Outcome of different treatment mixes in a multidimensional neuropsychological rehabilitation program.

Within a clinical demonstration program, 59 traumatically brain-injured patients were treated with 1 of 3 mixes of treatment. Mix 1 included cognitive remediation (CGR), small-group interpersonal (SGI) communication training, therapeutic community activities, and personal counseling. Mix 2 was similar to Mix 1 but stressed SGI exercises and eliminated CGR. Mix 3 emphasized CGR and eliminated SGI exercises. The efficacy of the treatment mixes was evaluated with performance on neuropsychological tests, improved independence in functional activities, measures of intra- and interpersonal functioning, and vocational outcome. Ss' participation in the program, irrespective of treatment mix, yielded improvements in (1) self-image, (2) quality of interpersonal relatedness and interaction, (3) involvement with others in naturalistic settings, and (4) vocational outcome. Overall, data point to the superiority of the balanced mix (Mix 1) over Mixes 2 and 3. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examined lives: Outcomes after holistic rehabilitation.

This article poses the question whether the attainment of optimal outcomes following neuropsychological rehabilitation requires that the individual achieve an "examined self." The author answers the question in the affirmative and provides data from a retrospective pilot study to substantiate his claim. Implications from the findings are briefly discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive remediation in traumatic brain injury: update and issues

Cognitive Remediation (CR) is a relatively new treatment technique for alleviating residual cognitive deficits following traumatic brain injury. This is a promising yet still changing technique. The future of CR as a rational and systematic endeavor requires the incorporation of important new ideas that have been emerging in allied fields. For example, the emerging field of instructional psychology has contributed relevant concepts such as scaffolding, metacognition, and generalization. It is furthermore argued that the issues of awareness, self-concept, and self-efficacy are vital to the process of CR intervention, and an integrative (holistic) approach to the remedial endeavor is thus indicated.     

Similarities and differences in block design performance between older normal and brain-injured persons: A task analysis.

Developed an objective scoring system to determine whether right and left hemiplegics differ from normal controls, and from one another, in terms of competence levels, style of performance, constructional deviations, and various rates of activity while attempting to solve block designs. A microanalysis of the wais block design performances of 40 normals, 56 right hemiplegics, and 49 left hemiplegics was conducted. Results indicate that (a) brain-injured ss were inferior to normals in competence, (b) brain-injured ss did not differ from normals in style of performance and in partial competence, (c) right hemiplegic ss differed from left hemiplegic ss on all parameters of performance but competence level. Theoretical and clinical implications are discussed. (29 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between initial competence and ability to profit from cues in brain-damaged individuals.

To study the relationships between competence and ability to profit from cues, the effects of premorbid education on current test performances, and whether the ability to profit from cues is uniform across tasks in brain-damaged persons, 62 left hemiplegics were tested consecutively on the WAIS Block Design (BD) and Similarities (SIM) tests, under standard and specially designed cuing conditions. Results indicate that the ability to profit from cues is a linear function of competence levels in both tasks. In BD, premorbid education was unrelated to either competence or cues gain. In SIM, education correlated with current competence but not with cues. No relationship was found between ability to gain from cues across tasks. Some significant clinical and theoretical implications from the data are discussed. (37 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of rehabilitation outcomes from psychometric parameters in left hemiplegics.

To test the proposition that an intake, multivariate battery of 42 psychometric predictors can predict duration of stay in rehabilitation and competence in ambulation and self-care, multiple-regression equations were computed for 54 Ss with left hemiplegia, and their retrospective outcome scores were highly accurately predicted. To reduce administration cost, redundant information was deleted. A compact battery of 27 variables was thus obtained, and the program was repeated. Resulting multiple correlations and predictive accuracy were only slightly less than those arrived at with the full battery. A cross-validation study on 15 new Ss yielded essentially identical results. It is concluded that the prediction of outcomes from psychometric measures, taken at the initiation of the rehabilitation program is highly feasible. (24 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)