Self-responsibility and coping with pain: disparate attitudes toward psychosocial issues in recovery from work place injury.

PURPOSE: To compare injured worker and health professional ratings of psychosocial variables as they relate to recovery. METHOD: Seventy patients and 70 health care staff at an injured worker rehabilitation centre completed a 17-item checklist. Each subject selected five psychosocial variables believed to be most important to recovery. Group ratings were compared using chi-square with a Bonferroni adjustment. RESULTS: In general, patients and health professionals agreed on the relative importance of 15 of 17 variables. However, the groups did differ significantly on two items--staff rated 'self-responsibility' higher than patients, while patients rated 'coping with pain' higher than staff. CONCLUSIONS: The ratings reflect the occasionally divergent goals and expectations of the rehabilitation staff and patient groups. Consequently, some patients may be moved into inappropriate treatment modalities, resulting in non-compliance. Being aware of patient beliefs and expectations should assist health care professionals in generating improved rehabilitation outcomes by promoting better co-operation through shared perceptions and goals.

Kinesigenic choreoathetosis due to brain injury.

This uncommon paroxysmal movement disorder featuring attacks of dystonic spasm with athetoid posturing is usually of idiopathic nature, often familial and starting in childhood. There are a few reported examples due to cerebral pathology, and only four previous cases due to brain trauma. We report here a 21 year old man with left-sided motor spasms, choreoathetoid in type, which were clearly caused by a right frontal penetrating injury with contusion and haemorrhage. The attacks were relieved by phenytoin therapy. In this case, it seems that the post-traumatic paroxysmal kinesigenic choreoathetosis may be a form of reflex epilepsy.

Frequency of occurrence of a WAIS dementia profile in male head trauma patients.

This study investigated Fuld's (1983) contention that a WAIS dementia profile occurs infrequently in conditions other than Alzheimer's Disease. A sample of 50 male head trauma patients was examined for incidence of the profile. The WAIS profile occurred in five cases (10%) of the patients. This compares favourably with the figures reported for patients with multiple infarcts and is consistent with Fuld's position.

Interactions between two simple visual patterns.

The interaction of linear and dot elements of simple visual patterns was examined. The following patterns were used: short line-dot, long line-dot, right turned angle-dot, downward angle-dot, circle-dot, and two dots. Except for circle-dot and two dots, perception of either of both elements of the composite stimulus deteriorates as compared to perception of the same elements when presented separately. Perception of either element is improved in the case of the circle-dot stimulus, while in the case of two dots the number of errors remained at approximately the same level. It is hypothesized that both susceptibility to influence from the other element in a composite stimulus and intensity of masking effect produced by the given stimulus depend on distance between the information points of masking and masked stimuli. The extent of susceptibility is also connected with perceptual difficulty in identification of a stimulus when presented separately.

Analysis of perception of complex visual stimulus-patterns.

This paper deals with the analysis of visual perceptions of complex patterns consisting of two simple patterns placed one above the other in one frame (united pattern) or in two separate frames each (divided pattern). The upper pattern consisted of a configuration of lines, the lower one of a configuration of dots. There were one positive pattern which a subject had to recognize in tachistoscopic exposure and a number of negative patterns which a subject had to reject. When the dot component of the positive pattern consisted of two dots situated near its left edge, the subjects committed a great number of errors in recognition of the positive pattern and also the negative patterns with dot-negative components. Errors in recognition of negative patterns with line-negative components were much less numerous. Generally less errors were committed with divided patterns than with united patterns. When in the dot component of the positive pattern the distance between the dots was increased and they were placed symmetrically, the number of errors in recognition of this pattern decreased considerably; errors made in rejecting the negative patterns were, however, the same as in the previous test. Contrary to the previous test, errors with united patterns were less numerous than with divided patterns. The data obtained are discussed with reference to the concept of lateral inhibition between components of the complex unknown patterns. It is postulated that this inhibition can be partially overcome if the components of the complex pattern are easy integrated as is the case with symmetric united patterns.