Neurobehavioral disorders.

Neurobehavioral disorders are composed of a large group of behavioral impairments seen in association with brain disease (e.g., stroke, multiple sclerosis, dementia, and neuro-oncological conditions), transient as well as permanent brain impairments (e.

Sodium amobarbital: historical perspectives and neurorehabilitation clinical caveats.

The sodium amobarbital (amytal) (SA) interview is a technique that has been utilized in the treatment of a variety of disorders since its introduction in 1929. Since that time, there has been an assortment of research conducted showing its value in both differential diagnosis and treatment of multiple conditions. Notwithstanding the substantive amount of experience with the technique and its application to a myriad number of clinical conditions, it remains a seldom used procedure in clinical practice and certainly in neurorehabilitation.

Community based rehabilitation: special issues.

The primary goal in the developing field of community based rehabilitation (CBR) for individuals with TBI / ABI is community participation and integration. At present, CBR is less than clearly defined and is represented by a set of interventions with varied types, degrees of clinical support and models of intervention that are conducted for a diverse and complex set of individuals, situations, deficits and settings. Nonetheless, holistic neurorehabilitation programs should be considered both evidence based and a practice standard.

Skill reacquisition after acquired brain injury: a holistic habit retraining model of neurorehabilitation.

Persistent cognitive, emotional and behavioral dysfunction following brain injury present formidable challenges in the area of neurorehabilitation. This paper reviews a model and practical methodology for community based neurorehabilitation based upon: 1. Evidence from the "automatic learning" and "errorless learning" literature for skills relearning after brain injury; 2.

Psychological, neuropsychological, and medical considerations in assessment and management of pain.

Pain is a common yet challenging problem, particularly following traumatic injuries to the head or neck. It is a complex, multidimensional subjective experience with no clear or objective measures; yet it can have a significantly disabling effect across a wide range of functions. Persisting misconceptions owing to mind-body dualism have hampered advances in its understanding and treatment.

The problem of pain.

Pain problems, especially posttraumatic headache, are very common following head trauma. Pain may be the most significant problem, more disabling than any brain or other injuries, and interfering with aspects of cognition or other function. However, posttraumatic headache and most other chronic posttraumatic pain problems remain poorly understood.

Cognitive impairment in patients with chronic pain: the significance of stress.

This review article examines the role of emotional distress and other aspects of suffering in the cognitive impairment that often is apparent in patients with chronic pain. Research suggests that pain-related negative emotions and stress potentially impact cognitive functioning independent of the effects of pain intensity. The anterior cingulate cortex is likely an integral component of the neural system that mediates the impact of pain-related distress on cognitive functions, such as the allocation of attentional resources.

Mild traumatic brain injury: Impairment and disability assessment caveats.

Mild traumatic brain injury (MTBI) accounts for approximately 80% of all brain injuries, and persistent sequelae can impede physical, emotional, social, marital, vocational, and avocational functioning. Evaluation of impairment and disability following MTBI typically can involve such contexts as social security disability application, personal injury litigation, worker's compensation claims, disability insurance policy application, other health care insurance policy coverage issues, and the determination of vocational and occupational competencies and limitations. MTBI is still poorly understood and impairment and disability assessment in MTBI can present a significant diagnostic challenge.

Pre-injury status and adaptation following traumatic brain injury.

There are an estimated two million traumatic brain injuries (TBI) each year in the US. Behavioural and psychosocial sequelae are the most disabling consequences of TBI, but relatively little empirical data exist that identify factors underlying the variability in patient outcomes. There is an increasing appreciation that pre-injury coping liabilities are likely to contribute to persistent disability and that outcome reflects the combined effects of pre-morbid, injury-related, and post-injury factors.

A brief introductory guide to chronic pain resources on the Internet.

The expanding Internet has become an increasingly valuable tool for world wide sharing of information. Health care professionals, patients, lay persons, family members and others are afforded instant access to masses of information and almost unlimited resources on virtually any topic, as well as an almost seamless vehicle for communication. This new medium offers tremendous implications for health care.

Psychological assessment of persons with chronic pain.

Chronic pain is one of the most prevalent and costly health care problems and variability is the rule more than the exception in terms of pain related outcomes. Clearly, psychological factors such as depression, anxiety, post traumatic stress, excessive somatic thoughts and a variety of psychiatric syndromes are recognized as actively contributing to a patient's perceptions and responses to pain and can represent significant potential impediments to functioning and optimal health care outcome. As a result, it is becoming increasingly common, and even required by many programs, for individuals who seek treatment for pain to undergo a comprehensive assessment that evaluates not only their medical findings, but also beliefs about their condition, coping strategies, psychological adjustment, activity level and quality of life.