The Emotion Builder: An Intervention for Emotional Deficits after Brain Injury

Neumann, Dawn

Abstract

People with traumatic brain injury (TBI) are often plagued with socio-emotional deficits that include difficulty identifying emotions in oneself (alexithymia), difficulty recognizing other peoples'emotions (impaired affect recognition), and empathy loss. These highly prevalent deficits, ranging between 39-70% of the moderate to severe TBI population, are significant because they are associated with poor emotional control, inappropriate behavior, negative social outcomes, and reduced community integration and quality of life. A major limitation of rehabilitation services is that there are no standard, evidece-based treatments for alexithymia, affect recognition, and empathy deficits after TBI. As a result, therapists and rehabilitation facilities are not equipped to adequately treat these impairments in patients with TBI. Consequently, there is a robust need for an intervention that can effectively address these socio-emotional problems. In order to meet this need, EmotEd, LLC will work with research partners at Indiana University and the Rehabilitation Hospital of Indiana to develop and market a high quality, evidence-based product to treat alexithymia, affect recognition, and empathy deficits. This product, entitled the Emotion BuilderTM, will be a serious virtual environment (VE) video game that will be used by clinicians to teach patients with TBI to overcome these deficits in naturalistic social scenarios. It will contain three treatment modules: alexithymia, affect recognition, and empathy. For the proposed Phase I STTR project, the main objective will be the development and preliminary evaluation of the alexithymia module of the Emotion BuilderTM.
Aim 1 is to develop a detailed treatment protocol to reduce alexithymia after TBI.
Aim 2 is to develop a beta version of a VE serious video game, the Emotion BuilderTM, to support the alexithymia t r e a t m e n t protocol.
Aim 3 is to demonstrate the feasibility of the Emotion BuilderTM to treat alexithymia in people with TBI. Feasibility will be demonstrated with a pilot study using a pre/ post-test design to determine product demand, acceptability, and treatment effect size on alexithymia after TBI (n=15). If successful, Phase II will aim to add affect recognition and empathy modules to the Emotion BuilderTM, and to conduct a large scale randomized control trial to determine efficacy, generalization of behavior, and skill retention for the comprehensive program. Short-term, the contribution of this project will be significant because it is the first step towards meeting the need for treatments that can effectively address emotional deficits after TBI. Long-term contributions are expected to minimize problems with alexithymia, affect recognition, empathy loss, and related socio-emotional problems for many people with TBI;enrich interpersonal relationships;and enhance community participation and quality of life after TBI. The video game format permits delivery either in the clinic or via home-based tele- rehabilitation, maximizing the number of patients who could benefit. There are no comparable treatments to the Emotion BuilderTM, poising this markedly innovative product to be in high demand.

Public Health Relevance

The proposed study and resulting product is relevant to public health because it will address a significant gap in traumatic brain injury (TBI) rehabilitation by providing an intervention to treat prevalent and debilitating socio- emotional deficits for which there are currently no treatments (ie. reduced emotional self- awareness, impaired affect recognition, and empathy loss). This intervention is expected to minimize the disability experienced by people with TBI by ultimately improving related socio-emotional functioning, which is projected to have a positive impact on interpersonal relationships, quality of life, and community participation. This product will be a standardized, evidence-based intervention that is expected to enhance the effectiveness of clinical services and to expand the scope of treatment delivery for the TBI population.