[show abstract][hide abstract] ABSTRACT: Correspondence of three core Trauma Symptom Inventory (TSI) posttraumatic stress disorder (PTSD) scales (Intrusive Experiences, Defensive Avoidance, and Anxious Arousal) and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV) PTSD module were examined among 72 veterans with traumatic brain injury (TBI), PTSD, or both conditions. Subjects were classified into PTSD only, TBI only, or co-occurring PTSD and TBI groups based on TBI assessment and SCID-IV PTSD diagnosis. Linear regression was used to model TSI T-Scores as a function of group. Scores on all three scales significantly differed between the TBI and PTSD groups (PTSD only and co-occurring PTSD and TBI) in the expected direction. Study findings indicate that despite the potential overlap of symptoms between PTSD and TBI, the TSI appears to be a useful measure of trauma-related symptoms in veterans who may also have a TBI, particularly mild TBI. Limitations and areas for future research are discussed.
Military medicine 10/2009; 174(10):1005-9. · 0.77 Impact Factor
[show abstract][hide abstract] ABSTRACT: Seventy-two veterans with traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), or both participated in assessment procedures to evaluate between group differences. Half the sample was randomly selected for magnetic resonance imaging (MRI). Neurologic examinations were conducted using the Neurologic Rating Scale (NRS). Neuropsychological measures included the Paced Auditory Serial Addition Test (PASAT), Rey Auditory Verbal Learning Test (RAVLT), Conners' Continuous Performance Test II (CPT II), and Halstead Impairment Index (HII) including the Booklet Category Test (BCT). Data were analyzed using linear regression. Participants with moderate/ severe TBI were significantly more likely to have trauma-related imaging findings, and more severe TBI predicted lower scores on the NRS. No significant between-group differences were identified on the HII, PASAT, RAVLT, or CPT II. TBI group performance was significantly better on the BCT. More severe TBI predicted abnormal imaging findings and lower NRS scores. Hypothesized between-group differences on neuropsychological measures were not supported.
Military medicine 05/2009; 174(4):347-52. · 0.77 Impact Factor
[show abstract][hide abstract] ABSTRACT: Our objective was to examine the Beck Depression Inventory-II (BDI-II) in a traumatic brain injury (TBI) sample using a receiver operating characteristic (ROC) curve to determine how well the BDI-II identifies depression. An ROC curve allows for analysis of the sensitivity and specificity of a diagnostic test using various cutoff points to determine the number of true positives, true negatives, false positives, and false negatives.
This was a secondary analysis of data gathered from an observational study. We examined BDI-II scores in a sample of 52 veterans with remote histories of TBI.
This study was completed at a Veterans Affairs (VA) Medical Center.
Participants were veterans eligible to receive VA health care services.
Outcome measures included the BDI-II and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-IV).
We generated an ROC curve to determine how well the BDI-II identifies depression using the SCID-IV as the criterion standard for diagnosing depression, defined here as a diagnosis of major depressive disorder. Results indicated a cutoff score of at least 19 if one has a mild TBI or at least 35 if one has a moderate or severe TBI. These scores maximize sensitivity (87%) and specificity (79%).
Clinicians working with persons with TBI can use the BDI-II to determine whether depressive symptoms warrant further assessment.
Archives of physical medicine and rehabilitation 05/2009; 90(4):652-6. · 2.18 Impact Factor
[show abstract][hide abstract] ABSTRACT: The Aspen Neurobehnvioml Conference was convened as a venue to consider interactions of mind and brain with regard to health and disease. The primary purpose of the conference was to provide a forum for discussion and scientific collaboration, particularly in areas marked by uncertainty and controversy, with eventual dissemination of conclusions. One of the selected topics for the inaugural session of the conference concerned the development of guidelines for evaluation and management of the vegetative and minimally conscious states. The purpose of this article is to acquaint neurorehabilitation specialists with the unique approach to consensus-based guideline development utilized at the Aspen Conference and to summarize the proceedings of the Aspen Workgroup on the Vegetative and Minimally Conscious States conducted since 1994
(C) Williams & Wilkins 1997. All Rights Reserved.
Journal of Head Trauma Rehabilitation 07/1997; 12(4). · 4.44 Impact Factor