ABSTRACT
Persistent symptoms following a mild traumatic brain injury (mTBI) can have profound implications on all aspects of an individual's functioning. Psychological factors have a significant role in contributing to the development of persistent post-concussion symptoms and predicting outcomes. Biopsychosocial explanations have therefore been applied to prognostic models of mTBI. What is not evident in the literature to date is an understanding of the psychological mechanisms that may be important in mediating the various psychological factors in these models. The construct of psychological flexibility holds promise in this regard. Psychological flexibility is the ability to act in alignment with values in the presence of inner discomfort such as pain and distress. It is hypothesised that psychological flexibility has a significant role in the development and maintenance of persistent symptoms following mild traumatic brain injury. The rationale that forms the basis of this hypothesis is as follows: a relationship exists between psychological flexibility and pre-injury psychological risk factors; psychological flexibility is vulnerable to the pathophysiology associated with mTBI; post-injury psychological and neuropsychological factors exacerbate and maintain psychological inflexibility; and psychological flexibility underlies psychological responses to mTBI that contribute to unfavourable outcomes. A discussion of the literature that pertains to each of these points is presented. Based on this hypothesis, we conclude, that there is rationale to empirically explore the role of psychological flexibility in mTBI and its relationship to outcomes. This may also lead to evaluation of specific interventions that target this psychological mechanism in mTBI, such as Acceptance and Commitment Therapy, and improve outcomes for this population.
Subject(s)
Acceptance and Commitment Therapy , Brain Concussion , Post-Concussion Syndrome , Brain Concussion/complications , Humans , PrognosisABSTRACT
OBJECTIVE: To characterize the language impairments that occur in brain tumor patients using a cognitively oriented theoretical framework. METHOD: Forty-nine preoperative brain tumor patients completed a new testing protocol (the BLAST) which assesses 8 well documented, "core" cognitive skills required for language: auditory word recognition, accessing semantic knowledge, lexical selection, phonological encoding, verbal short-term memory, goal-driven language selection, verb retrieval, and articulatory-motor planning. Patients were unselected with respect to lesion location. RESULTS: A surprising 65% of patients scored below controls on at least 1 core skill. Patients with left temporal tumors, as a group, had lower scores than the remaining patients on phonological encoding, accessing semantic knowledge and verbal short-term memory (STM). Those with left frontal tumors had the lowest scores on articulatory-motor planning. These findings are broadly consistent with previous studies examining the anatomical substrates of our "core" cognitive processes. CONCLUSIONS: We conclude that selective impairments in key language skills are common in brain tumor patients, but many of these are not adequately assessed on conventional aphasia assessments. Our protocol may provide a useful resource for preoperative, postoperative and intraoperative language assessment in this population. (PsycINFO Database Record
Subject(s)
Brain Neoplasms/complications , Language Disorders/diagnosis , Language Disorders/etiology , Neuropsychological Tests , Adolescent , Adult , Aged , Female , Humans , Language Disorders/physiopathology , Male , Middle Aged , Young AdultABSTRACT
News changes constantly. That change and the abundance of Web-based news resources available complicate finding the news. This paper reviews sixteen different online news sources for their coverage of recent health and medical issues; both general-interest and medical news sites are included. Three health-related news stories were searched in all resources within set time-frames to provide a comparison of coverage. Features and types of resources are described. The use of RSS feeds and weblogs to find news is also discussed with suggestions for using news aggregators to control the flow of information.
