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At least 55 records · Page 3Linked to original sources
PubMed1997

Awareness and perceptions of outcomes after traumatic brain injury.

Awareness or insight has been identified as a major factor in successful rehabilitation after traumatic brain injury (TBI). Anecdotal evidence suggests people with TBI are more likely to be aware of residual physical disabilities, perhaps focusing on these to the exclusion of other issues in the psychosocial and cognitive domains, for example. To investigate this more accurately, recovery and outcome questionnaires were administered to people with TBI and their nominated significant others, and, as appropriate, an assessment of their level of functioning was also recorded. Two- and three-way analyses (t-tests, Kendall's and Wilcoxon's) comparing these perceptions were then conducted. The results indicated a high level of agreement for basic demographic data and broad outcomes. It was found the subjects reported a lower rate of physical impairment and disability than the significant other or the author, suggesting that, as a group, they do not fixate on physical issues. Other areas of difference were found, such as a tendency for the significant other to perceive the subject as being more dependent in mobility and self-care tasks, possibly because of their close involvement. Also the author reported more impairments, using clinical language and assessment that did not necessarily have meaning or significance for the other groups. There was also evidence to support the notion that there is an inherent hierarchy of needs ranging from the lower-order, physiological or survival skills through to higher-order, self-actualizing areas. Because of the differing awareness and perceptions, care must be taken in service provision to identify the personal needs and values of each individual involved.

Activities of Daily Living↗
PubMed2004

Relative contribution of attention-deficit hyperactivity disorder, obsessive-compulsive disorder, and tic severity to social and behavioral problems in tic disorders.

The aim of this study was to investigate social and behavioral problems related to attention-deficit hyperactivity disorder (ADHD), obsessions and compulsions, and tic severity in children with a tic disorder. Parents of 58 children with a tic disorder with and without different forms of ADHD completed the Child Behavior Checklist (CBCL) and the Children's Social Behavior Questionnaire. Patients with a tic disorder with primarily hyperactive-impulsive ADHD had the highest questionnaire scores, patients with primarily inattentive ADHD had medium scores, and patients without ADHD had the lowest scores. On most subscales, significant part correlations with ADHD severity, but not tic severity, were obtained. Severity of obsessions and compulsions was independently correlated with the CBCL Thought Problems subscale but not with most other subscales. There was no significant correlation between tic severity and ADHD severity. Thus, in patients with a tic disorder, the presence and severity of ADHD are the main predictors of associated behavioral and social problems.

Adolescent↗
PubMedDate not supplied

The treatment of avoidance behaviour following severe brain injury by satiation through negative practice.

Brain-injured patients may frequently develop behaviour disorders in order to avoid participating in rehabilitation activities. In recent years, the use of behaviour modification techniques, particularly the use of positive reinforcement and time-out, has been increasingly reported in the literature as a means of remediating behaviour disturbance in this population. However, reward- or extinction-based programmes are generally not effective in the treatment of avoidance behaviours as they may be ineffective or, at worst, encourage further avoidance of rehabilitation activities. This paper, describes the use of satiation through negative practice in the successful treatment of a severely brain-injured patient whose behaviour, in the form of prolonged shouting, had previously not responded to the range of behavioural techniques used previously with this population. Two successive treatment programmes that were used in an attempt to satiate shouting are presented. Significant reductions in both the frequency and duration of shouting were found, enabling physical and functional gains to be made through successful participation in previously avoided rehabilitation activities. The validity of the use of this technique in the treatment of avoidance behaviour in brain-injured patients is discussed.

Adult↗
PubMed1975

The first seventy admissions to an adolescent unit in Edinburgh: general characteristics and treatment outcome.

1. The clinical functioning of the Young People's Unit, Edinburgh is described. This involves a relatively permissive, democratic "milieu". Psychotherapeutic efforts are devoted to the resolution of family psychopathology and the achievement of maturational progress for the adolescent. 2. Data on the first seventy admittions to the Unit were examined. Two-thirds of the patients were diagnosed "developmental crisis"; the majority of these also had a personality disorder. 3. Assessments of family functioning showed high levels of disturbance and psychiatric morbidity among the parents. The adolescents had mutually good, positive relationships with their opposite-sexed parents, but markedly negative ones with the same-sexed parents. This was not in accordance with the usual findings in "normal" families. Delinquent and impulsive patients showed uniformly negative family attitudes. 4. A simple estimation of treatment outcome at discharge gave results comparable to those of other units, with 70 per cent of patients rated as improved. Neurotic and psychotic patients had a relatively better outcome. Tension-discharge personality disorder and a history of very disruptive or antisocial behaviour were associated with poor outcome. 5. The poor response of very disturbed, impulsive adolescents to this type of therapeutic regime is discussed. These individuals do not appear to have sufficient personality resources and organization to benefit from this type of treatment. Emerging from this is a suggestion for an increased provision of specialized units offering containment and intensive care to the very disturbed adolescent.

Adolescent↗