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Observational themes of social behavioral disturbances in frontotemporal dementia

  • Joseph P. Barsuglia (a1), Frances R. Nedjat-Haiem (a1), Jill S. Shapira (a1) (a2), Christina Velasco (a2), Elvira E. Jimenez (a1) (a2), Michelle J. Mather (a1) (a2) and Mario F. Mendez (a1) (a2) (a3)...
ABSTRACT Background:

Caregivers report early disturbances in social behavior among patients with behavioral variant frontotemporal dementia (bvFTD); however, there are few direct observational studies of these social behavioral disturbances. This study aimed to identify social behavioral themes in bvFTD by direct observation in naturalistic interactions. The identification of these themes can help caregivers and clinicians manage the social behavioral disturbances of this disease.


Researchers observed 13 bvFTD patients in their homes and community-based settings and recorded field notes on their interpersonal interactions. A qualitative analysis of their social behavior was then conducted using ATLAS.ti application and a constant comparison method.


Qualitative analysis revealed the following themes: (1) diminished relational interest and initiation, indicating failure to seek social interactions; (2) lack of social synchrony/intersubjectivity, indicating an inability to establish and maintain interpersonal relationships; and (3) poor awareness and adherence to social boundaries and norms. These themes corresponded with changes from caregiver reports and behavioral scales.


This analysis indicates that real-world observation validates the diagnostic criteria for bvFTD and increases understanding of social behavioral disturbances in this disorder. The results of this and future observational studies can highlight key areas for clinical assessment, caregiver education, and targeted interventions that enhance the management of social behavioral disturbances in bvFTD.

Corresponding author
Correspondence should be addressed to: Joseph P. Barsuglia, PhD, Neurobehavior Service (116AF), West Los Angeles VA Healthcare Center; 11301 Wilshire Blvd, Los Angeles, CA 90073, USA. Phone: +(310) 478-3711; Ext.: 42393; Fax: +(310) 268-4181.
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AllenM. and WilliamsG. (2011). Consciousness, plasticity, and connectomics: the role of intersubjectivity in human cognition. Frontiers in Psychology, 2, 20.
AtzilS., HendlerT. and FeldmanR. (2013). The brain basis of social synchrony. Social Cognitive and Affective Neuroscience. Epublished ahead of print, doi: 10.1093/scan/nst105
BakkerC. et al. (2013). The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: a two-year follow-up study. International Psychogeriatrics. Epublished ahead of print, doi:
BlackB. S. and RabinsP. V. (2007). Qualitative research in psychogeriatrics. International Psychogeriatrics, 19, 167173.
CarletonR. N. et al. (2013). The center for epidemiologic studies depression scale: a review with a theoretical and empirical examination of item content and factor structure. PLoS One, 8, e58067.
CharmazK. (2006). Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis. London: Sage.
CorbinJ. and StraussA. (2007). Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Thousand Oaks, CA: SAGE Publications, Inc.
CummingsJ. L., MegaM., GrayK., Rosenberg-ThompsonS., CarusiD. A. and GornbeinJ. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 23082314.
Diehl-SchmidJ. et al. (2013). Caregiver burden and needs in frontotemporal dementia. Journal of Geriatric Psychiatry and Neurology, 26, 221229.
EavesY. D. (2001). A synthesis technique for grounded theory data analysis. Journal of Advanced Nursing, 35, 654663.
GhoshA., DuttA., BhargavaP. and SnowdenJ. (2013). Environmental dependency behaviours in frontotemporal dementia: have we been underrating them? Journal of Neurology, 260, 861868.
GlaserB. G. (1992). Basic of Grounded Theory Analysis. Mill Valley, CA: Sociology Press.
GraceJ. and MalloyP. F. (2001). Frontal Systems Behavior Scale Professional Manual. Lutz, FL: Psychological Assessment Resources.
HanS., NorthoffG., VogeleyK., WexlerB. E., KitayamaS. and VarnumM. E. (2013). A cultural neuroscience approach to the biosocial nature of the human brain. Annual Review of Psychology, 64, 335359.
JoshiA., BarsugliaJ. P., MatherM. J., JimenezE. E., ShapiraJ. and MendezM. F. (2014). Evaluation of emotional blunting in behavioral variant frontotemporal dementia compared to Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 38, 7988.
LoGiudiceD. and HassettA. (2005). Uncommon dementia and the carer's perspective. International Psychogeriatrics, 17 (Suppl 1), S223231.
MagaiC. and CohenC. I. (1998). Attachment style and emotion regulation in dementia patients and their relation to caregiver burden. Journal of Gerontology, 53B, 147154.
MendezM. F. and LimG. T. (2004). Alterations of the sense of “humanness” in right hemisphere predominant frontotemporal dementia patients. Cognitive and Behavioral Neurology, 17, 133138.
MendezM. F. and ManesF. (2011). The emerging impact of social neuroscience on neuropsychiatry and clinical neuroscience. Social Neuroscience, 6, 415419.
MendezM. F. and ShapiraJ. S. (2011). Loss of emotional insight in behavioral variant frontotemporal dementia or “frontal anosodiaphoria”. Consciousness and Cogniton, 20, 16901696.
MendezM. F., PerrymanK. M., MillerB. L. and CummingsJ. L. (1998). Behavioral differences between frontotemporal dementia and Alzheimer's disease: a comparison on the BEHAVE-AD rating scale. International Psychogeriatrics, 10, 155162.
MendezM. F., LauterbachE. C., SampsonS. M. and Research, A. C. O. (2008). An evidence-based review of the psychopathology of frontotemporal dementia: a report of the ANPA Committee on Research. Journal of Neuropsychiatry and Clinical Neuroscience, 20, 130149.
MendezM. F. et al. (2013a). Observation of social behavior in frontotemporal dementia. American Journal of Alzheimers Disease and Other Dementias. Epublished ahead of print, doi: 10.1177/1533317513517035
MendezM. F., JoshiA., TassniyomK., TengE. and ShapiraJ. S. (2013b). Clinicopathologic differences among patients with behavioral variant frontotemporal dementia. Neurology, 80, 561568.
NunnemannS., KurzA., LeuchtS. and Diehl-SchmidJ. (2012). Caregivers of patients with frontotemporal lobar degeneration: a review of burden, problems, needs, and interventions. International Psychogeriatrics, 24, 13681386.
O’BryantS. E. et al. (2010). Validation of the new interpretive guidelines for the clinical dementia rating scale sum of boxes score in the national Alzheimer's coordinating center database. Archives of Neurology, 67, 746749.
PardiniM. et al. (2013). Isolated theory of mind deficits and risk for frontotemporal dementia: a longitudinal pilot study. Journal of Neurology, Neurosurgery, and Psychiatry, 84, 818821.
PassantU., ElfgrenC., EnglundE. and GustafsonL. (2005). Psychiatric symptoms and their psychosocial consequences in frontotemporal dementia. Alzheimer Disease and Associated Disorders, 19 (Suppl 1), S1518.
PfefferR. I., KurosakiT. T., HarrahC. H.Jr., ChanceJ. M. and FilosS. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323329.
RankinK. P., KramerJ. H. and MillerB. L. (2005). Patterns of cognitive and emotional empathy in frontotemporal lobar degeneration. Cognive and Behavioral Neurology, 18, 2836.
RankinK. P., Santos-ModesittW., KramerJ. H., PavlicD., BeckmanV. and MillerB. L. (2008). Spontaneous social behaviors discriminate behavioral dementias from psychiatric disorders and other dementias. Journal of Clinical Psychiatry, 69, 6073.
RascovskyK. et al. (2011). Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain, 134, 24562477.
RosenH. J. et al. (2006). Neuroanatomical correlates of impaired recognition of emotion in dementia. Neuropsychologia, 44, 365373.
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International Psychogeriatrics
  • ISSN: 1041-6102
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