Prevalence of traumatic brain injury in an inpatient psychiatric population

This study investigated the prevalence of traumatic brain injury (TBI) in an inpatient psychiatric population. We hypothesized increased prevalence of TBI relative to the general population due to a variety of risk factors observed in psychiatric patients. One hundred (mean age = 34) psychiatric inpatients completed the revised Head Injury Questionnaire. Chart review of 17 subjects reporting injuries established whether injuries were documented in medical records. Sixty-eight percent of this psychiatric population reported one or more injuries in which they were unconscious or dazed. This number is higher than the prevalence in the general population. Injuries were generally of mild to moderate severity; multiple injuries were common. Chart review of 17 subjects reporting TBI indicated that histories of TBI had not been noted in the medical record. Finally, 63% of TBI subjects reported that their injury predated the onset of their psychiatric symptoms. These results suggest a possible role of TBI in psychiatric symptomatology and have implications for psychiatric treatment in this population.     

Behavioral assessment and treatment of acquired visuoperceptual disorders

Visuoperceptual deficits are common sequelae of damage to either hemisphere of the brain, but are typically more pronounced following injuries involving the right cerebral hemisphere. Common visuoperceptual disorders include visual field cuts, hemi-inattention and hemi-spatial neglect, hemi-perceptual deficits, and gaze and visual pursuit disturbances. A number of behavioral interventions have been developed to teach patients to compensate for acquired visual deficits. Studies addressing assessment and treatment issues in this area are reviewed, and future directions for research are outlined.     

Parental defense style and child competence: A match-mismatch hypothesis

This study sought to explore the possible relationship between parental style of psychological defense and children's social competence in 50 families in which one parent had been hospitalized for a psychiatric disorder. Based upon a formal analysis of the logical transformations inherent in various defense mechanisms, three levels of complexity of defenses were identified, along with a counterpart set of cognitive operations necessary for decoding these defense levels. It was hypothesized that children lacking the requisite cognitive skills to grasp the logical complexities of their disturbed parent's primary mode of psychological defense would be less socially adjusted and judged less competent than children who could understand the defensive transformations of their parent. The results suggested that children who, due to their cognitive immaturity, are potentially     

Methodological and theoretical issues in neuropsychological assessment

While there are philosophical and theoretical differences between neuropsychologists and behavior therapists, it is suggested that a significant reconciliation can be achieved in regard to assessment and treatment of the brain-damaged patient. While brain damage is often viewed as an irreversible disorder, there is evidence that substantial recovery of function can occur, particularly when adequate retraining is provided. There are practical and empirical considerations that suggest that neuropsychological tests are currently the best tools available for behavioral assessment of brain-damaged patients. However, the results of these tests can be used not only diagnostically but also to identify target behavioral deficits that may be rehabilitated through systematic retraining efforts. Such rehabilitation efforts can be optimally planned, implemented, and evaluated through an alliance between the neuropsychologist, who identifies the ability and deficit pattern, and the behavior therapist, who devises and evaluates the retraining program. It is possible that the successes of behavior therapy in numerous clinical and educational applications can be repeated in the cases of brain-damaged patients. However, such success would appear to be contingent on appreciation of the high degree of specificity often seen in neurological deficit patterns and the great complexities involved in the relationships between brain function and behavior.     

Individual and Dyadic Coping and Fear of Progression in Mothers and Fathers of Children with Hematologic Cancer

This study investigated the association of individual and dyadic coping strategies with fear of progression (FoP) in mothers and fathers of children with hematologic cancer. Parental couples (N = 44) whose children had been diagnosed with hematologic cancer were recruited at a university hospital and a rehabilitation clinic in Germany between 03/2017 and 08/2017. Data included parents' self-report on FoP (Fear of Progression Questionnaire—parent version, FoP-Q-SF/PR), individual coping (Coping Health Inventory for Parents, CHIP-D), and dyadic coping (Dyadic Coping Inventory, DCI). Statistical analyses were carried out for mothers and fathers individually as well as for parental couples using dyadic data analyses (e.g., actor-partner interdependence model, APIM). Individual and dyadic coping strategies were significantly correlated with FoP in mothers, but not in fathers. Fathers' evaluation of the couple's dyadic coping significantly predicted mothers' FoP. The more frequent use of familial integration (CHIP-D FAM) and maintaining social support (CHIP-D SUP) as well as a better evaluation of their partners' dyadic coping was significantly associated with lower FoP in mothers. Differences in individual and dyadic coping in parental couples were not associated with FoP. Individual and dyadic coping strategies should be addressed in the psychosocial care of mothers and fathers of children with hematologic cancer. Study results support the benefits of involving fathers in psychosocial interventions, for example, in couple-based interventions that acknowledge interpersonal effects of coping on FoP. Future research should further explore coping strategies applied by fathers of children with hematologic cancer for the regulation of FoP.     

Neurocognitive Functioning in Posttraumatic Stress Disorder

This paper reviews the literature on performance on standard neuropsychological tests among individuals with posttraumatic stress disorder (PTSD). Of 19 studies, 16 reported impairment of attention or immediate memory (or both); however, most of these studies included PTSD patients with significant psychiatric comorbidity, so that the extent to which the observed deficits are specifically attributable to PTSD remains unclear. Other potential confounds, including medical illness, substance abuse, and motivational factors, further preclude definitive conclusions at present. Results of structural and functional neuroimaging studies of PTSD are also summarized. Two studies have reported correlations between hippocampal volume and cognitive findings in PTSD patients; functional studies have indicated specific findings in limbic regions, although the relationship of these results to neuropsychological performance remains to be explored.     

A Critique of Miller and Rohling's Statistical Interpretive Method for Neuropsychological Test Data

A critical review of the 24-step procedure of Miller and Rohling's (in press) proposed standardization of clinician's use of neuropsychological assessment batteries is presented. Each step is examined for statistical sources of invalidity. It was concluded that parts of the procedure are quite vulnerable to between-battery variability that cannot be easily estimated or controlled, leading to significant errors in analysis and classification. A second fatal flaw is the failure to distinguish in the procedures between standard error measurement and standard error of the estimate in calculations in several steps. The purpose of the process remains viable, however, and is an important contribution toward the improvement of clinical diagnosis.     

Extension of Luria's Psycholinguistic Studies in Poland

One of Luria's basic interests was the organization of human cognitive processes, and thinking in particular. He believed that language and thought are closely related, and hence the manner in which we speak reflects the way we think. To verify this assumption, he and his collaborators performed a number of interesting psycholinguistic experiments with subjects of various ages and cultural backgrounds. The tasks used made the evaluation of both receptive and expressive language possible. The Narrative Ability Test described here stems from Luria's observations to a considerable degree. The test was administered to preschool children (N = 106), schoolchildren (N = 143), adolescents (N = 89), adults (N = 126), and older persons (N = 175). Findings of the 20-year studies with normal and deviant populations indicate close relationships among thought, language, and self-control. It was found that difficulty in developing narratives corresponds with a disability to process complex information. Correlations between narrative skills and age, sex, and social background were also noted.