M.A. / Certain topics almost have an interdicted status surrounding them. Avoidance of the unknown is a common reaction displayed by people especially when it involves a condition that strips another of normality. One such topic is brain damage. This study was undertaken to provide an alternative method of viewing a condition that is known to affect many individuals. Brain damage may be acquired by anyone at any point in time as a result of the forces of nature, such as illnesses or intervention of mankind, such as motor vehicle accidents. It seems more valuable to research the issue and provide some resolve, than to ignore or avoid it. To ensure that a well-founded study was accomplished one dimension of daily living affected by head injuries, was focused upon. Re-employability of labourers following mild to moderate brain damage was the area selected for this study. To achieve this objective, a psychometric battery which assesses the capabilities of an unskilled or semiskilled labourer with brain damage, has been designed. In order to assess the validity of the battery, it was administered to two groups of individuals. The first group constituted 25 brain-damaged labourers and the second group consisted of 100 normal labourers. By comparing the performance of the two groups, it became possible to determine whether the battery was feasible as an instrument of skill disparity. The data accumulated by the study showed that the battery does have the capability of distinguishing between the groups. A significant result of this study is that there now appears to be a method of differentiating between the jobrelated skills retained by brain-damaged labourers as opposed to normal labourers. This infers that the instrument has the capacity to assess how close to normal the skill competencies of injured persons are. In this setting this invariably implies an evaluation of the reemployability status of a person. Brain-damaged individuals are thereby given some recourse to determine their future work prospects and are provided with some clarity on one dimension of their functioning.

The issue of effortful patient performance has been an area of clinical interest in individuals with minor traumatic brain injury (mTBI). Clinical attention to this area has increased largely because of an increase in the number of worker's compensation claims, injury-related lawsuits and/or insanity defense pleas. As patients are presented with the opportunity for secondary gain, the issue of optimum performance on neuropsychological measures becomes salient. In addition to neurocognitive deficits, there are psychological characteristics associated with mTBI including depression, emotional disturbance, personality changes, and other psychopathology. This study utilized the MSVT, a set of standard neuropsychological instruments, and the Minnesota Multiphasic Inventory-2 (MMPI-2) to investigate the relationships between effort, psychological characteristics, and neuropsychological functioning in individuals with minor traumatic brain injuries. The first objective of this study was to determine which psychological factors were related to effort in mTBI. The second objective was to determine if there were differences between groups that performed poorly on effort testing and groups that performed adequately on effort testing, based on relevant psychological characteristics. The results of the analyses supported the first hypothesis. Hysteria was inversely related to effort, and Mania was positively related to effort on one of five measures of effort. The second hypothesis was not supported.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Arts in Clinical Psychology / This study investigated the emotional functioning of people who had been diagnosed as having traumatic brain injuries (TBI) of the frontal lobes. This was done with a view to examining whether there were changes in the emotional functioning of people with TBI in the period following their injuries. The pre-injury (or premorbid) emotional functioning of the respondents with TBI was assessed retrospectively through self-reports, which were compared with the ratings by the primary and secondary care-givers of these respondents. The current (post-injury) emotional functioning of the participants with TBI was also assessed through self-reports and the ratings by the primary and secondary care-givers. (abbreviation abstract) / Andrew Chakane 2019

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published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

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Introduction: After a brain injury there are often long term consequences impacting on QoL. However, this is a complex issue influenced by many factors. As someone recovers and adjusts it is likely that the way in which they evaluate QoL will also change. The theory of response shift suggests people will change the way they evaluate QoL in the face of changes in their life. The aim of this thesis is to investigate what influences a QoL judgement; examining the possibility of response shift. Methods: Quantitative and qualitative methods were used in 4 studies. These were a cross-sectional design utilising an individualised QoL measure (SEIQoL-DW); a longitudinal study utilising a ‘then-test’ approach; a cross-sectional questionnaire study; and a qualitative study using Interpretative Phenomenological Analysis. Study 1 (Ch.3) Results: Correlations between the QoL measures confirm the validity of the SEIQoL-DW; however, correlations were generally stronger for the simpler Hadorn Scale. There was little overall change in mean QoL when current and retrospective judgements were compared. There was evidence for a change in what areas of life were considered most important to QoL following injury. Study 2 (Ch.4) Results: Improvements in reported QoL between baseline and follow-up were small. A then-test indicates that any effect of response shift is small, and non-significant in the current research. There was also little evidence for reprioritisation or re-conceptualisation. Examination of other factors associated with QoL suggest that brain-injury specific factors (BIGI, RBANS) play a role in predicting QoL. Study 3 (Ch.5) Results: QoL was reported as worse post-injury on both Hadorn’s scale and the QOLIBRI-OS; a difference that was more pronounced on the QOLIBRI-OS. Differences were also reported in the importance of different areas of functioning. Change in QoL as measured by the QOLIBRI-OS was significantly influenced by disability as measured by the GOSE, emotional and informational support, and upwards social comparison. Optimism as measured by the LOT, but not upwards social comparison was a significant predictor of change on Hadorn’s scale; GOSE and emotional and informational support remain significant predictors. The GOSE, emotional and informational support, emotional coping styles and optimism were significant predictors of current QoL on the QOLIBRI-OS; and emotional and informational support and optimism were significant predictors of QoL on Hadorn’s scale. Little evidence was found to suggest that the factors proposed in Sprangers and Schwartz’s (1999) model of response shift have predicted relationships with QoL. Two candidate variables were studied: optimism and social support. However neither showed the predicted pattern of relationships. Nonetheless the study supports previous work indicating an influence of optimism and social support on QoL, and indicates that these warrant further study. There were systematic difference between current and retrospective ratings of importance of domains. The level of importance given to the areas of life defined by the QOLIBRI-OS is higher after injury than before, with the exception of “personal and social life” for which there is no significant difference. The areas of life chosen to reflect that which is measured by the GOSE (“work”, “close relationships”, and “social and leisure activities”) are rated as less important with the exception of “close relationships”. These findings provide further support for the idea that QoL domains are re-evaluated after brain injury. Study 4: This was an in depth qualitative investigation of the experience of recovery and adjustment following TBI. Semi-structured interviews and Interpretative Phenomenological Analysis (IPA) were used. Interviews were conducted with 4 men who were 3, 7, 12, and 18 years post injury. Main Outcome and Results: Themes emerging from the analysis were ‘Change: In Self and World’; ‘Reaching a point of realisation’; ‘Support’; ‘Adjusting to change/Coping with day to day life’; and ‘Participation, Goals and Focus’. These themes cover how participants felt both they and their lives had changed as a consequence of their injury; ways they went about coping and adjusting to changes; the importance of support; and the significance of social integration and participation in feeling satisfied with life. Summary and Conclusions: These studies provide evidence for response shift in different ways. There is little evidence for recalibration but there is some indication that reprioritization or reconceptualization may take place. Changes in how important different areas of life are before and after injury suggest that participants are changing the way they view and make evaluations of QoL. Factors identified as being important to QoL judgements were disability, social support (emotional and informational support identified in the questionnaire study and support in the IPA), upwards social comparison, and optimism. The IPA study suggests that functional outcome and participation are important after TBI; while also identifying ways of coping and providing an insight into the experience of recovery from brain injury. The different QoL measures used provides both evidence for their validity, but also evidence for the different conceptualisations of QoL that are measured by different instruments. The findings have implications both for understanding the QoL of the individual and for research on QoL after TBI.

No description available.

Memory impairment is an outcome of Traumatic Brain Injury (TBI), and associated with lower levels of post-morbid adjustment. This research isolated the memory impairment of retrieval deficit, and examined the efficacy of cues and mnemonics in remediating the impairment. Thirty-three male and female TBI survivors, 18 to 71 years old, were pre-tested for attention (COPY), short-term memory (SD), long-term memory (LD) and recognition memory (RS) employing the Rey Osterrieth Complex Figure Test (CFT), and Subtest. Sixteen subjects demonstrating a retrieval deficit were administered the post-test, with even random assignment into four treatment conditions: a control group (CONTROL), a group administered cues (CUES), a group administered mnemonics {MNEM), and a group administered mnemonics and cues (BOTH) (n = 4). A MANOVA revealed a significant effect of TRIAL (p5.05), no significant effect of TREATMENT, and no interaction. A power analysis indicated the lack of TREATMENT effect could be the result of sample size. Post-hoc t tests revealed a difference across TRIAL for SD and LO in the two experimental conditions which utilized mnemonics. The sample was divided into two groups according to subjects' level of functioning (HIGH and LOW). A MANOVA showed main effects for LEVEL for SD and RS, for TRIAL for SD, LO, and RS, and a LEVEL by TRIAL interaction for COPY (R

Includes list of articles published or accepted for publication during the period of PhD candidature. / "July, 2004" / Includes bibliographical references (leaves 255-293) / xxviii, 293 leaves : ill., plates (col.) ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Pathology, 2004?