Cognitive and Social Development Differences in Individuals with TBI

1. Cognitive and Social Development Differences in Individuals with TBI  Alejandra Aguilar, Jason Grossman, Kent Hsieh, & Joanne Wong 

2. Introduction Please give your attention to the tallest member of our group 

3. Traumatic Brain Injuries (TBI) Occur when an individual’s head hits an object but that object does not break through the skull.

5. Who is susceptible to a Traumatic Brain Injury (TBI)? • Anyone, including • Babies • Children • Young adults • Parents • Students • Professionals • Athletes • Soldiers

6. What the studies show • Individuals who have sustained a TBI have to work harder than individuals from the same backgrounds (socioeconomic and educational) than those who have not. • The studies showed how those who sustained the injury scored lower on tests while simultaneously requiring more time to do so.

7. Each year • 2% of the population are effected (Ouellet, & Morin, 2006) • Unlike broken bones or sprains a TBI remains with the victim for the rest of their lives

8. Classification of TBI • The Diagnostic and Statistical Manual of Mental Disorders labels TBI as an Axis III Disorder • An Axis III disorder is a General Medical Condition

9. Long term issues • Social problem solving and community integration (Rath, Hennessy, & Diller, 2003) • Performance decrements • Learning abilities • Work performance • Social interactions • Personal • Work • Educational

10. Causes of Injuries

11. Cognitive Development • Usually refers to how an individual thinks and gains understanding based on his or her genetic and learned factors. • Information processing, memory, reasoning, and intelligence are usually gathered to measure one’s cognitive development

12. Memory • Memory loss is one of the most common cognitive side effects of traumatic brain injury (TBI). • Even in mild TBI, memory loss is still very common. • The more severe the victim's memory loss after the TBI, the more significant the brain damage will most likely be.

13. Memory (Continued) • At the current time, there is no treatment for memory loss following TBI. • If the memory does not come back on its own, it will be lost permanently. • There is a great deal of research in the field of TBI and memory loss, but, unfortunately, there are no cures for memory loss following TBI. (Newsome et al., 2008)

14. Personality • Personality changes are a common effect of traumatic brain injury, and are often cited by family and friends as the most difficult effect to deal with. • In some cases personality changes are short term and resolve as the patient recovers, whereas in other cases the personality changes are permanent.

15. Personality (Continued) • Depression • Anxiety • Apathy • Irritability • Anger • Confusion • Agitation • Insomnia • Mood swings…etc

16. Treatment for Personality Changes • Most survivors of traumatic brain injury who suffer from personality changes, emotional problems, and problem behaviors will be treated with a combination of psychotherapy and medication. (Rush, Malec, Brown, & Moessner et al.,2006)

17. Social Development • Social is the interaction between organisms. • Interpreting social cues • Thumbs up • High Five • These are different cross-culturally • Taking into consideration the needs of others and maintaining interpersonal relationships

18. Interpreting Social Cues • TBI patients sometimes lose the ability to recognize facial expression (Knox & Douglas, 2008). • Interaction is hampered through the limitations on the individual (Long, McDonald, Tate, Togher, & Bornhofen, 2008) . • TBI can result in social isolation through-> • Loss of self • Decreased self-esteem • Deceased self-efficacy (Landau & Hissett, 2008)

19. Relationships • Loss of self • Decreased self-esteem • Deceased self-efficacy • Relationships are often broken because of the three factors. • Through this series of events, depression is common.

20. Recovery • Through a social support system, the impact of TBI can be lessened. (Engberg & Teasdale, 1998 ) • Social development recovery rates for children are higher than for adults demonstrating a level of plasticity (Hanten, et al., 2008). • However children with TBI still lack the social skills of children without brain trauma.

21. Conclusion • Studies on patients with TBI reveal differences in cognitive and social development

22. Further Research • Longitudinal Changes • Blame attribution • Association with other psychiatric disorders (Hart et al., 2007)

23. Further Research (Continued) • Reasons for the variety of outcomes among brain injury patients (Drotar et al., 2009)

24. TBI Patient’s Future • Regardless of TBI’s effects on people, studies show that there is still hope for a small amount of functional impairment to be actually caused by brain injury.

25. References Drotar, D., Fay, T.B., Stancin, T., Taylor, H.G.,Wade, S.L, & Yeates, K.O. (2009). Predicting longitudinal patterns of functional deficits in children with traumatic brain injury. Neuropsychology, 3(1), 271–282. doi:10.1037/a0014936   Engberg, A. & Teasdale, T.W. (1998). Traumatic brain injury in children in Denmark: A national 15-year study. European Journal of Epidemiology, 14(1), 165-173. Hanten, G., Wilde, E. A., Menefee, D.S., Li, X., Vasquez, C., Swank, P., Hunter, J.V., Lane, S., Chu, Z., Ramos, M.A., Yallampalli, R., Chapman, S.B., Gamino, J., & Levin, H.S. (2008). Correlates of social problem solving during the first year after traumatic brain injury in children. Neuropsychology, 22(3), 357-370. doi: 10.1037/0894-4105.22.3.357 Hart, T., Hanks, R., Bogner, J., Millis, S., & Esselman, P. (2007). Blame attribution in intentional and unintentional traumatic brain injury: Longitudinal changes and impact on subjective well-being. Rehabilitation Psychology, 52(2), 152-161. doi: 10.1037/0090-5550.52.2.152  Knox, L., & Douglas, J. (2009). Long-term ability to interpret facial expression after trauma brain trauma and its relation to social integration. Brain and Cognition, 69(1), 442-449. doi: 10.1016/j.bandc.2008.09.009 Landau, J., & Hissett, J. (2008). Mild traumatic brain injury: Impact on identity and ambiguous loss in the family. Families, Systems, & Health 26(1), 69-85. doi:10.1037/1091-7527.26.1.69

26. Long, E., McDonald, S., Tate, R., Togher, L., & Bornhofen, C. (2008). Assessing social skills in people with very severe traumatic brain injury: Validity of the social performance survey schedule (SPSS). Brain Impairment, 9(3), 274-281.  Newsome, M. R., Steinberg J. L., Scheibel, R. S., Troyanskaya, M., Chu, Z., Hanten, G., Lin, X., &Levin, H. S. (2008). Effects of traumatic brain injury on working memory-related brain activation in adolescents.  Neuropsychology, 22(4), 419-425. doi: 10.1037/0894-4105.22.4.419  Ouellet, M.C., & Morin, C.M. (2006). Following traumatic brain injury: Frequency, characteristics, and associated factors. Rehabilitation Psychology, 51(2), 140-149. doi: 10.1037/0090-5550.51.2.140 Rath, J., Hennessy, J., & Diller, L. (2003). Social problem solving and community integration in postacute rehabilitation outpatients with traumatic brain injury. Rehabilitation Psychology, 48(3), 137-144. doi: 10.1037/0090-5550.48.3.137   Rush, B., Malec, J. F., Brown, A.W., & Moessner, A. M. (2006). Personality and functional outcome following traumatic brain injury.  Rehabilitation Psychology 51(3), 257-264.  doi: 10.1037/0090-5550.51.3.257