Intellectual and emotional functioning in college students following mild traumatic brain injury in childhood and adolescence.

OBJECTIVE: To investigate whether college students with a history of mild traumatic brain injury (TBI) in childhood or adolescence show residual deficits in intellectual functioning, approaches to studying, or emotional stability. DESIGN: Participants with a history of mild TBI and two control groups. SETTING: Volunteers were recruited from students taking an introductory psychology course. PARTICIPANTS: 79 students with a history of mild TBI, 75 students with a history of general anesthesia, and 93 students with no history of either TBI or general anesthesia. MAIN OUTCOME MEASURES: Participants carried out tests of verbal memory, nonverbal memory, verbal fluency, and nonverbal fluency; in addition, they completed a short form of the Approaches to Studying Inventory and the Symptom Checklist-90-Revised (SCL-90-R). RESULTS: In comparison with the two control groups, the students with a history of mild TBI produced similar scores on the cognitive tests and similar orientations to studying. However, they showed a significantly higher level of emotional distress on the SCL-90-R. CONCLUSION: College students with a history of mild TBI in childhood or adolescence are intellectually unimpaired and approach their studying in a similar manner to their uninjured classmates. Nevertheless, they report more severe distress in terms of their general personal and emotional functioning.

Consistency in recalling features of former head injuries: retrospective questionnaire vs. interview retest.

The probability and features of memory concerning former head injuries with loss of consciousness was assessed in two formats: a group-test questionnaire and a retest using personal individual interview. Results are given concerning the greater likelihood of reporting short 'permanent' retrograde amnesias in the interview.

Length of retrograde amnesia after head injury: a revised formula.

Our earlier retrospective study presented a formula relating lengths of retrograde amnesia to length of post-traumatic amnesia (PTA) and length of time since injury (Crovitz, Horn and Daniel, 1983). The earlier study derived the formula from 27 cases with retrograde amnesia. The present study adds another 75 cases, and we discuss similarities and differences between the two samples.

Neuropsychological aspects of disorientation.

Patients were asked twelve orientation questions before ECT and during the recovery period (the postictal confusional state) following ECT. Disorientation was more severe in the elderly. The different orientation items did not recover simultaneously; different recovery times may enable patients to give responses that are logical contradictions. While certain models (e.g., "person" versus "place" versus "time") may be useful in describing the differential recovery of orientation items, other models based on memory will probably prove more useful in delineating what causes this differential recovery. Patients gave responses to age and current year that were displaced backwards in years from the correct response. It is suggested that this displacement represents retrograde amnesia. As the postictal confusional state cleared, however, these backwardly displaced responses decreased in years of remoteness, thus showing a pattern of "shrinkage" that is similar to shrinking retrograde amnesia following head-injury. It is suggested that this result supports Ribot's law of regression.

Perceptual learning with right unilateral versus bilateral electroconvulsive therapy.

Perceptual learning was examined with respect to variations in ECT electrode placement (bilateral versus right unilateral) and ECT stimulus waveform (sinusoidal versus brief-pulse). While patients receiving right unilateral ECT demonstrated more perceptual learning than did those receiving bilateral ECT, no difference in perceptual learning resulted from the variation in electrical stimulus waveform. Furthermore, the amount of perceptual learning was unaffected by EEG seizure duration and by the total amount of electrical stimulus energy delivered. The theoretical issue of whether an electrical or a seizure difference between bilateral and right unilateral ECT is responsible for inter-group learning or memory differences is discussed, as well as practical issues related to the choice of electrode placement.

Everyday forgetting experiences: real-time investigations with implications for the study of memory management in brain-damaged patients.

In order to attempt to measure everyday forgetting experiences outside the laboratory, groups of undergraduates, healthy old people, and neuropathological patients with memory complaints were asked to use portable memory diaries. For a period of 7 days, they were immediately to write down every instance of noticing that they had forgotten anything. Types of forgetting, their frequency, and types of cues in the world that served as reminders that forgetting had occurred are discussed.

Inter-relationships among retrograde amnesia, post-traumatic amnesia, and time since head injury: a retrospective study.

A questionnaire is described and data are analyzed from 1000 young adults who retrospectively reported on features of memory lapses associated with head injury with loss of consciousness as it may have occurred in their lifetimes. It was found that 24% of the males and 16% of the females claimed a former head injury with loss of consciousness. Lengths of retrograde amnesia, post-traumatic amnesia, and the length of time that had passed since the head injury are shown to be related to each other.

ECT-induced delirium and further ECT: a case report.

The authors report the occurrence of a severe confusional state (DSM-III delirium) in a patient who received bilateral sinusoidal ECT. Unilateral brief-pulse ECT was then used to successfully treat the patient's depression without the redevelopment of delirium.

Recovery of orientation after electroconvulsive therapy.

Studies which provide quantitative analyses of postictal disorientation following electroconvulsive therapy (ECT) are reviewed with emphasis on the variable of time since seizure induction as it relates to recovery of orientation. The studies make it clear that separable components of orientation (person, place, and time) recover at different rates following ECT. The length of disorientation tends to increase with treatment number, but modifications of electrode placement (nondominant unilateral ECT) and electrical stimulus waveform (brief-pulse ECT) result in a decrease in disorientation when compared to standard bilateral sinusoidal ECT. Bilateral ECT may produce more disorientation than dominant unilateral ECT if more generalized seizures occur with the former than the latter treatment modality. Practical implications of these issues are discussed.

Hidden memory: a rapid method for the study of amnesia using perceptual learning.

Performance on finding hidden figures in a set of picture-puzzles is shown to separate out autobiographical memory and perceptual learning in a group of male neurosurgical patients. Two traumatic amnesics had normal perceptual learning without ability to recognize which pictures they had seen before. The method may be used in the study of transient amnesias of very short duration.

Selecting retrieval cues for early-childhood amnesia: implications for the study of shrinking retrograde amnesia.

A method for selecting semantic cues for early childhood memories is presented. The written records of episodes submitted by the subjects in the study of Crovitz and Harvey (1979) were coded into three-word strings of words in accordance with the gist of the memories. Nouns which described many retrievals (Set A) and nouns which had described few retrievals (Set B) were presented to an independent group of young adults as prompts for early childhood episodes. Prompting with semantic cues gave a fast rate of retrieval, with nouns in Set A cuing early childhood memories more successfully than nouns in Set B. The difference between words in Set A and Set B was found not to be a function of the frequency of usage of these words in the language. Implications for selecting cues to prompt retrieval of memories during the period of shrinking retrograde amnesia are discussed.

Television questionnaire techniques in assessing forgetting in long-term memory.

Two experiments were designed to test methodological assumptions basic to the television questionnaire technique in order to analyze its appropriateness in assessing forgetting in long-term memory. After controlling for confounding variables in the technique as it is presently used, a non-linear function of time period of television program on recognition response to that program's title was found. Reported television viewing habits had a significant effect on recognition score. The relevance of these findings in regard to the quantitative study of retrograde amnesia is discussed.

Problems in the acquisition of imagery mnemonics: three brain-damaged cases.

The literature provides little direction on how to overcome difficulties which some brain-damaged patients have in acquiring imagery mnemonics as a memory aid during the period of anterograde amnesia. For those interested in the therepeutic usefulness of imagery mediation, we provide a detailed account of the acquisition of some mnemonic skill in three brain-damaged patients who initially failed in using visual imagery mediators to recall words lists.