Sleep and information processing in individuals who have sustained a traumatic brain injury

Individuals who have sustained a traumatic brain injury (TBI) often complain of t roubl e sleeping and daytime fatigue but little is known about the neurophysiological underpinnings of the s e sleep difficulties. The fragile sleep of thos e with a TBI was predicted to be characterized by impairments in gating, hyperarousal and a breakdown in sleep homeostatic mechanisms. To test these hypotheses, 20 individuals with a TBI (18- 64 years old, 10 men) and 20 age-matched controls (18-61 years old, 9 men) took part in a comprehensive investigation of their sleep. While TBI participants were not recruited based on sleep complaint, the fmal sample was comprised of individuals with a variety of sleep complaints, across a range of injury severities. Rigorous screening procedures were used to reduce potential confounds (e.g., medication). Sleep and waking data were recorded with a 20-channel montage on three consecutive nights. Results showed dysregulation in sleep/wake mechanisms. The sleep of individuals with a TBI was less efficient than that of controls, as measured by sleep architecture variables. There was a clear breakdown in both spontaneous and evoked K-complexes in those with a TBI. Greater injury severities were associated with reductions in spindle density, though sleep spindles in slow wave sleep were longer for individuals with TBI than controls. Quantitative EEG revealed an impairment in sleep homeostatic mechanisms during sleep in the TBI group. As well, results showed the presence of hyper arousal based on quantitative EEG during sleep. In wakefulness, quantitative EEG showed a clear dissociation in arousal level between TBls with complaints of insomnia and TBls with daytime fatigue. In addition, ERPs indicated that the experience of hyper arousal in persons with a TBI was supported by neural evidence, particularly in wakefulness and Stage 2 sleep, and especially for those with insomnia symptoms. ERPs during sleep suggested that individuals with a TBI experienced impairments in information processing and sensory gating. Whereas neuropsychological testing and subjective data confirmed predicted deficits in the waking function of those with a TBI, particularly for those with more severe injuries, there were few group differences on laboratory computer-based tasks. Finally, the use of correlation analyses confirmed distinct sleep-wake relationships for each group. In sum, the mechanisms contributing to sleep disruption in TBI are particular to this condition, and unique neurobiological mechanisms predict the experience of insomnia versus daytime fatigue following a TBI. An understanding of how sleep becomes disrupted after a TBI is important to directing future research and neurorehabilitation.

Ties From My Father: Personal Narrative as a Tool for Engaging Teenagers and Social Service Practitioners

The purpose of this project is to provide social service practitioners with tools and perspectives to engage young people in a process of developing and connecting with their own personal narratives, and storytelling with others. This project extensively reviews the literature to explore Why Story, What Is Story, Future Directions of Story, and Challenges of Story. Anchoring this exploration is Freire’s (1970/2000) intentional uncovering and decoding. Taking a phenomenological approach, I draw additionally on Brookfield’s (1995) critical reflection; Delgado (1989) and McLaren (1998) for subversive narrative; and Robin (2008) and Sadik (2008) for digital storytelling. The recommendations provided within this project include a practical model built upon Baxter Magolda and King’s (2004) process towards self-authorship for engaging an exercise of storytelling that is accessible to practitioners and young people alike. A personal narrative that aims to help connect lived experience with the theoretical content underscores this project. I call for social service practitioners to engage their own personal narratives in an inclusive and purposeful storytelling method that enhances their ability to help the young people they serve develop and share their stories.