The present study included three traumatic brain injury (TBI) groups (good effort mild TBI, poor effort mild TBI, and good effort moderate/severe TBI) and two neurologic control groups (dementia and unilateral left hemisphere stroke). Language impairment was examined using the following measures: Wechsler Adult Intelligence Scale-III Verbal Comprehension Index and the Vocabulary, Similarities, Information, and Comprehension subtests; the Boston Naming Test; the Phonemic and Semantic cue conditions of the Controlled Oral Word Association Test; the Auditory Comprehension subtest of the Cognistat; Wide Range Achievement Test-3 Reading subtest; and the Peabody Picture Vocabulary Test. When effort was controlled, there was a significant effect of injury severity on language impairment. Poor effort and diagnosable malingering were responsible for most of the neuropsychological test evidence of language impairment in mild TBI.

Attention impairment is one of the most common complaints following Traumatic Brain Injury (TBI). Multiple studies have shown that performance on neuropsychological tests of attention is affected by many factors, including injury severity and effort. The aim of this study was to determine the effect of injury severity on neuropsychological tests across different domains of attention while controlling for effort. The domains of focused attention, selective attention, divided attention, sustained attention, and working memory were assessed by performance on the Digit Span Forward subtest, the Stroop Color Word Test, the Trail Making Test, the Conners' Continuous Performance Test - II, and Digit Span Backwards subtest, respectively. Effort was determined according to performance on the Portland Digit Recognition Test and the Test of Memory Malingering. Effort was found to have a greater effect on test performance (.79) than injury severity (.47). Clinical implications of the findings are discussed.

Traumatic brain injury (TBI) is a devastating disease causing disability and death, and currently there are no effective treatments available. Therefore, there is an utmost need to improve our understanding of the pathophysiology of TBI and to identify potential therapies that can provide neuroprotection after injury. The aims of this thesis were to develop an in vivo and in vitro model of TBI, in which to assess the potential neuroprotective effects of an omega-3 polyunsaturated fatty acid (PUFAs), docosahexaenoic acid (DHA). Method The controlled cortical impact (CCI) in vivo model of TBI was optimized and performed in mice. Both a behavioural (Morris water maze (MWM) for cognitive deficits) and histological endpoints (astrogliosis, lesion size and activated microglia) were used to assess severity and neuroprotective effects of DHA. An in vitro model of mechanical TBI was also set up and optimized. This model employed 3D astrocyte cultures obtained from GFP positive rat pups. The CCI impactor from the in vivo studies was used to damage the cultures, and at 24 hours, 5 days and 10 days the astrogliosis and cell number was measured. Results The optimization of the in vivo studies demonstrated that at impaction depth of 2.2 mm produced an injury that was significantly different to the sham injury, in MWM performance and increased astrogliosis. Interestingly, there was an increase in the amount of astrogliosis on the contralateral side of the brain. A second study performed using the 2.2 mm injury parameters was performed, where an injection of DHA was administered via the tail vein 30 min after injury. The DHA-treated group did not demonstrate any neuroprotection compared to the injury-only group. However, there was an increase in the amount of astrogliosis in the contralateral hippocampus of the DHA-treat group. In the fat-1 studies it was shown that older male mice performed worse in the MWM, that the fat-1 gene did not confer neuroprotection but did lead to increased astrogliosis. The in vitro study revealed that astrocytes in the lesioned gels demonstrated an increase in astrogliosis, there was also an increase in the number of cell in the cultures following the lesion. Conclusion In conclusion, the in vivo model of CCI replicated components of the human TBI including a behavioural deficit and pathophysiological changes. Omega-3 PUFAs failed to demonstrate functional neuroprotection in this model, but histologically, promoted an increase in reactive astrogliosis. The development of a novel in vitro model of focal injury in a 3D culture system, that elicits reactive astrogliosis, could be used to support further studies of the astrocytic responses to mechanical injury.

The 567-item MMPI-2 is the most widely used personality measure; it requires a sixth-grade reading level, takes 60-90 minutes to administer, and reports robust psychometrics. However, traumatic brain injury (TBI) sequelae can cause cognitive deficits that affect test-taking abilities and item endorsement during differential diagnoses of neurological and personality factors. Therefore, this study examined the clinical utility of the shortened 338-item MMPI-2-RF inventory with a post-acute TBI population as a practical alternative. The MMPI-2-RF requires a fifth-grade reading level and takes 35-50 minutes to administer. The MMPI-2-RF also includes revised versions of the MMPI-2 Validity Scales and new substantive scales that may better psychometrically account for personality in TBI sequelae, such the Somatic/Cognitive Scales. This study conducted an incremental validity analysis of the MMPI-2-RF with a non-litigating, post-acute care TBI population in Central Texas. The goal of the study was to explore the measure’s performance, or its ability to capture functional dimensions in a TBI sample. More specifically, the study examined the construct validity of MMPI-2 to MMPI-2-RF Validity and Restructured Clinical Scales, and criterion validity for the Somatic/Cognitive Scales with neuropsychological and neurobehavioral functioning measures. An archival neuropsychological database (N = 60) was analyzed of patients who participated in TBI rehabilitation treatment at a Central Texas hospital. MMPI-2-RF profiles were retrospectively scored with MMPI-2 archival data. Statistical analysis between MMPI-2 to MMPI-2-RF Validity and Restructured Clinical Scales was conducted. MMPI-2-RF Somatic/Cognitive Scales and criterion measures of Weschler Adult Intelligence Scale, 4th Edition (WAIS-IV), The Weschler Memory Scales, 4th Edition (WMS-IV), The Booklet Category Test, 2nd Edition (BCT), and the Neurobehavioral Functioning Inventory (NFI) were examined. Patient demographics and measurement qualities were reported with the sample. / text

This research provides an analysis of the relationship between demographic information and between specific vocational rehabilitation services and employment outcome in RSA consumers with traumatic brain injury (TBI). The findings suggest that these is a relationship between a consumers' race (i.e., White, Black, Hispanic, and Hawaiian), level of education, and presence of substance abuse. No relationship was identified between a consumers' gender, age, or race of Asian or American Indian consumers. When specific services of assessment, job placement, job search, and diagnosis/treatment were provided consumers were more likely to obtain employment. The specific services of job placement, job search and diagnosis/treatment also predicted consumers' employment outcome. Only three of these services, job placement, job search, and diagnosis/treatment were significantly related to consumers' weekly earnings at case closure. Diagnosis/Treatment was positively related, while job placement and job search were negatively associated.

Traumatic brain injury is one of the leading causes of death and disability in the North America, and can result in long-term physical and psychological consequences, which over time change brain injury from a medical problem to an issue of quality of life. Various self-care activities can significantly improve the quality of life in people living with a chronic health condition. However, research on self-care in these populations has focused on the physical aspect of self-care, often excluding other domains of functioning. There is minimal self-care research involving people who had a traumatic brain injury; however, it is important to understand how they experience and make sense of their injury and its consequences in order to develop more effective approaches to their rehabilitation and support systems. In this study, I interviewed adults with traumatic brain injury who had their injury at least two years prior to the study. Narrative analysis of their stories revealed that the participants faced the following difficulties: constructing an explanation for the injury, dealing with losses and limitations, feeling misunderstood and insignificant, and dealing with memory deficits and physical problems. The ways in which participants tried to overcome these difficulties was understood as self-care. It manifested in a variety of ways, including deliberate health-related behaviours, changes in one’s way of thinking, emotional regulation strategies, and linguistic and paralinguistic means used in the narratives. I discuss ways to understand the findings using different theoretical models, such as illness narratives, social disenfranchisement, and social disability models. The results of the study strongly suggest that our understanding of self-care should encompass both physical and psychological health.

The purpose of this study was to evaluate the performance of adolescents with traumatic brain injury on a written persuasive discourse task. Nine adolescents with TBI (mean age = 14 years 4 months) and nine age, gender and education matched peers completed a written essay on the topic of whether trained animals in circuses should be allowed to perform for the public. Language measures included productivity (number of words, number of T-units and mean length of T-unit) and complexity (number of clauses, clause density and clause breakdown). Pragmatic measures were drawn from the developmental persuasive discourse literature and included essential elements of argument (claim, number of reasons, number of elaborations, conclusion, irrelevancies, repetition of information and attitude). In comparison to their age-matched peers, the TBI group produced significantly fewer reasons to support their claims, significantly more repetitions of information and failed to take alternative perspectives on the topic. There were no significant differences on any measures of language productivity or complexity, however the TBI group performed consistently below their peers on these measures. The results are discussed alongside current literature in the field of discourse production and persuasion. Implications for clinical practice and future directions for research in this area are also offered.

This study investigated the effects of working memory constraints on the comprehension of expository texts by adolescents with severe Traumatic Brain Injury (TBI). The performance of adolescents with TBI will be compared against a group of typically developing (TD) gender and age-matched peers. The research questions are: (1) How does the performance of adolescents with TBI compare to typically developing gender and age-matched peers on tasks examining comprehension of expository texts?; and (2) Does comprehension of expository text decrease when working memory constraints are increased for adolescents with TBI? Fifteen participants will participate in the study. One group of five adolescents with severe TBI and a second group of ten gender and age-matched typically developing adolescents without TBI completed a battery of assessments including: Test of Nonverbal Intelligence 3rd Edition (TONI-3), Clinical Evaluation of Language Fundamentals 4th Edition (CELF-4), Peabody Picture Vocabulary Test 3rd Edition (PPVT-3) and the Working Memory Span Task (Tompkins et al 1994). All participants also completed an experimental task which involved listening to an expository passage and answering comprehension questions. Scores were then submitted to statistical analysis using ANOVA methodology to determine the significance of any within and between group differences. Results showed that there was no significant group by task interaction effect. The study did show that there was a significant difference between the TBI and TD groups on the measure of working memory. Results of the study will enhance our understanding of how adolescents with TBI comprehend expository information. This study will also help to create a foundation for further research into this area which is critical for student’s success in secondary education.

Traumatic brain injury is one of the leading causes of death and disability in the North America, and can result in long-term physical and psychological consequences, which over time change brain injury from a medical problem to an issue of quality of life. Various self-care activities can significantly improve the quality of life in people living with a chronic health condition. However, research on self-care in these populations has focused on the physical aspect of self-care, often excluding other domains of functioning. There is minimal self-care research involving people who had a traumatic brain injury; however, it is important to understand how they experience and make sense of their injury and its consequences in order to develop more effective approaches to their rehabilitation and support systems. In this study, I interviewed adults with traumatic brain injury who had their injury at least two years prior to the study. Narrative analysis of their stories revealed that the participants faced the following difficulties: constructing an explanation for the injury, dealing with losses and limitations, feeling misunderstood and insignificant, and dealing with memory deficits and physical problems. The ways in which participants tried to overcome these difficulties was understood as self-care. It manifested in a variety of ways, including deliberate health-related behaviours, changes in one’s way of thinking, emotional regulation strategies, and linguistic and paralinguistic means used in the narratives. I discuss ways to understand the findings using different theoretical models, such as illness narratives, social disenfranchisement, and social disability models. The results of the study strongly suggest that our understanding of self-care should encompass both physical and psychological health.

The purpose of this study was to evaluate the performance of adolescents with traumatic brain injury on a written persuasive discourse task. Nine adolescents with TBI (mean age = 14 years 4 months) and nine age, gender and education matched peers completed a written essay on the topic of whether trained animals in circuses should be allowed to perform for the public. Language measures included productivity (number of words, number of T-units and mean length of T-unit) and complexity (number of clauses, clause density and clause breakdown). Pragmatic measures were drawn from the developmental persuasive discourse literature and included essential elements of argument (claim, number of reasons, number of elaborations, conclusion, irrelevancies, repetition of information and attitude). In comparison to their age-matched peers, the TBI group produced significantly fewer reasons to support their claims, significantly more repetitions of information and failed to take alternative perspectives on the topic. There were no significant differences on any measures of language productivity or complexity, however the TBI group performed consistently below their peers on these measures. The results are discussed alongside current literature in the field of discourse production and persuasion. Implications for clinical practice and future directions for research in this area are also offered.