Long-term vocational functioning after severe closed head injury: a controlled study.

Vocational functioning at least 2 years postinjury was examined in a group of 57 severely closed-head injured (CHI) patients and 50 nonbrain-injured spinal-cord injured (SCI) patients. The two groups were equated on the following preinjury parameters: age, education, socioeconomic status (SES), male/female ratio, and marital status. The CHI and SCI patients had a similar number of members who were employed at follow-up. However, mean follow-up socioeconomic status was significantly lower in the CHI group and premorbidly employed CHI patients suffered a greater loss of SES than did premorbidly employed SCI patients. These results indicate that the degree of vocational impairment after severe CHI goes beyond impairment seen with another chronic disabling condition (i.e., SCI) that is associated with severe physical impairment but not neuropsychological impairment. In the CHI group, the following variables were all correlated with SES at follow-up: preinjury education, posttraumatic amnesia duration, degree of neuropsychological impairment soon after injury, and emotional adjustment at follow-up.

MMPI and MMPI-2 profile and code type congruence in a brain-injured sample.

Examined the comparability of the Minnesota Multiphasic Personality Inventory (MMPI) and Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in a sample of brain-injured patients. There were 53 patients (36 males, 17 females; M age = 27.25, SD = 11.45), the majority of whom had suffered a closed-head injury. The MMPI-2 and MMPI items were administered in the context of an extensive neuropsychological examination. Results revealed a lack of congruence between the MMPI and MMPI-2 when the entire profile was compared using profile analysis. Analyses of code types found congruence to be high for single point elevations but modest for 2-point code types. The degree of congruence appears related to the nature of analysis, and for clinical purposes, code-type interpretation may be most relevant. These results provide some support for the congruence of the MMPI and MMPI-2 for brain-injured patients, but particular caution should be exercised in the interpretation of 2-point code types.

Recovery of memory after severe closed head injury: dissociations in recovery of memory parameters and predictors of outcome.

This study examined selective reminding and recognition memory performance of 21 severe closed-head injured patients tested within 6 months of regaining consciousness and then again after at least 1 year. Performances on selective reminding parameters were highly correlated and patients performed significantly worse at both testings than did hospitalized controls matched for age, education, and sex. Patients improved from testing 1 to testing 2 on only four of six memory variables. Average Impairment Rating at testing 1 was a marginally better predictor of memory performance at testing 2 than was length of coma. Results are discussed in terms of (a) utility of selective reminding parameters and predictors of outcome and (b) dissociations in recovery of memory parameters.

How useful is the WAIS-R in closed head injury assessment?

The present study examined whether head-injury assessment findings based on the WAIS could be generalized to the WAIS-R. It also investigated whether WAIS-R findings from individuals with focal mass lesions could be generalized to closed-head-injured patients with mass lesions. Subjects were 71 CHI patients assessed with the WAIS-R an average of 1.38 years post-injury. Results were not always consistent with previous research. Patients with left or right mass lesion loci did not exhibit previously reported Verbal IQ-Performance IQ discrepancies.