A taxonomy of neurobehavioral functions applied to neuropsychological assessment after head injury

Neuropsychological dysfunctions after traumatic brain injury are classified into a taxonomy to plan a comprehensive examination, and organize and report findings for diagnosis and treatment: consciousness, information processing, sensorimotor, neurophysiological, cerebral personality disorders, intelligence, memory, language, stress, psychodynamic, identity and weltanschauung, adaptation, complex adaptive functions, and development of children. Widerange sampling enhances the detection of acute and late-developing dysfunctions, and diagnosis of complex syndromes. Historical, personality, and injury data are components of the assessment. Issues discussed include underestimation of brain injury, malingering, interaction of symptoms, symptom persistence, and noncerebral lesional contributors to impairment after mild head injury.     

Relative absence of neuropsychological deficit in patients with low grade astrocytomas

Given the current accuracy and precision of modern brain imaging technology, there is presumed to be little utility in neuropsychological assessment procedures in patients with brain tumors. The primary exposure of many clinical neuropsychologists to patients with brain tumors is during their training, in the form of didactic classroom activities, such as reviewing the brain tumor cases of early investigators in the field. Historically, these brain tumors were the more aggressive and destructive tumors, such as grade III and IV astrocytomas, that could be identified with pre CT and pre MRI technology. With current imaging technology, low grade tumors that might previously have gone undiagnosed for years can be detected and patients followed over time. This series of cases represents documentation of the very unique neuropsychological status of patients with relatively slow growing, infiltrative brain tumors classified as grade II astrocytomas. The potential relevance of neuropsychological assessment for such cases is discussed.     

To drive or not to drive: Neuropsychological assessment for driver's license among stroke patients

Seventy-two stroke patients, 43 with right hemisphere (RHD) and 29 with left hemisphere damage (LHD), and 7 coronary infarct controls with no evidence of cerebral damage, were neuropsychologically tested as part of an assessment program for driver's license. Mean age in the group was 53 years. Stroke patients were tested on average 4 months post injury. The groups did not differ on major demographic variables except that RHD patients were more often hemiplegic than LHD patients. The test battery was factor analyzed into 4 valid principal components: (I) visual perception , (II) spatial attention , (III) visuospatial processing , and (IV) language/praxis. The presence of hemianopia (factor I) excludes driving. In addition, measures of neglect and reduced speed of mental processing from factor II, III and IV, were found to be the most discriminating variables when classifying patients for driving. Even though neglect was more frequently observed among RHD than LHD patients, the two hemisphere groups did not differ significantly in number of patients denied driving, 58% RHD compared to 41% LHD patients. The need for comprehensive neuropsychological assessment is underlined.     

A prework assessment of task preferences among adults with autism beginning a supported job

A prework paired-task assessment was evaluated for identifying work preferences among 3 adults with autism beginning a supported job. When the workers began the job, choices were provided between more and less preferred tasks (determined by previous assessment). Results supported the assessment for identifying single task preferences, but did not reveal preferences of 2 workers for alternate tasks. Results are discussed in terms of evaluating other prework assessments that may reveal task-alternation preferences.     

Episodes of momentary resilience in daily life are associated with HRV reductions to stressful operations in firefighters: an ambulatory assessment approach using bayesian multilevel modeling

ABSTRACT

Background: Resilience is discussed to constitute a protective buffer against stress, thus fostering health. Methods: This study aimed to assess resilience both via traditional questionnaire and in everyday life on a momentary basis, and to relate these measures to autonomic functioning (heart rate variability, HRV) in 38 male firefighters during a weekday. Stressful operations, non-stressful operations and routine work at the firestation were coded during 24 hours. Momentary negative affect, feelings of resilience, and HRV were recorded via ecological momentary assessment. Findings: Questionnaire-assessed resilience was significantly positively associated with aggregated momentary resilience (r = .58, p < .001), but unrelated to HRV. However, controlling for multiple confounders (e.g., age, smoking, bodily movement, waist-to-height ratio) momentary resilience was associated with attenuated HRV and lower negative affect during stressful encounters only. Discussion: The findings suggest that momentary feelings of resilience are accompanied by vagal withdrawal to stress, possibly indicating psychological flexibility and adaptive responding to stress.     

Positive factors associated with quality of life among Chinese patients with renal carcinoma: a cross-sectional study

Quality of life and positive psychological variables has become a focus of concern in patients with renal carcinoma. However, the integrative effects of positive psychological variables on the illness have seldom been reported. The aims of this study were to evaluate the quality of life and the integrative effects of hope, resilience and optimism on the quality of life among Chinese renal carcinoma patients. A cross-sectional study was conducted at the First Hospital of China Medical University. 284 participants completed questionnaires consisting of demographic and clinical characteristics, EORTC QLQ-C30, Adult Hope Scale, Resilience Scale-14 and Life Orientation Scale-Revised from July 2013 to July 2014. Pearson’s correlation and hierarchical regression analyses were performed to explore the effects of related factors. Hope, resilience and optimism were significantly associated with quality of life. Hierarchical regression analyses indicated that hope, resilience and optimism as a whole accounted for 9.8, 24.4 and 21.9% of the variance in the global health status, functioning status and symptom status, respectively. The low level of quality of life for Chinese renal carcinoma patients should receive more attention from Chinese medical institutions. Psychological interventions to increase hope, resilience and optimism may be essential to enhancing the quality of life of Chinese cancer patients.     

Effects of guided imagery with relaxation training on anxiety and quality of life among patients with inflammatory bowel disease

Background: Inflammatory Bowel Disease (IBD) impacts quality of life (QoL). Psychological factors influence the course of the disease and should be targeted for intervention.

Methods: Our study was a prospective, randomised control trial. Fifty-six outpatients were randomly chosen and allocated to a treatment group or a waiting-list control group. Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice. Evaluations performed pre and post-treatment: state anxiety was assessed with the State-Trait Anxiety Inventory, QoL with the IBD Questionnaire. The Visual Analogue Scale assessed pain, depression, stress and mood. Patients completed a symptom monitoring diary. The control group's symptoms were monitored without study-related treatment.

Results: Thirty-nine subjects completed the study and were included in the data analysis. Following the relaxation-training intervention, the treatment group's (n?=?18) measured results showed a statistically significant improvement as compared to the control group (n?=?21) (time by treatment interaction): anxiety levels decreased (p?<?0.01), QoL and mood improved (p?<?0.05), while levels of pain and stress decreased (p?<?0.01).

Conclusions: Findings indicate IBD patients may benefit from relaxation training in their holistic care. New studies as well as further investigation of the subject are warranted.     

动态测验对“数学学习困难”儿童的进一步甄别

本研究意在考查动态测验对数学学习困难儿童作进一步程度区分的有效性。以传统且常用的数学学习困难鉴别方式和标准选取30名四年级数学学习困难儿童为实验组,30名同年级智力匹配儿童为对照组,以Swanson认知加工测验(S-CPT)的4个子测验为测量工具对被试进行动态测验。结果发现：(1)在传统数学学习困难鉴别方式的基础上,动态测验的“潜在认知能力”指标可以对儿童数学成绩增加19%的预测力;(2)以“潜在认知能力”指标为依据能够将数学学习困难儿童进一步区分为“发展落后”和“发展缺陷”两个水平;(3)“发展落后”儿童一年内数学成绩发生了增长性变化,与正常儿童水平相当,而“发展缺陷”儿童的数学成绩没有变化。研究证实关注潜能指标的动态测验范式在快速、准确甄别数学学习困难儿童上具有独特效用。