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Development of an MMPI reference group for outpatients with persisting symptoms following mild TBI

Childs, Amanda; Bertisch, Hilary; Talis, Elina; Ricker, Joseph H; Rath, Joseph F
OBJECTIVE/UNASSIGNED:To develop an MMPI-2-RF reference group for persistently symptomatic patients with mTBI in order to aid interpretation and better evaluate atypical scale elevations. METHOD/UNASSIGNED:Using the Q Local MMPI-2-RF Comparison Group Generator (CGG), 200 valid MMPI-2-RF profiles were aggregated for mTBI outpatients with persisting symptoms 2-24 months post injury. RESULTS/UNASSIGNED:scores > 60 and standard deviations > 10 were observed for the F-r (Infrequent Responses), Fs (Infrequent Somatic Responses), FBS-r (Symptom Validity), RBS (Response Bias Scale), RC1 (Somatic Complaints), MLS (Malaise), HPC (Head Pain Complaints), NUC (Neurological Complaints), and COG (Cognitive Complaints) scales. All other scales were consistent with established norms for the general population. CONCLUSION/UNASSIGNED:This study is the first to establish an empirically derived MMPI reference group for individuals with persisting symptoms following mTBI. By comparing MMPI profiles of patients with mTBI against this reference group, clinicians may be better able to identify abnormal symptomatology. Evaluating profiles within this context may allow for more accurate case conceptualization and targeted treatment recommendations for those patients who demonstrate disproportionate symptomatology outside the range of the mTBI reference group.
PMID: 36324279
ISSN: 1362-301x
CID: 5358662

Brief Report: Cognitive Dependence in Physically Independent Patients at Discharge from Acute Traumatic Brain Injury Rehabilitation

Rath, Joseph F; McGiffin, Jed N; Glubo, Heather; McDermott, Hannah W; Beattie, Aaron; Arutiunov, Caitlyn; Schaefer, Lynn A; Im, Brian; Bushnik, Tamara
OBJECTIVE:To determine the incidence of cognitive dependence in adults who are physically independent at discharge from acute traumatic brain injury (TBI) rehabilitation. DESIGN/METHODS:Analysis of historical clinical and demographic data obtained from inpatient stay. SETTING/METHODS:Inpatient rehabilitation unit in a large, metropolitan university hospital. PARTICIPANTS/METHODS:Adult inpatients with moderate-to-severe TBI (N = 226) who were physically independent at discharge from acute rehabilitation. INTERVENTIONS/METHODS:Not applicable MAIN OUTCOME MEASURES: FIM Motor and Cognitive subscales, discharge destination, and care plan. RESULTS:Approximately 69% (n = 155) of the physically independent inpatients were cognitively dependent at discharge from acute rehabilitation, with the highest proportions of dependence found in the domains of problem solving and memory. Most (82.6%; n =128) of these physically independent, yet cognitively dependent, patients were discharged home. Of those discharged to home, 82% (n = 105) were discharged to the care of family members, and 11% (n = 15) were discharged home alone. Patients from racial-ethnic minority backgrounds were significantly more likely than White patients to be discharged while cognitively dependent. CONCLUSIONS:The majority of physically independent TBI patients were cognitively dependent at the time of discharge from acute inpatient rehabilitation. Further research is needed to understand the impact of cognitive dependence on caregiver stress and strain and the disproportionate burden on racial-ethnic minority patients and families. Given the potential functional and safety limitations imposed by cognitive deficits, healthcare policy and practice should facilitate delivery of cognitive rehabilitation services in acute TBI rehabilitation.
PMID: 35196504
ISSN: 1532-821x
CID: 5163132

Multi-shell diffusion MR imaging and brain microstructure after mild traumatic brain injury: A focus on working memory

Chapter by: Chung, Sohae; Fieremans, Els; Rath, Joseph F.; Lui, Yvonne W.
in: Cellular, Molecular, Physiological, and Behavioral Aspects of Traumatic Brain Injury by
[S.l.] : Elsevier, 2022
pp. 393-403
ISBN: 9780128230602
CID: 5349102

Multi-shell diffusion MR imaging and brain microstructure after mild traumatic brain injury: A focus on working memory

Chapter by: Chung, Sohae; Fieremans, Els; Rath, Joseph; Lui, Yvonne
in: Neuroscience of Traumatic Brain Injury by Rejendram, Rajkumar; Preedy, Victor; Martin, Colin
[S.l.] : Elsevier, 2022
pp. -
ISBN: 9780323991971
CID: 5110812

The effects of plasticity-based cognitive rehabilitation on resting-state functional connectivity in chronic traumatic brain injury: A pilot study

Lindsey, Hannah M; Lazar, Mariana; Mercuri, Giulia; Rath, Joseph F; Bushnik, Tamara; Flanagan, Steven; Voelbel, Gerald T
BACKGROUND:Traumatic brain injury (TBI) often results in chronic impairments to cognitive function, and these may be related to disrupted functional connectivity (FC) of the brain at rest. OBJECTIVE:To investigate changes in default mode network (DMN) FC in adults with chronic TBI following 40 hours of auditory processing speed training. METHODS:Eleven adults with chronic TBI underwent 40-hours of auditory processing speed training over 13-weeks and seven adults with chronic TBI were assigned to a non-intervention control group. For all participants, resting-state FC and cognitive and self-reported function were measured at baseline and at a follow-up visit 13-weeks later. RESULTS:No significant group differences in cognitive function or resting-state FC were observed at baseline. Following training, the intervention group demonstrated objective and subjective improvements on cognitive measures with moderate-to-large effect sizes. Repeated measures ANCOVAs revealed significant (p <  0.001) group×time interactions, suggesting training-related changes in DMN FC, and semipartial correlations demonstrated that these were associated with changes in cognitive functioning. CONCLUSIONS:Changes in the FC between the DMN and other resting-state networks involved in the maintenance and manipulation of internal information, attention, and sensorimotor functioning may be facilitated through consistent participation in plasticity-based auditory processing speed training in adults with chronic TBI.
PMID: 35404295
ISSN: 1878-6448
CID: 5205092

Veterans with Gulf War Illness perceptions of management strategies

Winograd, Darren M; Sullivan, Nicole L; Thien, Scott R; Pigeon, Wilfred R; Litke, David R; Helmer, Drew A; Rath, Joseph; Lu, Shou-En; McAndrew, Lisa M
AIMS/OBJECTIVE:Gulf War Illness (GWI) is a prevalent and disabling condition characterized by persistent physical symptoms. Clinical practice guidelines recommend self-management to reduce the disability from GWI. This study evaluated which GWI self-management strategies patients currently utilize and view as most effective and ineffective. MATERIALS AND METHODS/METHODS:Data were collected from 267 Veterans during the baseline assessment of a randomized clinical trial for GWI. Respondents answered 3 open-ended questions regarding which self-management strategies they use, view as effective, and view as ineffective. Response themes were coded, and code frequencies were analyzed. KEY FINDINGS/RESULTS:Response frequencies varied across questions (in-use: n = 578; effective: n = 470; ineffective: n = 297). Healthcare use was the most commonly used management strategy (38.6% of 578), followed by lifestyle changes (28.5% of 578), positive coping (13% of 578), and avoidance (13.7% of 578). When asked about effective strategies, healthcare use (25.9% of 470), lifestyle change (35.7% of 470), and positive coping (17.4% of 470) were identified. Avoidance was frequently identified as ineffective (20.2% of 297 codes), as was invalidating experiences (14.1% of 297) and negative coping (10.4% of 297). SIGNIFICANCE/CONCLUSIONS:Patients with GWI use a variety of self-management strategies, many of which are consistent with clinical practice guidelines for treating GWI, including lifestyle change and non-pharmacological strategies. This suggests opportunities for providers to encourage effective self-management approaches that patients want to use.
PMID: 33592197
ISSN: 1879-0631
CID: 4786692

Feasibility and acceptability of a brief videoconference-delivered group intervention for COVID-related anxiety in neurorehabilitation outpatients living in the epicenter of the pandemic [Meeting Abstract]

Arutiunov, C; Klepper, J; McGiffin, J; Rath, Joseph F
ISSN: 1532-821x
CID: 4871702

Continuity of care in the epicenter of a global pandemic: How one New York City rehabilitation psychology outpatient service met the challenge of COVID-19 [Meeting Abstract]

Arutiunov, C; Connor, F; Klepper, J; Rath, Joseph F
ISSN: 1532-821x
CID: 4871692


Winograd, Darren; Sullivan, Nicole L.; Thien, Scott; Pigeon, Wilfred; Litke, David R.; Helmer, Drew; Rath, Joseph; Lu, Shou-En; Kimber, Justin M.; Brunkow, Alye; Cannon, Margeaux; Long, Phoebe; McFarlin, Mikhaela; Crosky, Sarah; McAndrew, Lisa M.
ISSN: 0883-6612
CID: 4919862


Graff, Fiona S.; Litke, David R.; Anastasides, Nicole; Gonzalez, Christina; Lu, Shou-En; Pigeon, Wilfred; Quigley, Karen S.; Rath, Joseph; Sullivan, Nicole L.; McAndrew, Lisa M.
ISSN: 0883-6612
CID: 4919852