Faculty Bibliography

Proposes a tripartite model for conceptualizing lack of awareness after traumatic brain injury (TBI), that distinguishes potential contributants to 'not knowing,' The model's components include information, implication, and integration. Careful assessment of the causes of unawareness must precede treatment. Treatment in early inpatient rehabilitation should balance the patient's need to know with the implications, both positive and negative, of not knowing, at that point in time, for that individual patient. The challenge to the therapist is one of constant monitoring of dynamic fluctuations in a patient's readiness (neurological or emotional) over time to become more aware of losses without becoming devastated by shame or despair.

Analysis of a series of verbal memory experiments reveals a systematic performance deficit in subjects with Parkinson's disease, relative to matched normal and right-hemisphere stroke controls, in both recall and recognition tasks. Parkinson patients benefit less from semantic recall cues; they find semantically mediated synonym detections particularly difficult; and they show reduced benefits from the introduction of semantically novel material in a recall task. Their recall is as well organized semantically as that of normal controls, but reduced in amount. Recognition deficits arise principally from increases in false positive responses