TBI and outlines future directions for improving its measurement and recognition in practice.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | D.Clin.Psy |
| Title: | Apathy After Traumatic Brain Injury: Prevalence, 12-Month Trajectory, and Clinical Implications |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214500 |
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