Open and closed loops: A computational approach to attention and consciousness

Within recent years, researchers have proposed the independence of attention and consciousness on both empirical and conceptual grounds. However, the elusive nature of these constructs complicates progress in the investigation of their interaction. We present a framework within which we conceptualize attention and consciousness in computational terms. Here, the concepts are consi-dered as large-scale, functionally and structurally different processes, embedded in a biologically inspired architecture, spanning the full arc from stimulus to response. Our architecture assumes a general independence of attention and consciousness, but supposes strong interactions. Furthermore, it addresses the developmental aspect, stressing that these functions have to gradually develop through learning.     

Intimate Partner Violence (IPV) and Neurological Outcomes: A Review for Practitioners

ABSTRACT

Thirty-eight million women will experience intimate partner violence (IPV) during the course of their lifetime. Many of these women will experience brain injuries as a result of IPV and may not seek medical attention. Several types of practitioners who work with IPV survivors consistently, e.g., first responders, advocates, and clinicians, may be unfamiliar with brain functioning, screening, assessment, and treatment. This article reviews the dual traumas of IPV and TBI, the impact on neurological processes and symptomatology, and short and long-term outcomes. Recommendations for screening, intervention, interprofessional collaboration, and research are outlined.     

Developing an Occupation-Centred Framework for Trauma Intervention

Abstract

Experiencing work-related trauma can negatively impact coping abilities and daily life participation. Occupational therapists (OTs) often provide health services to workers who have experienced trauma, including military members, veterans, and public safety personnel. The Occupational Therapy Trauma Intervention Framework (OTTIF) is a novel clinical reasoning framework that matches a client’s level of readiness to engage with a spectrum of evidence-based OT approaches. Using surveys at two time points, evaluation of therapist experiences of using the OTTIF elicited positive feedback that suggests the OTTIF provides a useful occupation-centred framework for evidence-informed occupational therapy practice with clients who have experienced trauma.     

Depression and cognitive sequelae registered within the first year among young Danish TBI survivors

The aim of the study was to determine the proportion of depression and cognitive sequelae among young (15-30 years) Danish TBI survivors referred to interdisciplinary evaluation through a nationwide government-initiated health initiative. The cross-sectional study is based on data from the “Danish register for young adults with acquired brain injury” on TBI survivors included from October 2013 to December 2016. The main measures were Major depression inventory, Trail making test A and B, Fluency, Word learning with selective reminding, Matrix reasoning, Coding and Glasgow outcome scale - extended (GOS-E). During the study period, 131 young TBI survivors were referred to one of five national outpatient clinics. Ninety-six had complete data and of these 14.6% fulfilled the ICD-10 diagnostic criteria for depression and 34.4% had cognitive sequelae. An association was found between depression and cognitive sequelae (p = 0.004). Patients with both depression and cognitive sequelae (n = 10) had a significantly lower mean score on GOS-E (p = 0.0001). Depression and cognitive sequelae were frequent and associated with a poorer global functional outcome among young TBI survivors referred within a year after trauma. This finding and the notion that only 20% of the expected TBI population was referred to this nationwide health initiative indicate an unacknowledged need for interdisciplinary follow-up.     

Traumatic brain injury and adverse psychological effects: Examining a potential pathway to aggressive offending

Contemporary scholarship has demonstrated an association between traumatic brain injury (TBI) during adolescence and aggressive offending. Research, however, has yet to identify any mechanisms linking TBI to subsequent aggressive offending. Consequently, the current study hypothesized that adverse psychological effects is one such pathway. The current study used the Pathways to Desistance data set (n = 416) to examine the pathway of TBI to aggressive offending through adverse psychological effects. The findings of the structural equation model supported the hypothesized association. Specifically, increased exposure to TBI was indirectly associated with aggressive offending through adverse psychological effects. An additional supplemental analysis illustrated that a direct link between TBI and aggressive offending did not exist for the analytical sample. The findings suggested that the neurological disruptions commonly associated with TBI could result in direct increases in negative psychological outcomes and indirect increases in subsequent negative behavioral outcomes.     

The impact of motor vehicle injury on distress: Moderators and trajectories over time

Research reveals that motor vehicle injuries (MVIs) can result in severe and debilitating psychological distress. Yet, not every person who has sustained a MVI suffers psychologically. It appears that risk of distress varies by demographic and psychosocial characteristics. The present study aimed to explore the trajectories of post-MVI distress and the effect of pre-MVI psychological functioning on post-MVI distress. Hierarchical linear modeling was used to explore the longitudinal dataset from the Canadian National Population Health Survey. Participants were assessed up to nine years post-MVI. Post-MVI distress increased over time. Men experienced greater overall distress than women and a greater increase in distress over time. Pre-MVI distress predicted post-MVI distress. This relationship was strongest for those with greater pre-MVI alcohol consumption. At low levels of pre-MVI distress, greater pre-MVI alcohol consumption was related to lower post-MVI distress, but at high levels of pre-MVI distress, greater pre-MVI alcohol consumption predicted increased post-MVI distress. Those with partners experienced less distress than the unpartnered. This study supports the general findings of other post-MVI and post-trauma studies, although the current study’s main and interaction effects reveal more complex and nuanced relationships among variables in their prediction of post-MVI psychological distress.     

Rethinking Traumatic Brain Injury from Intimate Partner Violence: A Theoretical Model of the Cycle of Transmission

ABSTRACT

Despite growing evidence of the repeated nature of traumatic brain injury (TBI) in women experiencing intimate partner violence (IPV), there is no theoretical model depicting TBIs as a cyclical process throughout a lifetime. Situational analysis methodology was used on interviews with 10 women who self-reported passing out from being hit in the head during an episode of IPV to create a theoretical model depicting the cycle of transmission of TBI. We define the cycle of transmission of TBI as the way that women experience multiple TBIs over the course of their lifetime and how TBI can be perpetuated in a family or community. The cycle begins in childhood or adolescence, when women receive a TBI from abuse, sports, or motor vehicle accident. They enter into abusive relationships with men who are also described as living with a TBI and the women receive other TBIs during this relationship. With repeating head trauma, women described increasing TBI symptoms: problems with memory, cognition, executive functioning, depression, and concentration. If they do seek help, they must choose between healthcare and protective shelter. With either choice, the element of instability could be introduced and the cycle of transmission continues. This theoretical model shows that it is necessary to move beyond individual behaviors to think about how TBIs are transmitted through communities and how untreated symptoms can impact help-seeking behavior and perpetuate other risk factors for receiving a TBI.     

Involving Police Departments in Early Awareness of Concussion Symptoms during Domestic Violence Calls

ABSTRACT

Police officers around the world respond to and investigate calls regarding domestic violence (DV) daily. Police departments operate with standard protocols, particularly when engaging in investigations that involve allegations of strangulation or sexual assault. Operating under advisement of the Maricopa County Attorney’s Office, the Mesa Police Department (Mesa, AZ) has established protocols for detecting, recording, and prosecuting DV cases that involve strangulation and sexual assault. Allegations of strangulation (defined as impeded breathing) or sexual assault prompt officers to offer a forensic nursing exam (FNE) combined with strangulation treatment by forensic nurses at the Mesa Family Advocacy Center. Recognizing the potential for head injury to the assault victim in all DV situations, including intimate partner violence (IPV), the police department has added concussion-awareness training, as well as a point-of-incident investigative tool for its officers to record neurological function of the victim. Officers were instructed to use the ConQVerge device to measure and record the Near Point of Convergence (NPC) as a test of neurological impairment in suspected head injuries. In this article, we discuss the challenges and opportunities for assisting victims of DV strangulation and sexual assault (including non-DV sexual assault) with on-site assessment and consent for further medical assessment and treatment. Additionally, rates of domestic assault victims that report a crime, but decline to follow through with forensic medical tests, are reported for the first time. Lessons learned from the project that inform strategic operations in this space are offered to other agencies prior to the implementation of similar procedures.