Correlates of depression in adults with severe traumatic brain injury and their carers.

Although it is generally accepted that social support plays a role in the maintenance of psychological well-being, there has been relatively little direct investigation of the role that social support may play in affecting post-injury depressive symptoms and mediating the effects of traumatic brain injury (TBI). Consequently, social support was selected as the framework within which to investigate possible indicators of depression in adults with severe TBI and their carers. The authors were interested in the degree of association between social support and the criterion variable of depression in the context of demographic and disability-related variables that have been identified as significant correlates of depression. Thirty-five adults with severe TBI (PTA > 7 days) and their primary carers participated in the study. Time post-injury ranged from 3.5-10 years and all the participants were living in the community. Fifty-seven per cent of the adults with TBI and 60% of their carers were classified as showing significant symptoms of depression. As hypothesized, social support contributed significantly to the prediction of depression. In particular, strong-tie support appeared to be an important indicator of well-being for both the participants with TBI and their carers.

Somatosensory discrimination deficits following pediatric cerebral malaria.

Pathologic studies of central nervous system damage in human falciparum malaria indicate primary localization in the cerebral white matter. We report a sensory-perceptual investigation of 20 Ghanaian children with a recent history of cerebral malaria who were age-, gender-, and education-matched with 20 healthy control subjects. Somatosensory examinations failed to show any evidence of hemianesthesia, pseudohemianesthesia, or extinction to double simultaneous tactile stimulation. While unilateral upper limb testing revealed intact unimanual tactile roughness discrimination, bimanual tactile discrimination, however, was significantly impaired in the cerebral malaria group. A strong negative correlation (r = -0.72) between coma duration and the bimanual tactile roughness discrimination test was also found. An inefficiency in the integrity of callosal fibers appear to account for our findings, although alternative subcortical mechanisms known to be involved in information transfer across the cerebral hemispheres may be compromised as well.

Victoria Symptom Validity Test: efficiency for detecting feigned memory impairment and relationship to neuropsychological tests and MMPI-2 validity scales.

Error scores and response times from a computer-administered, forced-choice recognition test of symptom validity were evaluated for efficiency in detecting feigned memory deficits. Participants included controls (n = 95), experimental malingerers (n = 43), compensation-seeking patients (n = 206), and patients not seeking financial compensation (n = 32). Adopting a three-level cut-score system that classified participant performance as malingered, questionable, or valid greatly improved sensitivity with relatively little impact on specificity. For error scores, convergent validity was found to be adequate and divergent validity was found to be excellent. Although response times showed promise for assisting in the detection of feigned impairment, divergent and convergent validity were weaker, suggesting somewhat less utility than error scores.

Indicators of long-term family functioning following severe traumatic brain injury in adults.

This study investigated the degree of association between four sets of predictor variables (demographic, injury-related, patient functioning, and caregiver functioning variables) and the criterion variable of long-term family functioning following severe traumatic brain injury (TBI). Thirty families participated in the study and a minimum of 3.5 years had elapsed since the time of injury. The mean length of post-traumatic amnesia (PTA) for the brain-injured individuals was 92.4 days. Data collection took place in the family home and both the brain-injured family members and primary caregivers were involved. Standard regression analyses revealed that two sets of variables accounted for a significant amount of variance in long-term family functioning. The largest amount of variance, 55% (44% adjusted), was accounted for by the caregivers' self-report variables which measured caregivers' depression, social support, and coping as well as caregivers' preceptions of patient competency. Overall, measures of severity of injury (PTA), residual neurobehavioural function, and adequacy of social support for caregivers proved to be reliable and significant indicators of family functioning. These findings are discussed with respect to their implications for service delivery and long-term provision of support for caregivers of severely brain-injured individuals living with their families.

Prediction of recidivism in young offenders after brief institutionalization.

Administered 100 delinquent adolescent boys a battery of tests that measured intelligence, mental control, self-concept and physical fitness. The battery of tests was administered at the beginning and at the end of short-term institutional placement (M = 6 months) and again 1 to 2 years after release from the institution. Significant prediction of prosocial behavior in the year after institutionalization was achieved by using tests that reflected mental control and academic achievement. Background variables such as race, socioeconomic status, family status, and previous criminal charges were not related significantly to presence or absence of antisocial behavior during the year after institutionalization. Implications for management and treatment are discussed.