Service needs and barriers to care five or more years after moderate to severe TBI among Veterans.

Primary Objective: The objective of this paper is to identify the most frequent service needs, factors associated with needs, and barriers to care among Veterans and service members five or more years after moderate to severe traumatic brain injury (TBI).

Research Design: Survey administered via telephone 5-16 years after injury (median eight years) and subsequent acute inpatient rehabilitation at a regional Veterans Affairs (VA) medical centre.

Methods And Procedures: Participants were 119 Veterans and military personnel, aged 23-70 (median 35), 90% male.

Prospective Tracking and Analysis of Traumatic Brain Injury in Veterans and Military Personnel.

Objective: To describe the ongoing Clinical Tracking Form (CTF) study of the Defense and Veterans Brain Injury Center (DVBIC).

Design: Prospective longitudinal study. Data at baseline and postinjury are collected on participants through interview and questionnaire, review of medical records, and periodic follow-ups throughout their lifetime.

Long-term outcomes after moderate-to-severe traumatic brain injury among military veterans: Successes and challenges.

Objective: To assess long-term outcomes after traumatic brain injury (TBI) among veterans and service members.

Setting: Regional Veterans Affairs medical centre.

Participants: One hundred and eighteen veterans and military personnel, aged 23-70 years (median = 35 years), 90% male, had moderate-to-severe TBI (82% in coma > 1 day, 85% amnesic > 7 days), followed by acute interdisciplinary rehabilitation 5-16 years ago (median = 8 years).

Self-awareness and neurobehavioral outcomes, 5 years or more after moderate to severe brain injury.

Objective: To examine self-awareness 5 years or more after traumatic brain injury (TBI) and its relation to outcomes.

Participants: Sixty-two adults with moderate to severe TBI and significant other (SO) informants (family or close friend).

Setting: Regional veterans medical center.

Low maternal hemoglobin during pregnancy and diminished neuromotor and neurocognitive performance in offspring with schizophrenia.

Objective: Previous research has linked maternal anemia during pregnancy with increased risk for schizophrenia in offspring. However, no study has sought to determine whether this early insult leads to a more severe form of the disorder, characterized by worsened motor and neurocognitive functioning.

Method: Subjects were 24 cases diagnosed with schizophrenia and 22 controls from the Developmental Insult and Brain Anomaly in Schizophrenia (DIBS) study.

Association of maternal genital and reproductive infections with verbal memory and motor deficits in adult schizophrenia.

Maternal exposure to genital and reproductive infections has been associated with schizophrenia in previous studies. Impairments in several neuropsychological functions, including verbal memory, working memory, executive function, and fine-motor coordination occur prominently in patients with schizophrenia. The etiologies of these deficits, however, remain largely unknown.

Structural brain alterations in schizophrenia following fetal exposure to the inflammatory cytokine interleukin-8.

Background: Maternal infection during pregnancy has been repeatedly associated with increased risk for schizophrenia. Nevertheless, most viruses do not cross the placenta; therefore, the damaging effects to the fetus appear to be related to maternal antiviral responses to infection (e.g.

Cognitive decline in schizophrenia from childhood to midlife: a 33-year longitudinal birth cohort study.

Background: We examined cognitive deficits before and after onset of schizophrenia in a longitudinal study that: 1) covers a long time interval; 2) minimizes test unreliability by including the identical measure at both childhood and post-onset cognitive assessments; and 3) minimizes bias by utilizing a population-based sample in which participants were selected neither for signs of illness in childhood nor for being at risk for schizophrenia.

Methods: Participants in the present study, Developmental Insult and Brain Anomaly in Schizophrenia (DIBS), were ascertained from an earlier epidemiologic study conducted in Oakland, CA. The original version of the Peabody Picture Vocabulary Test (PPVT), a test of receptive vocabulary, was administered at age 5 or 9 and repeated as part of the DIBS study at an average age of 40.

Prenatal exposure to maternal infection and executive dysfunction in adult schizophrenia.

Objective: Executive dysfunction is one of the most prominent and functionally important cognitive deficits in schizophrenia. Although strong associations have been identified between executive impairments and structural and functional prefrontal cortical deficits, the etiological factors that contribute to disruption of this important cognitive domain remain unclear. Increasing evidence suggests that schizophrenia has a neurodevelopmental etiology, and several prenatal infections have been associated with risk of this disorder.

The potential utility of driving simulators in the cognitive rehabilitation of combat-returnees with traumatic brain injury.

A large number of Operation Enduring Freedom/Operation Iraqi Freedom returnees are seeking DOD and VA rehabilitative care for war-related traumatic brain injury (TBI). This article reviews evidence on the utility of driving simulators as tools for assessment and training in TBI rehabilitation. Traditionally, cognitive rehabilitation has been shown to improve specific cognitive skills.

Prenatal infection and cavum septum pellucidum in adult schizophrenia.

Increased length of the cavum septum pellucidum (CSP) and in utero infection are each associated with increased risk of schizophrenia. Hence, we examined whether prenatal infections are related to CSP length in schizophrenia patients. In a well-characterized birth cohort, in utero infection was assessed using serologic biomarkers or physician diagnoses.

Simultaneous measurement of perceptual and motor cortical potentials: implications for assessing information processing in traumatic brain injury.

Objective: Psychomotor slowing is a common manifestation of traumatic brain injury. Previous electrophysiological studies of traumatic brain injury have focused on abnormal attentional and perceptual responses to incoming stimuli. We hypothesize that traumatic brain injury is also associated with abnormal cortical components of motor execution.

Self and other in schizophrenia: a cognitive neuroscience perspective.

Objective: Recent basic science data indicate that in healthy individuals, self-referential processing and social cognition rely on common neural substrates. The authors assessed self-referential source memory and social cognition in a large sample of schizophrenia outpatients and healthy comparison subjects in order to compare how these critical processes are associated in the two groups.

Method: Ninety-one schizophrenia outpatients and 30 healthy comparison subjects were assessed on measures of basic social cognition and source memory for previously learned word items: self-generated, externally presented, and new words.

A neurocognitive model of borderline personality disorder: effects of childhood sexual abuse and relationship to adult social attachment disturbance.

Borderline personality disorder (BPD) is a paradigmatic disorder of adult attachment, with high rates of antecedent childhood maltreatment. The neurocognitive correlates of both attachment disturbance and maltreatment are both presently unknown in BPD. This study evaluated whether dimensional adult attachment disturbance in BPD is related to specific neurocognitive deficits, and whether childhood maltreatment is related to these dysfunctions.

Program development and defining characteristics of returning military in a VA Polytrauma Network Site.

The conflicts in Iraq and Afghanistan have resulted in a new generation of combat survivors with complex physical injuries and emotional trauma. This article reports the initial implementation of the Polytrauma Network Site (PNS) clinic, which is a key component of the Department of Veterans Affairs (VA) Polytrauma System of Care and serves military personnel returning from combat. The PNS clinic in Palo Alto, California, is described to demonstrate the VA healthcare system's evolving effort to meet the clinical needs of this population.

The effects of increasing stimulus complexity in event-related potentials and reaction time testing: clinical applications in evaluating patients with traumatic brain injury.

This study compared the effectiveness of P300 event related potentials (ERPs) and reaction time (RT) in discriminating patients with traumatic brain injury (TBI) from healthy control subjects. In particular, we examined how the use of more complex, ecologically relevant stimuli may affect the clinical utility of these tasks. We also evaluated how length of posttraumatic amnesia (PTA) and loss of consciousness (LOC) related to P300 and RT measures in our patient sample.

Temporal stability of auditory event-related potentials in healthy individuals and patients with traumatic brain injury.

Historically, cognitive event-related potentials (ERPs) have received limited acceptance for clinical use due to lack of evidence for their reliability. However, recent advances in computer technology and artifact rejection methods have greatly enhanced the fidelity of ERP measurements. The present study examined the test-retest reliability of ERP measurement by using current data processing methods.

Social-emotion recognition in borderline personality disorder.

Borderline personality disorder (BPD) is characterized by interpersonal disturbances, but the neurocognitive aspects of these symptoms are poorly understood. We hypothesized that patients with BPD have impaired perception of emotional expressions, which are related to symptoms of interpersonal dysfunction. To control potential confounding factors, this study excluded subjects with comorbid diagnoses known to be associated with impaired affect perception.

Prognostic value of evoked and event-related potentials in moderate to severe brain injury.

Clinicians are often expected to project patients' clinical outcomes to allow effective planning for future care. This can be a challenge in patients with moderate to severe traumatic brain injury (TBI) who are often unable to participate reliably in clinical evaluations. With recent advances in computer instrumentation and signal processing, evoked potentials and event-related potentials show increasing promise as powerful tools for prognosticating the trajectory of recovery and ultimate outcome from the TBI.

Adult social attachment disturbance is related to childhood maltreatment and current symptoms in borderline personality disorder.

We characterized borderline personality disorder (BPD) along two fundamental dimensions of adult social attachment and evaluated attachment associations with childhood maltreatment and current symptoms using self-report measures in 40 outpatients with DSM-IV BPD. The BPD group had significantly greater dimensional attachment impairment and rate of fearful attachment type compared with a healthy control group. Among BPD subjects, dimensional attachment-anxiety was specifically associated with sexual abuse, whereas attachment-avoidance was associated with all five maltreatment types.

Slowed lexical access is uniquely associated with positive and disorganised symptoms in schizophrenia.

Introduction: This study addressed the relationship of both semantic priming and slowed lexical access to the symptoms of schizophrenia, and evaluated their association with other neurocognitive deficits.

Methods: 57 outpatients with schizophrenia and 20 nonpsychiatric control subjects performed a lexical decision semantic priming task (LDT), and a brief neuropsychological battery. The schizophrenia group was also assessed with an extended Positive and Negative Symptom Scale.

Reduced Self-Referential Source Memory Performance is Associated with Interpersonal Dysfunction in Borderline Personality Disorder.

Source memory is impaired in schizophrenia, and this deficit is related to symptoms of interpersonal antagonism such as suspiciousness and hostility. The present study evaluated source memory in borderline personality disorder (BPD) and its relation to interpersonal antagonism. Forty-one noninpatient adults with BPD according to the DSM-IV and 26 healthy control subjects performed a verbal source memory test requiring completion of sentences with and without emotional content ("Hot" vs.

Predictive validity of driving-simulator assessments following traumatic brain injury: a preliminary study.

Objective: To evaluate whether driving simulator and road test evaluations can predict long-term driving performance, we conducted a prospective study on 11 patients with moderate to severe traumatic brain injury. Sixteen healthy subjects were also tested to provide normative values on the simulator at baseline.

Method: At their initial evaluation (time-1), subjects' driving skills were measured during a 30-minute simulator trial using an automated 12-measure Simulator Performance Index (SPI), while a trained observer also rated their performance using a Driving Performance Inventory (DPI).