Objectives: The purpose of this review is to educate and guide the actions of rehabilitation psyc... more Objectives: The purpose of this review is to educate and guide the actions of rehabilitation psychologists by providing a summary of the current literature on pharmacotherapies and treatment effectiveness for the chronic sequelae associated with severe traumatic brain injury (TBI). A number of medications are reviewed for use in treating deficits in arousal, cognition, function, and other problems associated with
Archives of physical medicine and rehabilitation, 2003
To examine the occurrence of and characteristics associated with violent traumatic brain injury (... more To examine the occurrence of and characteristics associated with violent traumatic brain injury (TBI) in the Traumatic Brain Injury Model Systems (TBIMS) project for 4 of the 5 original Model Systems centers and to determine the patient characteristics of this group, as well as the risk factors for sustaining such an injury. Prospective evaluation of individuals with violent TBI over a 10-year period. Four TBIMS centers. A total of 1,229 individuals who received acute hospitalization and inpatient rehabilitation care for TBI. Not applicable. The occurrence of a violent TBI. Twenty-six percent of the participants in the TBIMS project sustained a violent TBI. This type of injury was more common in African-American men who were single and slightly older than the average TBI patient, were unemployed before injury, and had had a previous TBI. A higher injury rate was noted in the earlier part of the evaluation period. Those who sustained a violent TBI had higher levels of caregiver burde...
Perception of caregiving after traumatic brain injury (TBI) has been shown to be an important par... more Perception of caregiving after traumatic brain injury (TBI) has been shown to be an important part of both survivor and family adjustment. The roles of coping style, family functioning, perceived social support and the TBI survivor's functional status have not been fully examined with respect to appraisal of caregiving. This study examined these factors with respect to both positive and negative appraisals of caregiving in four main areas: perceived burden, caregiving relationship satisfaction, beliefs about caregiving, and mastery with caregiving. Sixty primary caregivers of individuals who sustained a TBI within the last 6 months to 15 years were administered the Caregiver Appraisal Scale, as well as the Coping Inventory for Stressful Situations, a 21-item version of the Family Assessment Device, and the Social Provision Scale. These findings were examined in relation to the TBI survivor's scores on the Disability Rating Scale and the Functional Independence Measure at the...
A number of performance validity tests (PVTs) are used to assess memory complaints associated wit... more A number of performance validity tests (PVTs) are used to assess memory complaints associated with traumatic brain injury (TBI); however, few studies examine the concordance and predictive accuracy of multiple PVTs, specifically in the context of combined models in known-group designs. The present study compared five widely used PVTs: the Test of Memory Malingering (TOMM), Medical Symptom Validity Test (MSVT), Reliable Digit Span (RDS), Word Choice Test (WCT), and California Verbal Learning Test - Forced Choice (CVLT-FC). Participants were 51 adults with bona fide moderate to severe TBI and 58 demographically comparable healthy adults coached to simulate memory impairment. Classification accuracy of individual PVTs was evaluated using logistic regression and receiver operating characteristic (ROC) curves, examining both the dichotomous cutting scores as recommended by the test publishers and continuous scores for the measures. Results demonstrated nearly equivalent discrimination ab...
Two common measures used to evaluate verbal learning and memory are the Verbal Paired Associates ... more Two common measures used to evaluate verbal learning and memory are the Verbal Paired Associates (VPA) subtest from the Wechsler Memory Scales (WMS) and the second edition of the California Verbal Learning Test (CVLT-II). For the fourth edition of the WMS, scores from the CVLT-II can be substituted for VPA; the present study sought to examine the validity of the substitution. For each substitution, paired-samples t tests were conducted between original VPA scaled scores and scaled scores obtained from the CVLT-II substitution to evaluate comparability. Similar comparisons were made at the index score level. At the index score level, substitution resulted in significantly lower scores for the AMI (p = .03; r = .13) but not for the IMI (p = .29) or DMI (p = .09). For the subtest scores, substituted scaled scores for VPA were not significantly different from original scores for the immediate recall condition (p = .20) but were significantly lower at delayed recall (p = .01). These findings offer partial support for the substitution. For both the immediate and delayed conditions, the substitution produced generally lower subtest scores compared to original VPA subtest scores.
The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpat... more The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpatients with cognitive (n=28) and noncognitive (n=28) impairments. Each individual was tested twice: morning (preferred time) and evening (nonpreferred time); sessions and test batteries were counterbalanced to control for practice effects. Standard measures assessed attention, language, memory, visuospatial, and executive functions. Persons with cognitive impairment showed disproportionate vulnerability to the effects of circadian preference and time of testing, performing more poorly at nonpreferred than preferred times. Substantial effects (eta2 .12 to .48) were found on tests of executive functioning and tasks incorporating similar higher-order demands (e/g/. complex figure copy). Results are supported by tympanic temperature changes during a vigilance task, and index of cerebral blood flow in response to cognitive challenge. Cognitive reserve theory is suggested as an explanation for the differential effects. These findings may have implications for inpatient therapeutic interventions and discharge planning.
This study investigated the ability of the Wechsler Memory Scale-4th Edition (WMS-IV) and the Adv... more This study investigated the ability of the Wechsler Memory Scale-4th Edition (WMS-IV) and the Advanced Clinical Solutions (ACS) package including the new Word Choice test (WCT) to distinguish poor performance due to intentional response bias among simulators of traumatic brain injury (TBI) from poor performance due to actual TBI. Participants were 45 survivors of moderate to severe TBI and 39 healthy adult coached to simulate TBI. Logistic regression indicated that a five-variable model containing all the ACS variables and a single-variable model using only the WCT were statistically reliable. Comparing predictive accuracy of each model found that adding the WCT to the ACS increased predictive accuracy. Diagnostic efficiency for the full ACS model was considered "excellent" according to interpretive guidelines.
The present study investigated whether speeded word generation performance patterns seen in healt... more The present study investigated whether speeded word generation performance patterns seen in healthy subjects are also produced in genuine and feigned traumatic brain injury (TBI). An expanded version of the Controlled Oral Word Association Test was administered to healthy controls, TBI patients, simulated malingerers, and probable clinical malingerers. Four performance patterns were operationalized. Three of these patterns were replicated in the healthy control sample and found to be unaltered by genuine TBI. They were then combined into a logistic regression model that discriminated well between examinees who put forth adequate effort and those who evidenced response bias.
Objectives: The purpose of this review is to educate and guide the actions of rehabilitation psyc... more Objectives: The purpose of this review is to educate and guide the actions of rehabilitation psychologists by providing a summary of the current literature on pharmacotherapies and treatment effectiveness for the chronic sequelae associated with severe traumatic brain injury (TBI). A number of medications are reviewed for use in treating deficits in arousal, cognition, function, and other problems associated with
Archives of physical medicine and rehabilitation, 2003
To examine the occurrence of and characteristics associated with violent traumatic brain injury (... more To examine the occurrence of and characteristics associated with violent traumatic brain injury (TBI) in the Traumatic Brain Injury Model Systems (TBIMS) project for 4 of the 5 original Model Systems centers and to determine the patient characteristics of this group, as well as the risk factors for sustaining such an injury. Prospective evaluation of individuals with violent TBI over a 10-year period. Four TBIMS centers. A total of 1,229 individuals who received acute hospitalization and inpatient rehabilitation care for TBI. Not applicable. The occurrence of a violent TBI. Twenty-six percent of the participants in the TBIMS project sustained a violent TBI. This type of injury was more common in African-American men who were single and slightly older than the average TBI patient, were unemployed before injury, and had had a previous TBI. A higher injury rate was noted in the earlier part of the evaluation period. Those who sustained a violent TBI had higher levels of caregiver burde...
Perception of caregiving after traumatic brain injury (TBI) has been shown to be an important par... more Perception of caregiving after traumatic brain injury (TBI) has been shown to be an important part of both survivor and family adjustment. The roles of coping style, family functioning, perceived social support and the TBI survivor's functional status have not been fully examined with respect to appraisal of caregiving. This study examined these factors with respect to both positive and negative appraisals of caregiving in four main areas: perceived burden, caregiving relationship satisfaction, beliefs about caregiving, and mastery with caregiving. Sixty primary caregivers of individuals who sustained a TBI within the last 6 months to 15 years were administered the Caregiver Appraisal Scale, as well as the Coping Inventory for Stressful Situations, a 21-item version of the Family Assessment Device, and the Social Provision Scale. These findings were examined in relation to the TBI survivor's scores on the Disability Rating Scale and the Functional Independence Measure at the...
A number of performance validity tests (PVTs) are used to assess memory complaints associated wit... more A number of performance validity tests (PVTs) are used to assess memory complaints associated with traumatic brain injury (TBI); however, few studies examine the concordance and predictive accuracy of multiple PVTs, specifically in the context of combined models in known-group designs. The present study compared five widely used PVTs: the Test of Memory Malingering (TOMM), Medical Symptom Validity Test (MSVT), Reliable Digit Span (RDS), Word Choice Test (WCT), and California Verbal Learning Test - Forced Choice (CVLT-FC). Participants were 51 adults with bona fide moderate to severe TBI and 58 demographically comparable healthy adults coached to simulate memory impairment. Classification accuracy of individual PVTs was evaluated using logistic regression and receiver operating characteristic (ROC) curves, examining both the dichotomous cutting scores as recommended by the test publishers and continuous scores for the measures. Results demonstrated nearly equivalent discrimination ab...
Two common measures used to evaluate verbal learning and memory are the Verbal Paired Associates ... more Two common measures used to evaluate verbal learning and memory are the Verbal Paired Associates (VPA) subtest from the Wechsler Memory Scales (WMS) and the second edition of the California Verbal Learning Test (CVLT-II). For the fourth edition of the WMS, scores from the CVLT-II can be substituted for VPA; the present study sought to examine the validity of the substitution. For each substitution, paired-samples t tests were conducted between original VPA scaled scores and scaled scores obtained from the CVLT-II substitution to evaluate comparability. Similar comparisons were made at the index score level. At the index score level, substitution resulted in significantly lower scores for the AMI (p = .03; r = .13) but not for the IMI (p = .29) or DMI (p = .09). For the subtest scores, substituted scaled scores for VPA were not significantly different from original scores for the immediate recall condition (p = .20) but were significantly lower at delayed recall (p = .01). These findings offer partial support for the substitution. For both the immediate and delayed conditions, the substitution produced generally lower subtest scores compared to original VPA subtest scores.
The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpat... more The influence of circadian preference was examined among 56 morning-oriented rehabilitation inpatients with cognitive (n=28) and noncognitive (n=28) impairments. Each individual was tested twice: morning (preferred time) and evening (nonpreferred time); sessions and test batteries were counterbalanced to control for practice effects. Standard measures assessed attention, language, memory, visuospatial, and executive functions. Persons with cognitive impairment showed disproportionate vulnerability to the effects of circadian preference and time of testing, performing more poorly at nonpreferred than preferred times. Substantial effects (eta2 .12 to .48) were found on tests of executive functioning and tasks incorporating similar higher-order demands (e/g/. complex figure copy). Results are supported by tympanic temperature changes during a vigilance task, and index of cerebral blood flow in response to cognitive challenge. Cognitive reserve theory is suggested as an explanation for the differential effects. These findings may have implications for inpatient therapeutic interventions and discharge planning.
This study investigated the ability of the Wechsler Memory Scale-4th Edition (WMS-IV) and the Adv... more This study investigated the ability of the Wechsler Memory Scale-4th Edition (WMS-IV) and the Advanced Clinical Solutions (ACS) package including the new Word Choice test (WCT) to distinguish poor performance due to intentional response bias among simulators of traumatic brain injury (TBI) from poor performance due to actual TBI. Participants were 45 survivors of moderate to severe TBI and 39 healthy adult coached to simulate TBI. Logistic regression indicated that a five-variable model containing all the ACS variables and a single-variable model using only the WCT were statistically reliable. Comparing predictive accuracy of each model found that adding the WCT to the ACS increased predictive accuracy. Diagnostic efficiency for the full ACS model was considered "excellent" according to interpretive guidelines.
The present study investigated whether speeded word generation performance patterns seen in healt... more The present study investigated whether speeded word generation performance patterns seen in healthy subjects are also produced in genuine and feigned traumatic brain injury (TBI). An expanded version of the Controlled Oral Word Association Test was administered to healthy controls, TBI patients, simulated malingerers, and probable clinical malingerers. Four performance patterns were operationalized. Three of these patterns were replicated in the healthy control sample and found to be unaltered by genuine TBI. They were then combined into a logistic regression model that discriminated well between examinees who put forth adequate effort and those who evidenced response bias.
Uploads
Papers by Robin Hanks