International Psychogeriatrics

Research Article

Observational themes of social behavioral disturbances in frontotemporal dementia

Joseph P. Barsugliaa1 c1, Frances R. Nedjat-Haiema1, Jill S. Shapiraa1a2, Christina Velascoa2, Elvira E. Jimeneza1a2, Michelle J. Mathera1a2 and Mario F. Mendeza1a2a3

a1 Veterans Health Administration Greater Los Angeles Healthcare System, Neurobehavior Service (116AF), Los Angeles, California, USA

a2 Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California

a3 Department of Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California


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.

Methods: 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.

Results: 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.

Conclusion: 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.

(Received January 23 2014)

(Reviewed March 03 2014)

(Revised March 22 2014)

(Accepted April 18 2014)

(Online publication May 20 2014)

Key words:

  • Behavioral variant frontotemporal dementia;
  • social behavior in dementia;
  • observational study;
  • intersubjectivity in dementia;
  • early onset dementia


c1 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.