Neural correlates of risky decision making in adolescents with and without traumatic brain injury using the balloon analog risk task.

We studied risky decision making (RDM) in 8 healthy adolescents (TC) and 11 adolescents with mild to moderate traumatic brain injuries (TBI) using the Balloon Analog Risk Task (BART) and functional magnetic resonance imaging (fMRI). Participants inflated simulated balloons (with more points awarded to bigger balloons), which might burst at any time. Increasing brain activation levels were associated with increasing balloon size in a largely bilateral network, including cerebellar, inferior parietal, limbic, and frontal areas. Both groups performed similarly and activated similar networks.

Neural correlates of interference control in adolescents with traumatic brain injury: functional magnetic resonance imaging study of the counting stroop task.

Difficulty in inhibition or cognitive control is a common and significant sequela of pediatric traumatic brain injury (TBI). The present study used functional MRI to examine one specific inhibitory function, interference control, in 11 adolescents, aged 12-16 years, (mean age, 15.7 years) with TBI who were at least 1 year postinjury and 11 age-matched typically developing control participants (TC) (mean age, 15.2 years). Participants completed a Counting Stroop task with 2 main conditions: (1) a neutral condition requiring the counting of animal words and (2) an interference condition in which mismatched number words were counted. Both TBI and TC adolescents activated similar networks of brain regions relevant to interference control, but the TBI group showed higher levels of activation relative to the TC group in multiple brain areas within this network, including predominantly right frontal and parietal regions. Findings of greater activation of the relevant neural network in the TBI group are consistent with recent fMRI findings using other interference control paradigms with individuals with a history of TBI.

Parent-Child Interactions During the Initial Weeks Following Brain Injury in Young Children.

OBJECTIVE: To understand how traumatic brain injury (TBI) affects parent-child interactions acutely following injury. PARTICIPANTS: Young children hospitalized for TBI (n = 80) and orthopedic injuries (OI; n = 113). METHOD: Raters coded videotaped interactions during free play and structured tasks for parental warmth/responsiveness and negativity and child warmth, behavior regulation, and cooperation. Raters also counted parental directives, critical/restricting statements, and scaffolds. RESULTS: Parents of children with TBI exhibited less warm responsiveness and made more directive statements during a structured task than parents in the OI group. Children with TBI displayed less behavior regulation than children with OI. Parental warm responsiveness was more strongly related to child cooperativeness in the OI group than in the TBI group. Child behavior also mediated group differences in parental responsiveness and directiveness. TBI accounted for as much variance in parental behaviors as or more than did sociodemographic factors. CONCLUSION: TBI-related changes in child behavior may negatively influence parent-child interactions and disrupt the reciprocity between parent and child.

Two models of caregiver strain and bereavement adjustment: a comparison of husband and daughter caregivers of breast cancer hospice patients.

PURPOSE: Caregiver bereavement adjustment literature suggests opposite models of impact of role strain on bereavement adjustment after care-recipient death-a Complicated Grief Model and a Relief Model. This study tests these competing models for husband and adult-daughter caregivers of breast cancer hospice patients. DESIGN AND METHODS: This study used secondary data from the National Hospice Study ( Greer & Mor, 1987). Stepwise multiple regression analyses, using caregiver's age and two formulations of prebereavement caregiver role strain as independent variables, predicted grief and despair bereavement adjustment as dependent variables. RESULTS: Data from husbands supported a Complicated Grief Model, as greater empirically derived (anxiety and depression symptoms) and theoretically derived (psychological and health strain) caregiver role strain formulations both predicted more difficult bereavement adjustment for husbands. Neither model was supported for adult daughters, as neither formulation of caregiver role strain predicted daughters' bereavement adjustment. Older caregiver age predicted better bereavement adjustment for both husbands and daughters. Adult daughters experienced more caregiver role strain than husbands did. IMPLICATIONS: The family role relationship between caregiver and patient (husband-wife vs. daughter-mother relationship) affects how caregiving factors influence bereavement adjustment.