Psychometric assessment of recovery from mild traumatic brain injury

The Rapid Screen of Concussion (RSC) is a brief psychometric test battery, designed to provide a functional criterion to aid clinical diagnosis of mild traumatic brain injury (mTBI). The present research aimed to examine the utility of this instrument for assessing recovery after mTBI. Three studies were conducted. In Study 1, Discriminant Function Analysis was performed to determine how well the RSC differentiated uninjured controls (N¼16), from mTBI patients (N¼22) and moderate to severe TBI patients (N¼14), several months post-injury. As predicted, moderate to severe TBI patients achieved lower scores than the mTBI and control groups. The RSC also successfully differentiated between each of the diagnostic groups, yielding an overall correct classification rate of 75%. Study 2 examined the predictive utility of the RSC in the mTBI sample (N¼22). Acute injury performance on the RSC was correlated with post-injury scores at an average of 5.5 months post-injury. Statistically significant partial correlation coefficients (r¼0.53r¼0.80) were found for each of the subtests, showing that low acute RSC scores were predictive of poor recovery scores on the RSC after mTBI. In the third study, Reliable Change Indices were calculated on the RSC subtests to examine individual patterns of recovery from mTBI. While 17 of the 23 participants made a significant improvement on their acute injury DSST scores (74%), only 13 of 25 made a significant improvement on the Rapid Sentence Judgement Test (52%), highlighting differential recovery of function, and challenging the notion of full recovery from mTBI within 3 months. These overall results offer support for the construct and predictive validity of the RSC and demonstrate that inexpensive tests of brain function may be useful for managing mTBI acutely for prognosis.

Dysprosodic speech following basal ganglia insult: Toward a conceptual framework for the study of cerebral representation of prosody

Progress in understanding brain/behavior relationships in adult-acquired dysprosody has led to models of cortical hemispheric representation of prosodic processing based on functional (linguistic vs affective) or physical (timing vs pitch) parameters. These explanatory perspectives have not been reconciled, and also a number of neurobehavior syndromes that include dysprosody among their neurological signs have not yet been integrated. In addition to expanding the functional perspective on prosody, some of these syndromes have implicated a significant role of subcortical nuclei in prosodic competence. In this article, two patients with acquired dysprosodic speech following damage to basal ganglia nuclei were evaluated using behavioral, acoustic, cognitive, and radiographic approaches. Selective quantitative measures were performed on each individual’s performance to provide detailed verification and clarification of clinical observations, and to test hypotheses regarding prosodic function. These studies, combined with a review of related clinical research findings, exemplify the value of a broader perspective on the neurobehavioral dysfunction underlying acquired adult dysprosodic speech, and lead to a new, proposed conceptual framework for the cerebral representation of prosody.

Social Vulnerability Scale for older adults: Validation study

The Social Vulnerability Scale (SVS), an informant-report of social vulnerability for older adults, was piloted in a sample of 167 undergraduate students (63 male, 104 female) from the University of Queensland. Participants aged 18 - 53 (M = 25.53 years, SD = 7.83 years) completed the SVS by rating a relative or friend aged ≥50 years (M = 71.65 years, SD = 12.49 years): either someone with memory problems, stroke, dementia, or other neurological condition (n = 85); or a healthy older adult (n = 82). Excellent internal consistency and test - retest reliability were demonstrated, and the SVS effectively differentiated healthy older adults from those with a neurological condition based on proxy ratings of social vulnerability. The SVS is a potentially useful adjunct measure of older adults' capacity to reside independently. 1 *For information on using the Social Vulnerability Scale, email d.pinsker@psy.uq.edu.au or stone@psy.uq.edu.au

Screening for anxiety in mild cognitvely impaired individuals

Anxiety disorders are one of the most common psychiatric complaints across aU age cohorts, including older adults over age 65 (Regier et al., 1988; Regier, Narrow & Rae, 1990). Despite being a common complaint among older adults, anxiety remains underreported by patients and under diagnosed by health professionals (Stanley & Beck, 2000). Anxiety disorders have been less well studied in older adults than depression, both in terms of the assessment as well as treatment. While several anxiet)' inventories have normative data available for older populations, few anxiet)' measures have been specifically designed to be used with older populations. The primar)' aim of this pilot project was to evaluate the utility of a new anxiety screen specifically designed for older adults, the Geriatric Anxiet)' Inventor)' (GAI) on an older cohort with mild cognitive deficits.