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

When children have a moderate to severe traumatic brain injury (TBI), they are treated in a continuum of care that includes triage and emergency care, hospitalization, rehabilitation and outpatient therapy. Physical and cognitive recovery from brain injury may take several years. Children’s recovery varies, depending on numerous factors including pre-injury conditions and injury severity. While children and families are eager to return home to familiar activities, there are often significant physical, cognitive, behavioral and emotional changes that challenge families. Successful community reintegration depends on the ability of the family to understand and support the child, dealing with and responding effectively to those challenges. The purpose of this study is to understand how parents manage the care and community reintegration of their child who has experienced a TBI over time. This study utilized a mixed methods approach exploring the dimensions of the health challenge faced by parents caring for a child after a TBI, critical turning points as they face health challenges, and approaches for movement toward resolving health challenges. Story theory and story inquiry method were used to gather stories from 10 parents of children who experienced moderate to severe traumatic brain injury between the ages of 12 and 18, and between 2 and 5 years ago. Parents’ perceptions of their child’s quality of life and their ability to manage their child’s health challenge were explored using the Pediatric Quality of Life Inventory and Family Management Measure. Health challenges identified were: living with overwhelming personal upheaval, navigating the unknown, and struggling with how to support independence/dependence. Turning points were chronological or epiphanies. Approaches for movement toward resolving were continuously re-creating a new normal, being fully engaged in meeting the needs of one’s child, and embracing caring relationships to construct the new normal. Qualitative and quantitative data were analyzed to synthesize the findings. Results include a sense of ease in managing the health condition of the child associated with continuously creating a new normal. Healthcare providers can support and strengthen family management of children after TBI by understanding the health challenge, critical turning points and how parents move toward resolving. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection

[Truncated abstract] Controlled and automatic processing are broad categories, and how best to measure these constructs and their impact on functioning after mild traumatic brain injury (TBI) remains uncertain. The purpose of this thesis was to examine automatic and controlled processing aspects of attention after mild TBI using the Paced Auditory Serial Addition Task (PASAT) and event-related potentials (ERPs). The PASAT is one of the most frequently used tests to evaluate attentional functioning. It has been demonstrated to be a measure sensitive to both acute and longer-term effects of mild TBI, presumably due to demands for rapid processing and executive attentional control. ERPs provide a noninvasive neurophysiological index of sensory processing and cognitive functions and have demonstrated sensitivity to even minor cognitive dysfunction. The parameters provided by this functional technique may be those most likely to distinguish individuals with mild TBI from controls. Initially, it was hypothesized that successful novice PASAT performance requires the engagement of executive attention to establish novel controlled information processing strategies. Ten individuals who had suffered a mild TBI an average of 15.20 months previously were therefore expected to demonstrate processing abnormalities on the PASAT, relative to 10 healthy matched controls. Although the mild TBI group reported significant intensification of subjective symptoms since their injury, compared to controls, the mild TBI group provided a similar amount of correct PASAT responses. ... In the first experiment a visual search task consisting of an automatic detection and a controlled search condition was developed. In the second experiment the search task was performed concurrently with the PASAT task in a dual-task paradigm. In the mild TBI group, prior failure to establish more efficient forms of information processing with practice was found to significantly interfere with simultaneous performance of the PASAT task and the attention demanding condition of the search task. The pattern of impaired performance was considered to reflect a reduction in processing resources rather than a deficit in resource allocation. Dual-task performance in the control group was not associated with a large interference effect. In general, the results of this thesis suggest that individuals with mild TBI are impaired in their ability to progress from the stage of effortful controlled information processing to a stage of more efficient, automatic processing, and thus suffer a subtle attentional deficit. Following mild TBI, performance levels equivalent to controls may only be achieved with an abnormal expenditure of cognitive effort. As a result of the neuropathologic consequences of injury, individuals who have sustained a mild TBI are less able to benefit from practice, experience difficulty coping with simultaneous performance of secondary task, and are susceptible to distressing subjective symptomatology.

The research process illustrates the interaction between the therapist and the neuropsychological impaired client in the therapeutic context where we utilised drawing and painting as a creative medium I descn'be the interaction from a systems paradigm New paradigm research is used as the researcher is included in the research findings. The focus is on new meanings that the therapist and clients generated. Three case studies are descn'bed in this study. A circular description is given of the use of drawing and painting in therapy. The losses that the clients suffer are described and explained to make sense of the interaction. The use of art is described and incorporated in the therapeutic process as creative exercises were important ways to connect with the clients. This study illustrates that creativity should always be part of the therapeutic endeavour, especially when understanding the verbal expression of the client is difficult. / Psychology / M.A. (Clinical Psychology)

The research process illustrates the interaction between the therapist and the neuropsychological impaired client in the therapeutic context where we utilised drawing and painting as a creative medium I descn'be the interaction from a systems paradigm New paradigm research is used as the researcher is included in the research findings. The focus is on new meanings that the therapist and clients generated. Three case studies are descn'bed in this study. A circular description is given of the use of drawing and painting in therapy. The losses that the clients suffer are described and explained to make sense of the interaction. The use of art is described and incorporated in the therapeutic process as creative exercises were important ways to connect with the clients. This study illustrates that creativity should always be part of the therapeutic endeavour, especially when understanding the verbal expression of the client is difficult. / Psychology / M.A. (Clinical Psychology)