摘要:

This article describes the complex processes involved in evaluating safety, judgment, and risk after brain injury. Starting with a review of common risk factors after onset, the article then moves to a discussion of the dilemmas faced by family members and clinicians alike when determining the individual's level of risk. Numerous suggestions are offered to identify support system concerns and to establish specific barriers to independence. The need to adopt a systematized approach to empirically verifying concerns about safety is emphasized, in addition to utilizing therapeutic interventions that are sensitive to the individual's learning capacity, psychological status, and environmental influences. The article concludes with examples of how to structure support for individuals who present with ongoing risk factors but still need to experience greater levels of personal freedom.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objectives:To document service utilization by people with a traumatic brain injury at different times postinjury and to identify factors that predict service use.Design:Cross-sectional study design. Four groups of subjects were randomly selected from a regional database, according to their time postinjury: 6–18 months; 2–4 years; 6–9 years; and 10–17 years.Subjects:A total of 119 adults with a traumatic brain injury (TBI).Setting:Hospital and community-based clients in Sydney, Australia.Outcome measures:Glasgow Outcome Scale, Disability Rating Scale; Functional Independence Measure; Lidcombe Psychosocial Disability Scale; number, type, and frequency of services used in the previous 12 months.Results:Subjects in all four groups used a variety of services. The mean number of services used was 4.2, and there was only a moderate decline in service use over time. The use of medical and allied health services remained high in all four groups. Severity of injury, physical and cognitive disability, and psychosocial disability were all predictors of service utilization. Psychosocial disability was strongly associated with ongoing service utilization.Conclusion:In this study, people with TBI used services well beyond the early stage of recovery. Psychosocial disability may be a better predictor of service use than physical and cognitive disability alone.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:To investigate whether college students with a history of mild traumatic brain injury (TBI) in childhood or adolescence show residual deficits in intellectual functioning, approaches to studying, or emotional stability.Design:Participants with a history of mild TBI and two control groups.Setting:Volunteers were recruited from students taking an introductory psychology course.Participants:79 students with a history of mild TBI, 75 students with a history of general anesthesia, and 93 students with no history of either TBI or general anesthesia.Main Outcome Measures:Participants carried out tests of verbal memory, nonverbal memory, verbal fluency, and nonverbal fluency; in addition, they completed a short form of the Approaches to Studying Inventory and the Symptom Checklist-90—Revised (SCL-90-R).Results:In comparison with the two control groups, the students with a history of mild TBI produced similar scores on the cognitive tests and similar orientations to studying. However, they showed a significantly higher level of emotional distress on the SCL-90-R.Conclusion:College students with a history of mild TBI in childhood or adolescence are intellectually unimpaired and approach their studying in a similar manner to their uninjured classmates. Nevertheless, they report more severe distress in terms of their general personal and emotional functioning.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Design:The current study compared the Symptom Checklist 90—Revised (SCL-90-R) results from a population of 88 individuals with traumatic brain injury (TBI) to those of a normative group.Setting:Individuals with traumatic brain injury referred to a university-based psychology clinic.Results:Results corroborated those from a smaller study,1where a considerable proportion of the elevations found on the subscales was attributed to endorsement of items identified as having a neurological basis.Conclusion:This reinforces the view that the results of neurological groups on clinical measures of emotional distress that have been standardized on physically healthy populations can be distorted because many of the items can be answered from physical and emotional perspectives.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objectives:To investigate coping strategies in relation to emotional adjustment in individuals with traumatic brain injury (TBI) 1–5 years postinjury and to compare these with a group of 40 participants who sustained serious orthopedic injuries.Design:Participants completed measures of handicap and coping strategies, and rated their levels of depression, anxiety, and self-esteem on standardized questionnaires.Setting:Participants had received inpatient rehabilitation at Bethesda Hospital 1–5 years prior to completing questionnaires. They were recruited from a list of consecutive admissions.Participants:88 TBI individuals were compared with 40 participants who had sustained serious orthopedic injuries without damage to the central nervous system. They had all been involved in motor vehicle or work-related accidents.Outcome Measures:Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI).Results:Consistent with previous studies; a significant proportion of the current sample displayed high levels of emotional distress. Results showed few differences between the TBI and orthopedic groups. Coping strategies characterized by worry, wishful thinking, and self-blame were associated with higher levels of depression and anxiety in both groups. Strategies focusing on problem solving and having a positive outlook were related to lower anxiety levels, but to a lesser degree.Conclusions:This study has provided further evidence that coping strategies are associated with emotional outcome in TBI individuals. There is now a growing empirical basis on which preliminary interventions can be based.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objective:To develop a service-relevant, suicide prevention strategy based on the perspectives of people with brain injuries and their family members.Design:Structured interview-based, qualitative case design.Setting:Interviews were conducted in the context of community-based brain injury rehabilitation service delivery.Participants:Ten persons with moderate to severe brain injuries who exhibited suicidal orientations and four family member/carers of these participants.Results:Qualitative analysis of interview transcripts revealed a number of relevant themes. The primary theme was that informal relationships play a key role in preventing suicide. Secondary themes included the potential role of specialist brain injury rehabilitation services in suicide prevention and the need for provision of more information about brain injury to family and friends to promote understanding.Conclusions:Some discrepancy was noted between the perspectives of people with brain injuries and family members. The need for multiple strategies to respond to suicide risk was reinforced. Service-relevant resources (suicide risk screen, contract, and brochure) have been developed and included in service delivery.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

This article presents a new approach to the remediation of memory deficits by studying the electrophysiological functioning involved in memory and applying biofeedback techniques. A Quantitative EEG (QEEG) activation database was obtained with 59 right-handed subjects during two auditory memory tasks (prose passages and word lists). Memory performance was correlated with the QEEG variables. Clinical cases were administered the same QEEG activation study to determine their deviations from the values that predicted success for the reference group. EEG biofeedback interventions were designed to increase the value (to normal levels) of the specific electrophysiological variable that was related to successful memory function and deviant in the subject. Case examples are presented that indicate the successful use of this intervention style in normal subjects and in subjects with brain injury; improvement cannot be fully explained by spontaneous recovery, given the time postinjury. Five cases (two normal, two subjects with brain injury, and one subject who had stereotactic surgery of the hippocampus for seizure control) are presented. Improvements ranged from 68% to 181% in the group of patients with brain injury, as a result of the interventions.

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:2000

数据来源: OVID