摘要:

This paper presents a conceptual model describing the relationships between quality of life outcomes following traumatic brain injury (TBI), coping patterns, and beliefs regarding self-efficacy to assist health-care professionals in understanding the complexity of social and psychological sequelae of TBI. The model hypothesizes that long-lasting cognitive, behavioural, emotional psychiatric, and interpersonal after-effects of TBI may create a real life 'learned helplessness' with consequent deficits in coping, and altered locus of control beliefs. As a result, TBI patients are at risk for developing self-limiting belief systems about their effectiveness in altering significant events that may result in over-generalizing the effects that TBI has in their day-to-day lives. Subsequently, a feedback loop may be set up where their beliefs in not being able to influence outcomes are not tested, life chances are further restricted, outcomes are suboptimal, and quality of life is reduced. The clinical and theoretical implications of this model are discussed, and an expanded model with future research directions is suggested.

ISSN:0269-9052    

DOI:10.3109/02699059509008185

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The present study investigated the influence of a man's brain injury on both his and his wife's self-concept and perception of marital vulnerability. Thirty-six couples in which the husbands had brain damage and twenty-nine couples without disability filled out the Tennessee Self-concept Scale [1], and the Marital Vulnerability Scale [2]. Marital vulnerability of husbands with brain damage was found not to differ from that of the husbands in the control group. However, the marital vulnerability of the wives of the former husbands was lower than that of the other wives. Both men with brain damage and their wives exhibited a decrease in self-esteem and an increase in conflict and pathology. Brain damage appears to affect both the extent and direction of the relations between aspects of the self-concept and marital vulnerability differentially for husbands with brain damage and their wives. Practical and theoretical implications of the negative impact of brain damage upon the person with the damage, upon his wife, and upon their marital relationship are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059509008186

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Fifty-four patients with traumatic brain injury (TBI) consecutively admitted to a rehabilitation hospital were examined 2 years post-injury. Social interaction and support, subjective complaints, and functional status were assessed. A large variability in social interaction and support patterns was found. Most patients had more interaction and received more support from family members than from friends and neighbours. Thirty-one patients (57-4%) reported that their social networks had markedly declined subsequent to injury. Relatively short duration of coma (>1 week) and severe sequelae in terms of low functional status and poor emotional adjustment at follow-up, especially in terms of deficits in initiating behaviour, were found to be related to little interaction and support. The importance of both provider and patient initiative in order to establish and preserve a social support network is suggested, and clinical implications briefly discussed.

ISSN:0269-9052    

DOI:10.3109/02699059509008187

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Perseveration refers to the inappropriate continuation or repetition of a response or activity. It is associated with a variety of neurological disorders and, when pronounced, is thought to be pathognomonic of brain damage. Perseveration manifests itself in several different forms which have had various labels applied, and many hypotheses have been proposed to explain the mechanisms underlying these perseverative behaviours. In this article we review descriptions and classifications of perseveration as it occurs in various neurological disorders, and then discuss some of the neurobehavioural and neuropathological mechanisms thought to account for it.

ISSN:0269-9052    

DOI:10.3109/02699059509008188

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This study examines the nature and extent of perseveration in 15 individuals with closed-head injury (CHI) by (a) identifying and describing the types of perseveration that occurred on verbal and non-verbal tasks, (b) examining the possible underlying neuropsychological mechanisms of perseverative behaviour and (c) exploring neuroanatomical correlates of perseveration. Performance of the 15 CHI patients was compared with 15 neurologically normal subjects matched for sex, age, handedness and educational level. The CHI subjects produced significantly more perseverations than did normals, and 'recurrent' perseveration was the most frequently occurring type. A test of verbal learning elicited the greatest number of recurrent perseverations. Overall test performance of the CHI group suggested that memory dysfunction and impaired attention were most likely responsible for perseverative errors. CT scan analyses showed that the three most perseverative CHI subjects evidenced left temporal lobe damage.

ISSN:0269-9052    

DOI:10.3109/02699059509008189

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The present study extended the utilization of developmental models of social cognition to the investigation of stress and relatives' perception of traumatic brain injury (TBI) survivors. Structured interviews were conducted with 21 TBI survivors utilizing interpersonal negotiation strategies (INS) and self understanding (self) in the framework of Selman's model of social perspective-taking and Damon and Hart's multidimensional model of self understanding. A relative group composed of 21 participants was interviewed and their predictions of the responses of the TBI survivors to the action domain of the INS stories were obtained. The relative participant group was also administered the Beck Anxiety and Depression Inventories and Leeds Scales of Depression and Anxiety. The relationships among relative groups' predictive scores, INS and self domains and stress levels were analysed. The result of the survivor groups responses on INS and self were in agreement with the previous findings that TBI survivors respond at psychosocially immature levels. Comparison of INS action scores obtained by the survivor group and predicted by relative group were within one developmental level of each other in 874% of the cases. Fifty-two per cent of the relative group scored in mild to moderate or greater depression and 48% scored in the mild to moderate range of anxiety on the Beck scales. Pearson correlation coefficients indicated significant negative correlations between Beck scores and predictive INS scores. ANOVA indicated significantly higher Beck depression scores in relatives of TBI survivors living in residential facilities than relatives of TBI survivors in an outpatient treatment programme. The study supports the view that developmental social cognition methods appear to advance our understanding of psychosocial adjustments and relatives' perceptions of social cognition in TBI survivors.

ISSN:0269-9052    

DOI:10.3109/02699059509008190

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Two hundred and sixty-three consecutive head-injured patients aged over 65 years, admitted to a neurosurgical service, are reported. In contrast to younger age group the main cause was falls concomitant with a high rate of cardiovascular pre-existing disorders. The distribution of causes and grim results justify, in our opinion, regarding head injury in the elderly as a distinct entity requiring special surgical, medical, organizational and ethical considerations.

ISSN:0269-9052    

DOI:10.3109/02699059509008191

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The classification systems currently utilized to categorize closed-head injury (CHI) patients are all based on severity levels. However, these scales are unable to account for the wide variability among CHI patients. Another way to classify these patients is to use the clinical picture independent of the overall severity level. That approach is used with aphasic patients but not with the CHI population. These preliminary data indicate that there are distinct subgroups in the CHI population. These subgroups can be identified by their overall pattern of performance on a battery of tests covering language, memory, visuospatial, cognitive and discourse skills. The characteristics of the tentative subgroups are described, but a more extensive study is needed to confirm the robustness of this classification.

ISSN:0269-9052    

DOI:10.3109/02699059509008192

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Motor Speech Disorders: Advances in Assessment and Treatment. Edited by J. A. Till, K. M. Yorkston and D. Beukelman (Paul H. Brookes, Baltimore, London, Toronto&Sydney, 1994) ISBN 1-55766-137-5 [pp. 260]. $38.00.Brain Injury and Neuropsychological Rehabilitation: International Perspectives. By Anne-Lise Christensen and Barbara P. Uzzell (Lawrence Erlbaum Associates, Hillsdale, New Jersey; Hove, United Kingdom, 1994) [Pp. 341].Communication-Based Intervention for Problem Behavior. A User's Guide for Providing Positive Change. By E. G. Carr, L. Levin, G. Mcconnachie, J. I. Carlson, D. C. Kemp and C. E. Smith (Paul H. Brookes, Baltimore, MD 21285, 1994) [Pp. 251].Communication-Based Intervention for Problem Behavior is a great book, and is worthwhile reading.

ISSN:0269-9052    

DOI:10.3109/02699059509008193

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor