Objective: To examine sleep and wake disorders following traumatic brain injury (TBI) and their impact on recovery of cognition, communication and mood. Research Design: This three-manuscript thesis comprises an introduction to sleep in the context of human function and development. It is followed by a systematic review of the literature pertaining to sleep and wake disorders following TBI, and then explores the relationship between sleep and arousal disturbance and functional recovery of cognitive-communication through a single case study, pre–post intervention. Finally, a larger study longitudinally explores the impact of treatment to optimize sleep and wakefulness on recovery of cognition, communication and mood through objective and subjective measures, pre-post intervention. The thesis concludes with a chapter that addresses the implications of findings for rehabilitation from the perspective of the International Classification of Functioning, Disability and Health (ICF), and a presentation of future research directions for the field Methods: The first manuscript involved a systematic review and rating of the quality of evidence. The second manuscript involved the evaluation of sleep and wakefulness by objective measures, and longitudinally by self-report through the Daily Cognitive-Communication and Sleep Profile (DCCASP, © Wiseman-Hakes 2008, see Appendix S). Cognitive-communication abilities were also measured by the DCCASP. The third manuscript utilized a single case series and cohort design to evaluate sleep and wakefulness, and to examine cognition, communication and mood at baseline and following optimization of sleep and wakefulness. Results: For Manuscript One, 43 articles were reviewed for levels and quality of evidence across 5 domains: epidemiology, pathophysiology, neuropsychological implications, intervention and paediatrics. In Manuscript Two, we showed that there was a statistically and functionally significant relationship between perceived quality of sleep and language processing, attention and memory, seen across the phases of the intervention. In Manuscript Three, we showed that there were statistically and functionally significant improvements across several domains of cognition, communication and mood in response to treatment. Conclusions: Sleep and wake disorders after TBI are pervasive, and can negatively impact rehabilitation and recovery. There is a need for systematic evaluation and intervention for these disorders in all persons with TBI.

In der vorliegenden Arbeit wurden die Auswirkungen des Musikhörens nach der einmaligen Inhalation eines Gasgemisches aus 35 % CO2 und 65 % O2 auf Emotionen, die aktuelle Stimmung sowie auf die Stress- und Immunparameter Noradrenalin, Leptin, Somatostatin und TNF-α untersucht. Außerdem wurden die Stress- und Immunparameter betreffs ihres Zusammenhangs mit den Emotionen und Stimmungen sowie ihrer Geschlechter- und Tageszeiteneffekte näher betrachtet. In die Studie wurden 143 gesunde Probanden eingeschlossen, die randomisiert jeweils einer Experimentalgruppe und einer Kontrollgruppe zugeteilt wurden. Die Experimentalgruppe hörte nach der Inhalation des Gasgemisches fröhliche belebende Instrumentalmusik, während die Versuchspersonen der Kontrollgruppe nach Zugabe des Gasgemisches neutrale Zwölftonfolgen dargeboten bekamen. Während des Hörens wurden die Emotionen an Hand standardisierter Fragebögen bewertet. Die aktuelle Stimmung wurde jeweils vor und nach dem Experiment erhoben. Zu 6 definierten Zeitpunkten wurden den Probanden Blutproben entnommen, die auf die Stress- und Immunparameter untersucht wurden. Dabei zeigte sich die Inhalation des Gasgemisches aus 35 % CO2 und 65 % O2 als wirkungsvoller Stressor, der die Schlüsselmechanismen der humanen Stressantwort zu aktivieren imstande war. Das Hören der Instrumentalmusik erbrachte signifikant positive Effekte auf die Einschätzung der Emotionen und aktuellen Stimmung verglichen mit dem Hören von Zwölftonfolgen. In den Konzentrationen der Stress- und Immunparameter zeigten sich im Vergleich von Instrumentalmusik mit Zwölftonfolgen jedoch keine eindeutigen Unterschiede. Diese Arbeit liefert damit einen Beleg zur positiven Wirkung von Musik und unterstützt die Bestrebungen, vergleichbare musikalische Stimuli im klinischen Alltag therapeutisch einzusetzen.

No abstract available

[Truncated abstract] The anxiety-assimilation hypothesis (Wilder, 1993) and the capacity constraint plus control motivation model (Fiske & Morling, 1996) predict that anxiety causes people to form more stereotypic impressions of others. Affect-as-information (Schwarz & Clore, 1983) and affect-priming (Bower, 1991) theories predict that anxiety causes people to form affect-congruent (i.e., more threatening) impressions of others. A novel research paradigm was used in Experiment 1 to separate the predictions of these two classes of theories, recognizing that their predictions were not mutually exclusive. Experiment 1 found that anxious persons formed more threatening, but not more stereotypic, impressions of a target person. This result replicated in Experiment 2, with a different population and a different anxiety manipulation. In addition, Experiment 2 found that the anxiety-congruent bias in impression formation was limited to participants? ratings of traits that corresponded to the information presented about the target. The results of Experiments 1 and 2 were taken as support for an affect-priming rather than affect-as-information account of the effect of anxiety on impression formation. Experiments 3 and 4 investigated anxiety effects on encoding and recall that underlie affect-priming explanation of affect-congruent impression judgment biases. Experiment 3 found that anxious participants spent more time encoding non-stereotypic information and recalled less stereotypic information than non-anxious participants. In Experiment 4 anxious participants again recalled less stereotypic information. This study also found that anxious participants? recall and impression judgments were affect-congruent. ... As predicted by the modified affect-as-information theory, the affect-attribution manipulation left participants? anxiety levels unaltered but it did attenuate the anxiety-congruent impression bias. In addition, anxious participants in this study recalled less stereotypic than non-stereotypic information. The findings of this thesis raised several new questions and theoretical challenges. The new experimental paradigms that were used to examine the questions in this thesis will also allow the examination of the interplay of stereotypes and valence in judgments in future research for persons in affective states other than anxiety. Such research would allow for the continued revision and development of theories of affect and social cognition.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.

Thesis (M.S.)--University of Massachusetts Amherst, 2008. / Includes bibliographical references (p. 46-52).

Thesis (M.S.)--Missouri State University, 2008. / "May 2008." Includes bibliographical references (leaves 45-49). Also available online.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2008. / Härtill 9 uppsatser. Titel på omslag och spikblad börjar: "On the influence of ..."

Thesis (M.S.)--University of Michigan, 1999. / Running title: Social support and depressed mood state. Includes bibliographical references.