The associations among self-awareness, emotional well-being, and employment outcome following acquired brain injury: A 12-month longitudinal study.

Objective: To investigate self-awareness and emotional well-being according to change in employment outcome in people with acquired brain injury (ABI). Design: A 12-month longitudinal study. Participants and Setting: Fifty adults with ABI attending outpatient rehabilitation (n = 17) or vocational rehabilitation services (n = 33). Time since injury ranged from 6 months to 12 years (M = 4.3 years, SD = 4.1). Main Outcome Measures: Self Awareness of Deficits Interview, Self-Regulation Skills Interview, Hospital Anxiety Depression Scale, and employment outcome (stable employment, improved employment, and stable unemployment). Results: At the initial assessment, level of awareness for the improved employment group was significantly lower than that for the stable employment group (p = .017), whereas no between-groups differences were found at the 12-month follow-up assessment. Employment outcome was not significantly associated with changes in self-monitoring or emotional well-being (p = .017). Demographic and injury-related variables were generally not related to employment outcome. Conclusions: The findings empirically support the theoretical view that an increase in self-awareness is associated with improved employment status, although the direction of this relation is unclear. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Neurocognitive Driving Test: Applying Technology to the Assessment of Driving Ability Following Brain Injury.

Objective: To compare the Neurocognitive Driving Test (NDT) with an established driving assessment method. Study Design: A prospective matched-control study. Participants: Fifteen adult volunteers with acquired brain injury (ABI), aged 21-59 years, referred for a driving evaluation and 15 healthy control (HC) participants. Methods: Individuals with ABI were administered the NDT and a traditional hospital-based driving evaluation. An overall performance score was calculated and used to rank order driving ability. HCs were administered the NDT to establish NDT performance range. Main Outcome Measures: Overall performance on the NDT; overall performance on a comprehensive hospital-based evaluation. Results: Comparison of the rank orders of driving ability for participants with ABI revealed a significant Spearman correlation. NDT scores discriminated between individuals with ABI who passed the driving evaluation and those who failed. Conclusions: Results help establish the potential utility of the NDT for evaluating driving ability in persons with ABI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy with nonoffending parents of children who have been sexually abused.

Examined the effectiveness of a 10 wk filial therapy training model as a method of intervention for nonoffending parents (24–56 yrs old) and their children (4–10 yrs old) who have experienced sexual abuse. Ss were assigned to either an experimental or control group and were given pretraining sessions and assessments. The parents in the experimental group then conducted weekly 30 min special play sessions with their children, as recommended by Landreth (1991). One session was videotaped. The parents received constructive feedback and support from the facilitator and group members during meetings. A posttest battery of instruments was administered to parents and children following the training sessions. Analyses of covariance revealed that the nonoffending parents in the experimental group significantly increased their level of empathy in their interactions with their children, significantly increased their attitude of acceptance toward their children, and significantly reduced their level of stress. Measures of the children's behavior, anxiety, emotional adjustment, and self-concept indicated positive trends. The authors maintain that this study supports filial therapy as an effective intervention for nonoffending parents and their children who have experienced sexual abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anoxic Versus Traumatic Brain Injury: Amount of Tissue Loss, Not Etiology, Alters Cognitive and Emotional Function.

Research in neuropsychology suggests that the etiology of a neurologic injury determines the neuropathological and neuropsychological changes. This study compared neuropsychological outcome in subjects who had traumatic brain injury (TBI) with subjects who had anoxic brain injury (ABI), who were matched for age, gender, and ventricle-to-brain ratio. There were no group differences for morphologic or neuropsychological measures. Both groups exhibited impaired memory, attention, and executive function, as well as slowed mental processing speed. Intelligence correlated with whole brain volume, and measures of memory correlated with hippocampal atrophy. There was no unique contribution of hippocampal atrophy on neuropsychological outcome between the groups. In the absence of localized lesions, the amount of neural tissue loss, rather than etiology, may be the critical factor in neuropsychological outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An online family intervention to reduce parental distress following pediatric brain injury.

This study examined whether an online problem-solving intervention could improve parental adjustment following pediatric traumatic brain injury (TBI). Families of children with moderate-to-severe TBI were recruited from the trauma registry of a large children's hospital and randomly assigned to receive online family problem solving therapy (FPS; n = 20) or Internet resources (IRC; n = 20) in addition to usual care. The FPS group reported significantly less global distress, depressive symptoms, and anxiety at follow-up than did the IRC group after controlling for baseline symptoms. The FPS group also reported significant improvements in problem-solving skills, although the groups did not differ significantly at follow-up. Findings suggest that an online, skill-building approach can be effective in facilitating parental adaptation after TBI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Filial therapy with immigrant Chinese families.

The purpose of this study was to determine the effectiveness of filial therapy as a method of prevention and intervention for immigrant Chinese families in Canada. Results of the analyses of covariance indicate that parents in the experimental group demonstrated a significant increase in empathic interaction with their children, a significant increase in acceptance of their children, a significant reduction of perceived stress related to parenting, and a significant reduction of perceived problems related to their children's behavior. Children of parents in the experimental group demonstrated a significant increase in self-concept. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Crisis intervention training program: Influence on staff attitudes in a postacute residential brain injury rehabilitation setting.

Purpose/Objective: Acquired brain injury produces a host of behavioral changes, and specialized training in proper management of these behaviors is essential to resolve crises and calm aggressive clients. This study was conducted to determine whether crisis intervention training was effective in increasing staff comfort with difficult client behaviors in a residential rehabilitation program for individuals with postacute acquired brain injury and whether changes would be maintained over time. Research Method/ Design: Twenty-five rehabilitation staff members participated in Nonviolent Crisis Intervention training and completed the Rehabilitation Situations Inventory before training, immediately following completion of the program, and 1 month later. Results: Immediately following completion of the program, participants reported increased comfort when faced with client behaviors related to motivation and adherence, sexuality, and aggression and when interacting with other staff and client families. Changes in comfort level with sexual situations, aggression, and staff/staff interactions were maintained 1 month post training. Conclusions/Implications: These results suggest that crisis intervention training is effective in increasing levels of staff comfort with difficult situations commonly experienced in the rehabilitation setting and the changes are maintained following training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intensive filial therapy with child witnesses of domestic violence: A comparison with individual and sibling group play therapy.

The rationale for utilizing filial therapy as a treatment intervention with child witnesses of domestic violence while residing with their mothers in a shelter facility is explored and the effectiveness of an intensive 12-session filial therapy parent training group, conducted within 2-3 weeks, is described (n=11; aged 4-10 yrs). Results of analysis of covariance revealed that child witnesses in the experimental group significantly reduced behavior problems prevalent in child witnesses and significantly increased their self-concept as compared to child witnesses in the non-treatment comparison group. In addition, t-test results showed that mothers who facilitated treatment of the experimental group scored significantly higher after training on both their attitudes of acceptance and their empathic behavior. Comparative analysis revealed that intensive filial therapy as facilitated by the children's mothers was as effective in reducing behavior problems as was intensive individual play therapy and intensive sibling group play therapy as facilitated by professionally trained therapists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer group training of pragmatic skills in adolescents with acquired brain injury

OBJECTIVE: To empirically evaluate a method of treating adolescents with cognitive communication disorders, including pragmatic deficits, secondary to acquired brain injury (ABI) in a group setting by objectively measuring outcomes before treatment and immediately after treatment and at 6 months posttreatment. DESIGN: A before-after trial with follow-up in a consecutive sample, with no control group. SETTING: Inpatient and outpatient pediatric rehabilitation center. SUBJECTS: Adolescents who demonstrated pragmatic deficits and scored a rating of 3 or less on each subdomain of the Rehabilitation Institute of Chicago Rating Scale of Pragmatic Communication Skills (RICE-RSPCS) were eligible for the study. Eight subjects were recruited into the study, and two subjects were lost to follow-up. Thus, six of the eight completed the study. MAIN OUTCOME MEASURES: RICE-RSPCS, Communication Performance Scale (CPS). Results: Clinically relevant and statistically significant (P <.01) changes occurred during the treatment and were maintained at follow-up for the four RICE-RSPCS subscales and the CPS. CONCLUSION: These results suggest that the potential and often typical long-term pragmatic and subsequent social difficulties associated with ABI can possibly be lessened through effective intervention.     

Comparison of interventions for women experiencing body image problems.

In this study, we investigated the effects of three counseling interventions on women's body image and self-concept. The interventions used were cognitive therapy techniques, cognitive behavior therapy techniques, and reflective therapy techniques. Women experiencing body image problems (N?=?79) completed Secord and Jourard's (1953) Body-Cathexis and Self-Cathexis Scales and were classified into either moderate or severe body image disturbance groups. Participants were randomly assigned to a therapy or the control group. Those assigned to the therapies participated in three structured interviews and did homework. Cognitive techniques emphasized changing self-statements, and reflective techniques explored feelings. A double repeated measures multivariate analysis of variance was performed on pre- and postscores on the Body-Cathexis and Self-Cathexis Scales, which had been found to be correlated. All participants improved in body image and self-concept. Therapy was better than no therapy. Cognitive therapy techniques were most effective for body image, and cognitive therapy techniques and cognitive behavior therapy techniques were most effective for self-concept. Participants in both classifications improved significantly on body image. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of cholesterol reduction on peripheral arterial disease in the Program on the Surgical Control of the Hyperlipidemias (POSCH)

BACKGROUND: Few lipid/atherosclerosis intervention trials have assessed the impact of cholesterol reduction on peripheral arterial disease. The 838 patients evaluated in the Program on the Surgical Control of the Hyperlipidemias (POSCH) trial represent more than the total number of patients in the seven previously reported studies. METHODS: Peripheral arterial disease in POSCH was assessed by progression of clinical disease, serial changes in the systolic blood pressure ankle/brachial index (ABI), and changes on sequential peripheral arteriograms. RESULTS: At the time of formal closure of the POSCH trial on July 19, 1990, claudication or limb-threatening ischemia was exhibited in 72 of 417 control group (CG) patients and in 54 of 421 intervention group (IG) patients (IG relative risk [RR] 0.702, 95% confidence interval [CI] 0.169 to 1.000, p = 0.049). With additional follow-up evaluation to September 30, 1994, clinical peripheral arterial disease was evident in 91 CG patients and 64 IG patients (RR 0.656, 95% CI 0.200 to 0.903, p = 0.009). At the 5-year follow-up evaluation, an ABI of less than 0.95 was present in 41 of 120 CG patients and in 24 of 126 IG patients, all of whom had an ABI of 0.95 or greater at baseline (RR in the IG of 0.557, 95% CI 0.360 to 0.863, p < 0.01). No appreciable differences were noted in the progression or regression of arteriographic peripheral arterial disease between the two groups. CONCLUSIONS: Effective cholesterol reduction in POSCH led to statistically significant differences between the control and the intervention groups in the development of clinically evident peripheral arterial disease and in the ABI values, but not in the peripheral arteriograms. Additional studies need to assess the correlation between peripheral arterial changes and coronary arterial changes and clinical atherosclerosis events. Intervention trials that study peripheral arterial disease have intrinsic value in the evaluation of the impact of risk factor modification on progression of atherosclerotic peripheral arterial disease.     

The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury.

Objective: To examine whether an online cognitive-behavioral intervention could improve child adjustment following traumatic brain injury (TBI). Participants: Thirty-nine families of children with moderate to severe TBI. Intervention: Families were randomly assigned to the online family problem-solving (FPS) group or to the Internet resources comparison (IRC) group. Main Outcome Measures: Outcomes included child behavior problems, social competence, and self-management/compliance. Results: The FPS group reported better child self-management/compliance at follow-up than did the IRC group. The child's age and socioeconomic status (SES) moderated treatment effects, with older children and those of lower SES who received FPS showing greater improvements in self-management and behavior problems, respectively. Conclusions: Findings suggest that an online cognitive- behavioral approach can improve child adjustment after TBI, particularly in older children and children of lower SES. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive functioning ten years following traumatic brain injury and rehabilitation.

Many previous studies investigating long-term cognitive impairments following traumatic brain injury (TBI) have focused on extremely severely injured patients, relied on subjective reports of change and failed to use demographically relevant control data. The aim of this study was to investigate cognitive impairments 10 years following TBI and their association with injury severity. Sixty TBI and 43 control participants were assessed on tests of attention, processing speed, memory, and executive function. The TBI group demonstrated significant cognitive impairment on measures of processing speed (Symbol Digit Modalities Test [SDMT], Smith, 1973; Digit Symbol Coding, Wechsler, 1997), memory (Rey Auditory Verbal Learning Test [RAVLT]; Rey, 1958; Lezak, 1976), Doors and People tests; Baddeley, Emslie & Nimmo-Smith, 1994) and executive function (Hayling C [Burgess & Shallice, 1997] and SART errors, Robertson, Manly, Andrade, Baddeley & Yiend, 1997). Logistic Regression analyses indicated that the SDMT, Rey AVLT and Hayling C and SART errors most strongly differentiated the groups in the domains of attention/processing speed, memory and executive function, respectively. Greater injury severity was significantly correlated with poorer test performances across all domains. This study shows that cognitive impairments are present many years following TBI and are associated with injury severity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hero/heroine modeling for Puerto Rican adolescents: A preventive mental health intervention.

Culturally sensitive treatments of the special mental health needs of high-risk Puerto Rican adolescents are lacking. The hero/heroine intervention was based on adult Puerto Rican role models to foster ethnic identity, self-concept, and adaptive coping behavior. 90 nonclinical Puerto Rican 8th and 9th graders were screened for presenting behavior problems in school and randomly assigned to an intervention and a control group. After 19 sessions, the intervention significantly increased adolescents' ethnic identity and self-concept and reduced anxiety. Treatment outcomes varied as a function of grade level, sex, and household composition. Self-concept was negatively affected among girls from intact families. The study supports the effectiveness of the culturally sensitive modality as a preventive mental health intervention for high-risk Puerto Rican adolescents, especially from single-parent families. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in fMRI Following Cognitive Rehabilitation in Severe Traumatic Brain Injury: A Case Study.

Objective: To illustrate the relationship between changes in neuropsychological testing and changes in functional magnetic resonance imaging (fMRI) before and after cognitive rehabilitation therapy (CRT). Study Design: Single case study. Setting: Outpatient treatment center. Participant: A woman with history of severe traumatic brain injury (TBI) 16 years before study. Intervention: Individualized CRT using a developmental metacognitive model. Main Outcome Measures: Neuropsychological tests and fMRI imaging performed during an eye movement task and a reading comprehension task. Results: Improvements on some neuropsychological test scores (>1 SD) and changes in the magnitude and distribution of the blood oxygen level dependent (BOLD) response as a function of task performance on both fMRI tasks. Conclusions: Individuals with severe TBI many years postinjury can demonstrate improvements in neuropsychological testing following CRT. Behavioral improvements can be related to changes in brain activity using fMRI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The stability of the self-concept in adolescence.

"A study of the stability of the self-concept over two years in adolescence resulted in the following conclusions:… Relative stability… was demonstrated… between Q sorts… . Subjects whose self-concept was negative at the first setting were significantly less stable in self-concept than subjects whose self-concept was positive… . Subjects who persisted in a negative self-concept over the two year period gave evidence of significantly more maladjustment." 16 refs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intensive child-centered play therapy with child witnesses of domestic violence.

Examined the effectiveness of child-centered play therapy sessions every day for 2 wks as an intervention for child witnesses of domestic violence. 22 children (aged 4–10 yrs) participated. The analyses of covariance indicated that children in the experimental group experience a significant increase in self-concept, a significant decrease in external and total behavior problems, a significant increase in the play behavior of physical proximity to the therapist, and a significant increase in the play behavior of nurturing and creative play themes. The results support utilizing intensive play therapy to treat child witnesses of domestic violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of parent involvement in isolation or in combination with peer tutoring on student self-concept and mathematics achievement.

The present study examined the effects of a home-based, parent involvement (PI) intervention and the reciprocal peer tutoring (RPT) intervention on the self-concept and mathematics achievement of academically at-risk urban elementary school students. Seventy-two 4th- and 5th-grade students evidencing difficulties in mathematics were selected. Students were assigned randomly to 3 conditions: PI?+?RPT, PI, and practice control (PC). Student self-concept reports showed that students in the PI?+?RPT and PI conditions reported higher ratings of scholastic and behavior conduct than controls. Students in the PI?+?RPT conditions perceived themselves as more socially confident than did PI or PC students. Mathematics findings indicated that students who received PI?+?RPT displayed higher levels of accurate mathematics computations on a curriculum-based measure than PI or PC students. PI?+?RPT students also had significantly higher scores on a standardized measure of mathematics computation than PC students. The relationships between the PI intervention components and school adjustment were discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-concept and peer status among gifted program youth.

The authors examined the relation between self-concept and peer status among 465 high-ability youth (Grades 5–11) attending a university summer enrichment program. The differential relation of 4 facets of self-concept (social, academic, athletic, and physical appearance) was investigated in both an academic and a nonacademic peer group setting. Results indicate that (a) self-concept, particularly social self-concept, is moderately predictive of peer status; (b) there appear to be developmental and gender differences in the role that self-concept plays in peer status; and (c) most findings are consistent across both peer group settings. This study supports the theoretical link between self-concept and peer status in high-ability youth and suggests directions for further research on the role of specific facets of self-concept in children with peer status difficulties. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-concept therapy for adolescent females.

14 adolescent females referred for delinquent and acting-out behaviors were compared pre- and posttreatment on measures of self-concept, ideal self-concept, and anxiety. These Ss were in a 10-wk socialization program designed to produce positive changes in self-concept; 9 Ss were in a group run by community volunteers, and 5 Ss were in a group run by mental health professionals. Self-concept changes in a nonreferred comparison group of 8 nondelinquent Ss appeared nearly random in contrast to the systematic improvement for the 14 Ss in therapy. There was some evidence of differential affectiveness in that Ss in the professionally led group appeared to undergo the most marked changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)