L’urgence, la préméditation, la persévérance et la recherche de sensations suite à un traumatisme cranio-cérébral en lien avec les fonctions exécutives
Impulsivity is a common sequela following traumatic brain injury (TBI) to which are associated many negative consequences and necessitates important resources. A thorough assessment of impulsivity is therefore necessary in a rehabilitation setting. However, there is no consensual definition of post TBI impulsivity nor is there a specific measure allowing its assessment. It is generally acknowledged, in recent literature, that impulsivity is a multidimensional construct. The UPPS-P model is gaining a significant amount of support and could allow a better understanding of post-TBI impulsivity. According to this model, there are four dimensions to impulsivity, namely urgency (tendency to experience and act on strong impulses frequently under conditions of strong affect),  lack of perseverance (inability to remain focused on a task that may be boring or difficult), lack of premeditation (inability to think and reflect on the consequences of an act before engaging in that act) and sensation seeking (tendency to enjoy activities that are exciting and a willingness to try new experiences). It has been suggested that urgency, lack of perseverance and lack of premeditation are linked to impairments on prepotent response inhibition, on resistance to proactive interference and on decision making, respectively (Bechara and Van der Linden, 2005). This conceptualisation offers a promising avenue as to the assessment of post-TBI impulsivity. This project aims to clarify the construct of post-TBI impulsivity, to determine whether the same cognitive mechanisms come into play in the different dimensions of impulsivity in an intensive functional rehabilitation setting and to determine which performance tasks allow the prediction of impulsive behaviors in that setting.  Firstly, a literature review among studies on post-TBI impulsivity gives support to a multidimensional conceptualisation of impulsivity and allows to bring out the obstacles which make the study of post-TBI impulsivity more complicated. Secondly, the use of different performance tasks is used to assess the links between UPPS-P dimensions and cognitive mechanisms. Results indicate impairments on the mechanisms linked to prepotent response inhibition, to resistance to proactive interference and to decision making. However, they do not support Bechara and Van der Linden’s (2005) propositions as to the underlying mechanisms to the dimensions of post-TBI impulsivity in an acute rehabilitation setting. Thirdly, the results show the relevance of ecological performance tasks as to the prediction of impulsive behaviors in everyday life. The theoretical and clinical implications of the results are discussed.
inhibition impulsivity assessment traumatic brain injury urgency perseverance premeditation sensation-seeking decision-making performance tasks disinhibition TBI brain injury impulse control regulation inhibitory control definitions upps