Traumatic brain injury is a major health problem with much of its morbidity associated with traumatic axonal injury (TAI). To date, significant insight has been gained into the initiating pathogenesis of TAI. However, the specific anterograde and retrograde sequelae of TAI are poorly understood because the diffuse nature of TAI complicates data analysis. To overcome this limitation, we subjected transgenic mice expressing yellow fluorescent protein (YFP) within the visual system to central fluid percussion injury, and consistently generated diffuse TAI within the optic nerve that could easily be followed in the organized YFP positive fibers. We demonstrated progressive axonal swelling, disconnection and proximal and distal axonal dieback, with regression and reorganization of the proximal swellings, and the persistence of the distal disconnected and degenerating swellings. Antibodies targeting the C-terminus of amyloid precursor protein, a marker of TAI, mapped to the proximal axonal segments without distal targeting. Antibodies targeting microglia/macrophages, revealed activated microglia/ macrophages closely encompassing the distal disconnected, degenerating axonal segments at 7 - 28 days post injury, suggesting their role in the delayed axonal degeneration. In contrast, in the proximal reorganizing axonal segments, microglia/macrophages appeared less reactive with their processes paralleling preserved axonal profiles. Concomitant with these events, YFP fluorescence quenching also occurred, complicating data analysis. This quenching mapped to Texas-Red-conjugated-IgG immunoreactive loci, suggesting that blood–brain barrier disruption and its attendant edema participated in fluorescence quenching. This was confirmed through antibodies targeting endogenous YFP, which identified the retention of intact axons despite YFP fluorescent loss. Paralleling these events, TAI was not accompanied by retrograde retinal ganglion cell (RGC) death. Specifically, no TUNEL+ or cleaved caspase-3 immunoreactive RGCs were observed from 2 days to 3 months post-TBI. Further, Brn3a immunoreactive RGC quantification revealed no significant RGC loss. This RGC preservation was accompanied by the persistent phospho-c-Jun expression for up to 3 months post-TBI, a finding linked to neuronal survival and potential axonal repair. Parallel ultrastructural study again failed to identify RGC death. Collectively, this study provides unprecedented insight into the evolving pathobiology associated with TAI, and offers advantages for future studies focusing on its therapeutic management and neuronal reorganization.

Trauma and grief often co-occur, however the degree to which these two constructs overlap or are distinguishable is still poorly understood. Homicidally bereaved individuals are exposed to both trauma and loss-related stressors. Previously collected data were used to explore the relationship between trauma and grief components in homicide bereavement distress, and whether homicide bereavement distress was distinguishable from that of other adverse life events. The overarching research question for this study was: Are event and loss related distress distinguishable among siblings bereaved by homicide,1 as measured on the Impact of Event Scale-Revised (IES-R)? Data from 67 individuals who lost a sibling to murder while growing up (Murder Group) were compared to data from 80 comparison individuals who grew up with a sibling (Comparison Group), but who had no experience of homicide bereavement. A cross-sectional, iterative survey design using group comparisons was used. Participants in the Murder Group reported significantly higher levels of current subjective distress compared with the Comparison Group. Among the siblings bereaved by the homicide loss of a sibling, event- and loss-related subjective distresses were highly and significantly correlated. In addition, both decreased significantly over time (years), and at similar rates. Preliminary findings from exploratory analyses of the IES-R provide insight into the avoidance, intrusion, and hyperarousal components of subjective distress following homicide loss. Findings will inform understanding of the overlap, and distinguishing features, of concurrent trauma and grief. Implications for theory and empirical research are noted, and recommendations for future research and counselling practice are discussed. / Graduate / 2017-09-13 / simpson9@uvic.ca

This study aimed to determine if Junior Eysenck Personality Inventory (JEPI) scores would differentiate between youth with and without PTSD. More specifically, the study compared JEPI Neuroticism and Extraversion scores across youth with PTSD, trauma exposed youth without PTSD, and non-traumatized youth using a three group case control design. The Children’s PTSD Inventory and unstructured DSM-IV based diagnostic interviews were utilized to determine diagnostic status. Given that prior research has indicated a relationship between neuroticism and internalizing disorders, and as PTSD is primarily an internalizing disorder, it was expected that youth with PTSD would have higher JEPI Neuroticism scores relative to trauma exposed youth without PTSD or case controls. It was further expected that JEPI Neuroticism scores of trauma exposed youth without PTSD and control subjects would not significantly differ. Finally, it was expected that JEPI Extraversion scores would not significantly differ between groups. As expected, youth with PTSD had significantly higher Neuroticism scores relative to traumatized youth without PTSD and controls. The Neuroticism scores of trauma exposed youth without PTSD and controls did not significantly differ. There were no significant differences between groups in regard to Extraversion scores. Implications for research and practice were considered.

Thesis (M. A. (Psychology)) --University of Limpopo, 2017 / This study investigated the perceptions of African families of TBI. Caregivers and TBI victims were given the opportunity to talk about their TBI perceptions. The study revealed that people’s knowledge of TBI is not good. This is proven by the way in which the participants understood and explained the conditions the victims found themselves in, after the accidents and how their family members are. Findings reveal that culture does play a vital role in the perceptions of African people. The study illustrates that the perceptions are culturally-rooted. The study interviewed five individuals (n=5) with TBI and a total of nine caregivers (n=9) were interviewed. A total of fourteen (n=14) participants were interviewed. The study reveals that the causes of TBI were attributed a number of things. According to the participants TBI is caused by witchcraft, the will of God and ancestors. The study also helped highlight the beliefs and the cultural system of Africans. It also explained the reality of an African. The Afrocentric theory helped shape the study as it helped in explaining the importance of an Africans’ view. The Afrocentric theory postulates that Africans have a different reality from that of Westerns and it has been proven by the findings. Although the participants were told about TBI by the doctors, they still had their own explanations and attributions to the problem.

While multiple Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans suffer from mild Traumatic Brain Injury (mTBI), Post-traumatic Stress Disorder (PTSD), and co-morbid mTBI and PTSD, there remains difficulty disentangling the specific symptoms associated with each disorder using self-report and neurocognitive assessments. We propose that neurological soft signs (NSS), which are tasks associated with general neurologic compromise, may prove useful in this regard. Based on our review of the literature we hypothesized that individuals with PTSD would present with a greater number of NSS than controls or individuals with mTBI. Further, we hypothesized a synergistic effect, such that individuals with mTBI + PTSD would present with the greatest number of NSS. To test these hypotheses, we analyzed a subset of individuals (N=238) taken from a larger study of neurocognitive functioning in veterans. Participants completed a battery of neuropsychological measures, which included the Behavioral Dyscontrol Scale (BDS), the current study’s measure of NSS. A subset of other neuropsychological measures were also included to examine the utility of NSS over and above traditional neuropsychological measures. Individuals were removed from the study if they sustained a moderate/severe TBI or did not meet validity criteria on the Green’s Word Memory Test or the Negative Impression Management subscale of the Personality Assessment Inventory. Binomial logistic and multinomial logistic regression were used to examine the ability of NSS to discriminate between the study groups, first by themselves and then after the variance explained by the traditional neuropsychological measures was accounted for. Exploratory cluster analyses were performed on neuropsychological measures and NSS to identify profiles of cognitive performance in the data set. Results indicated that individuals in the mTBI and/or PTSD group had more NSS compared to controls. Of the individual NSS items only a go/no-go task of the BDS discriminated between groups, with worse performance among individuals in the mTBI, PTSD, and mTBI + PTSD group compared to controls. In contrast, the overall BDS score and individual NSS, in general, did not discriminate between the mTBI, PTSD, and mTBI + PTSD group. Overall, the current study suggests that, when eliminating participants who do not meet validity criteria, NSS do not aid in discriminating between individuals with mTBI, PTSD, and mTBI + PTSD.

Active duty personnel as well as combat veterans of the United States often engage in military operations during their service that require deployments to participate in missions, which may lead to extended periods away from home. When active duty men and women are appointed to combat zones, they may return with psychological burdens such as post traumatic stress disorder, which can complicate their reintegration into civilian life. This study explored the experiences of combat veterans who faced challenges when returning home from a war zone, along with the experiences of their family members. The study involved 26 combat veterans, spouses, significant others, and parents. In data analysis, semistructured interview responses were given concerning personal experiences. The interviews produced a vast amount of information with manual notes. Participants discussed treatment, interventions, and strategies for family reintegration. Many of the veteran participants shared that family members did the 'best they could' to help them reintegrate. The themes received for the study were family reintegration, command strategies and intervention, community services, and mental health services. The study showed how combat veterans and family members can successfully complete family reintegration with social support as well as support from mental health professionals. In association with social change, psychologists, psychiatrists, mental health practioners, and licensed professional counselors may benefit from the findings of this study. Professionals involved with mental health treatments and assessments would learn how to connect with combat veterans and family members. This study supports the recommendation that combat veterans and family members receive services from mental health professionals.

Previous studies have suggested that mechanisms for neural compensation involve a reorganisation to right hemisphere processing in people with post-traumatic stress disorder (PTSD), and are associated with functional alterations in the capacity for behavioural flexibility. However, research has not established a direct relationship between the complex physiological and psychological processes of the heterogeneous disorder and right hemisphere cortical activity. The present study examined cognitive information processing in people with PTSD, reaction patterns associated with perceived traumatic stressors, and quantitative electroencephalographic (qEEG) indices of hemispheric asymmetry. Individuals with PTSD (N=34) and age and sex-matched normal controls (N=136) completed standardised web-based self-report questionnaires assessing traumatic stressor events and reaction patterns to those events. Neuropsychological indices of verbal, visuospatial, sensori-motor performance, and electrophysiological recordings, were examined for right hemisphere coding. The relationships among traumatic characteristic reaction patterns of numbing and avoidance, cognitive performance, and frontal and posterior EEG alpha asymmetry were also investigated. Structural and functional alterations were shown in those with PTSD, using indices of working memory for the retrieval of verbal and psychomotor information, indicating a reduced speed of processing and alterations to background cortical arousal in left hemisphere frontal regions. The study supported and extended previous findings of verbal working memory abnormality, alterations to left frontal cortical rhythmic oscillations, and low EEG alpha amplitudes in those diagnosed with PTSD. Results indicated a pattern of compensatory mechanisms associated with reduced speed of information processing and right-sided activation patterns in PTSD participants and control participants who experienced strong reactions to perceived traumatic events. Findings support the impact of traumatic events on psychobiological health in high-risk populations, implicating an association with specific patterns of neural and cognitive functioning in characteristic numbing and avoidance behaviours. / Thesis (Ph.D.) -- University of Adelaide, School of Population Health and Clinical Practice, 2008

Prior research has established that a history of post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI) increases the risk of suicide behavior. Few studies have examined the role of specific PTSD symptom clusters and suicide attempts. The current study is among a handful of studies that have examined the association between the presence of PTSD symptom clusters and suicide attempts among Veterans with PTSD and/or TBI. The study utilized archival data from a sample of 137 Veterans receiving mental health treatment at the Denver Veteran Affairs Medical Center. Results from logistic regression analyses indicated that PTSD symptom clusters were not associated with an increased risk for suicide behavior among individuals with and without a history of TBI. Results suggest that looking at the presence of PTSD symptoms is not sufficient to account for the risk of suicide behavior. Clinical and research implications on the need to examine the role of PTSD symptom severity and suicide behavior are discussed.

Thesis (Ph. D.)--University of Sydney, 2009. / Title from title screen (viewed Nov. 26, 2009) Includes tables and questionnaires. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Kolling Institute of Medical Research, Faculty of Medicine. Degree awarded 2009; thesis submitted 2008. Includes bibliography. Also available in print form.

No abstract available. / Thesis (MMed.)-University of Natal, Durban, 1991.