Women's experience of brain injury: An interpretative phenomenological analysis

Acquired traumatic brain injury (TBI) can leave the survivor with a complex range of psychological sequalae. This study aims to investigate the experience from the perspective of women with acquired TBI. Using a qualitative research method, six women with a TBI were interviewed about their experience, and the interviews were transcribed verbatim and analysed according to Interpretative Phenomenological Analysis (IPA). The major themes that emerged were: awareness of change; the emotional reaction; struggling to make sense; adaptation and acceptance. This article describes the process of adaptation, and the implications for rehabilitation are discussed. It is suggested that an intervention based on these themes might be an effective tool in rehabilitation.     

The Rationality of Ultimate Concern: Moral Exemplars,Theological Ethics,and the Science of Moral Cognition

This paper argues that consideration of moral exemplars may provide a means for integrating insights across philosophical ethics, theological ethics, and the scientific study of moral cognition. Key to this endeavor is an understanding of the relation of cognition and emotion in ethical decision-making, a relation that is usually understood to be oppositional but which in proper circumstances may be understood to be quite the opposite. Indeed, a distinctive feature of moral exemplarity may consist in the ability to properly integrate the emotions into the moral life, and reference to and imitation of exemplars may involve a referencing and imitating of the emotions of the exemplar.     

Frontal and parietal lobe involvement in the processing of pretence and intention

We assessed whether different processes might be at play during pretence understanding by examining breakdowns of performance in participants with acquired brain damage. In Experiment 1 patients with frontal or parietal lesions and neurologically intact adults were asked to categorize videos of pretend and real actions. In Experiment 2 participants saw three types of videos: real intentional actions, real accidental actions, and pretend actions. In one session they judged whether the actions they saw were intentional or accidental, and in a second session they judged whether the actions were real or pretend. Parietal patients had particular difficulties in the identification of pretend actions, and both parietal and frontal patients were more impaired than controls in understanding the intentional nature of pretence. Analyses of individual patients’ performance revealed that parietal lesions, and in particular lesions to the temporo-parietal junction, impaired the ability to discriminate pretend from real actions. However, this did not necessarily affect the discrimination of intentional from unintentional actions, which instead may be independently disrupted by damage to frontal areas. Moreover, spared ability to discriminate pretend actions from real actions, and intentional actions from accidental actions, did not grant a full conceptual understanding of the intentional nature of pretence. The implications for pretence understanding are discussed.     

Increasing Behavioral Skills and Level of Understanding in Adults: A Brief Method Integrating Dennison's Brain Gym & #x00AE; Balance with Piaget's Reflective Processes

A single session intervention was given individually to 4 adults in order to assist them in achieving their personal goals by improving their behavioral skills for achieving the goals and their conceptual understanding of & #x201C;how to & #x201D; attain these goals. The method was based on a brain-ability analysis of understanding & #x201C;conservation & #x201D; on Jean Piaget's conservation tasks combined with Paul and Gail Dennison's Brain Gym & #x201C;balance & #x201D; procedure. My & #x201C;whole brain understanding & #x201D; model (C. A. Wolfsont, 1999, 2000) and M. L. Commons et al.'s Hierarchical Complexity Scoring System manual were used to analyze the verbal protocols (M. L. Commons et al., 1992; Commons, Danaher, & Meaney, 2000). Increases were found in the participants' conceptual understanding and in the complexity of their performance.     

Neurocognitive outcomes following pediatric brain injury: A developmental approach

Developmental neuropsychologists postulate that “immaturity” of the cerebral cortex should no longer be perceived as a protective factor. They argue that injury to the young brain may affect new learning by disrupting the skills in the midst of being acquired and skills that are yet to be developed. Cognitive deficits or weaknesses that are not detectable in the acute phase following a traumatic brain injury (TBI) may emerge over development as more complex skills are needed, thereby creating a developmental lag between children who sustained a pediatric TBI and typical age peers. This literature review was conducted to evaluate the developmental perspective on neurocognitive recovery/development following a TBI. Overall, the described findings support a developmental view and suggest that predictions of prognosis should be based on the child's remaining ability to learn.     

An organizing model for recent cognitive science work on the self

An organizing model of ‘the self’ emerges from applying various kinds of brain injury to recent cognitive science and philosophical work on ‘the self’. This model unifies various contents and mechanisms central to current notions of the self. The article then highlights several criteria and aspects of this notion of self. Qualities of the right type and level of psychological significance delineate ‘the self’ as an organizing concept useful for recent philosophical work and cognitive science research.     

Survival from the Brain's Perspective

The concern about man's harmful impact on the environment focuses attention on the external environment, i.e., the real world out there, which may not survive in a form to support life. But supporting life of an individual is in the hands of that individual's brain, which is primarily concerned with various needs of the internal environment, also referred to as the self. Confronted with diverse and often competing needs, the brain has evolved a complexity in man, which makes it doubtful that any one collective strategy may be effective in preserving the external environment.     

Dynamic testing of learning potential in adults with cognitive impairments: A systematic review of methodology and predictive value

Dynamic testing includes procedures that examine the effects of brief training on test performance where pre‐ to post‐training change reflects patients’ learning potential. The objective of this systematic review was to provide clinicians and researchers insight into the concept and methodology of dynamic testing and to explore its predictive validity in adult patients with cognitive impairments. The following electronic databases were searched: PubMed, PsychINFO, and Embase/Medline. Of 1141 potentially relevant articles, 24 studies met the inclusion criteria. The mean methodological quality score was 4.6 of 8. Eleven different dynamic tests were used. The majority of studies used dynamic versions of the Wisconsin Card Sorting Test. The training mostly consisted of a combination of performance feedback, reinforcement, expanded instruction, or strategy training. Learning potential was quantified using numerical (post‐test score, difference score, gain score, regression residuals) and categorical (groups) indices. In five of six longitudinal studies, learning potential significantly predicted rehabilitation outcome. Three of four studies supported the added value of dynamic testing over conventional testing in predicting rehabilitation outcome. This review provides preliminary support that dynamic tests can provide a valuable addition to conventional tests to assess patients’ abilities. Although promising, there was a large variability in methods used for dynamic testing and, therefore, it remains unclear which dynamic testing methods are most appropriate for patients with cognitive impairments. More research is warranted to further evaluate and refine dynamic testing methodology and to further elucidate its predictive validity concerning rehabilitation outcomes relative to other cognitive and functional status indices.     

Relationships between factors of intelligence and brain volume

The recent explosion of studies aimed at determining the biological basis of intelligence has revealed that cognitive ability has a strong biological substrate. This study expands on this literature by examining the relation between cognitive ability and MRI-measured brain volume and head size in a sample of adult male siblings recruited from the London, Ontario community in Canada. It was found that brain volume correlated with IQ at 0.35 (P<0.01), thus replicating the results of past studies. Corrections for restriction of range and attenuation in both this and past studies suggest that the population value of the brain volume-IQ correlation is closer to 0.50. Head size variables, with one exception, also showed the expected positive correlations with IQ. The results of a vector analysis on factor scores indicated that the more highly g-loaded a test was the more highly it correlated with brain volume (r=0.59, P<0.01). The sum of the data suggested that although brain volume (and to a lesser extent, head size) is predictive of g, fluid ability, and memory, it does not predict crystallized ability. Unexpectedly, the higher the spatial imaging loading of a test, the less its correlation with brain volume (vector correlation=−0.84, P<0.001).