Most studies of cardiovascular reactivity utilize tasks that are highly standardized and controlled. However, there is some concern whether the information obtained from these tasks is relevant to understanding the cardiovascular responses to behavioral stimuli encountered in real life. Historically, various forms of a stress interview have been used to examine physiological concomitants of emotional arousal. However, these tools fell into disuse because of ethical concerns, their intensive time requirements, and the perception that the interviews could not be standardized. We have developed a short (16-minute) interview that is not aversive or threatening. In studies on 24 normotensives and 19 hypertensives, the interview elicited greater blood pressure elevations than those elicited by mathematical calculations or cold pressor (p less than 0.0001). The interview increased systolic and diastolic pressures by 38/32 mm Hg in hypertensives and 31/24 mm Hg in normotensives. The variance in BP elicited by this interview is not appreciably greater than that found in highly structured tasks such as mathematical calculations. The test-retest stability of the interview is comparable to that of resting baseline blood pressure and is superior to that of mathematical calculations or cold pressor. Techniques such as the interview may be at least as useful as highly standardized tasks and possibly more valid as models for examining cardiovascular reactivity.

Adult↗

PubMedDate not supplied

Incidence, CT findings and rehabilitation outcome of patients with communicative hydrocephalus following severe head injury.

Communicative hydrocephalus (CH) is considered as one of the late sequelae of severe craniocerebral injury. However, as most of the series of patients with CH described in the literature deal with the results of various shunting procedures, the incidence of post-traumatic communicative hydrocephalus is not documented. We have found that almost 3.9% of 335 severe craniocerebral-injured patients develop communicative hydrocephalus. These patients were unconscious for various periods of time, therefore the triad described by Hakim and Adams cannot by itself lead the clinician to suspect possible development of communicative hydrocephalus. It is suggested that in prolonged coma, or in the presence of arrest in clinical progress in conscious craniocerebral-injured patients, communicative hydrocephalus should be suspected.

Activities of Daily Living↗

PubMedDate not supplied

Dreams in head-injured patients.

It is commonly believed that patients following severe head injury tend to dream less than before the injury. In order to evaluate this assumption 51 married head injury patients were interviewed about the frequency and content of their dreams before and after injury. Dreams with threatening content and dreams with manifest sexual content were especially analysed. The results indicate that the overall incidence of dreams in the late post-traumatic phase was similar to the pre-injury era. Threatening dreams were almost significantly more frequent after injury, and the reported incidence of dream with sexual manifest content decreased significantly post-injury. It is suggested that the dynamic mechanism for this phenomenon in head-injured patients is different from that found in the post-traumatic neurosis syndrome.

Adaptation, Psychological↗

PubMedDate not supplied

Psychotherapy in cases of brain damage: a possible mission.

We present here a psychodynamic model for treating brain-injured patients. In contrast to the common assumption that brain-injured patients remain in an emotional vacuum, our model uses dream material to enable a direct access to the psychic inner life of the patient. It thus refutes the view that these patients can only benefit from supportive psychotherapy.

Adult↗

PubMedDate not supplied

Acceptance of disability, work involvement and subjective rehabilitation status of traumatic brain-injured (TBI) patients.

A follow-up of 78 TBI patients one to two years after discharge from rehabilitation hospital supported hypothesized correspondence between work involvement and subjective rehabilitation status (SRS). Subjective rehabilitation was defined as the gratification of basic needs: physical well-being, emotional security, and family, social, economic, and vocational needs. Highest SRS was found among patients employed in the open market. Lower SRS was found in patients employed under protected conditions who also reported their work to be much less congruent with their expectations. Unemployed patients living active lives reported higher SRS than unemployed patients living passive lives, but both showed lower SRS than employed patients. Both work involvement and SRS were found to be related to acceptance of disability (AD). However, longitudinal data are needed to ascertain whether AD precedes or follows the other two variables. Both possibilities may be correct.

Activities of Daily Living↗

PubMedDate not supplied

Self-concept, marital vulnerability and brain damage.

The present study investigated the influence of a man's brain injury on both his and his wife's self-concept and perception of marital vulnerability. Thirty-six couples in which the husbands had brain damage and twenty-nine couples without disability filled out the Tennessee Self-concept Scale [1], and the Marital Vulnerability Scale [2]. Marital vulnerability of husbands with brain damage was found not to differ from that of the husbands in the control group. However, the marital vulnerability of the wives of the former husbands was lower than that of the other wives. Both men with brain damage and their wives exhibited a decrease in self-esteem and an increase in conflict and pathology. Brain damage appears to affect both the extent and direction of the relations between aspects of the self-concept and marital vulnerability differentially for husbands with brain damage and their wives. Practical and theoretical implications of the negative impact of brain damage upon the person with the damage, upon his wife, and upon their marital relationship are discussed.

Adaptation, Psychological↗