Nancy M. Crewe

Marital status and adjustment to spinal cord injury.

Individuals with spinal cord injury were studied in 1974 (N = 256), 1985 (N = 347) and 1989 (N = 286) using the Life Situation Questionnaire (LSQ). The latter surveys included nearly all of the surviving participants from the 1974 sample plus a new sample of individuals with more recent injuries. Items covered activities, frequency of medical treatment, ratings of satisfaction with various aspects of life, ratings of problem areas, and judgments regarding personal adjustment to SCI. Subjects were grouped according to marital status (single, married or other) and compared on these variables. The single group was somewhat younger than the other two and included a higher proportion of employed individuals. Few differences were found in terms of subjective adjustment variables, however, possibly because the married group included both individuals who were married before their injuries and those married afterwards. A second set of analyses reported in this paper focused on subjects who were single during the 1974 study. On data collected in 1974 as well as data from 1985, the group who married were measurably different in several respects from those who remained single. This suggests that individuals in post-injury marriages were a select group and that the experience of marriage further strengthened their satisfaction with life and with their own adjustment.

Test-retest practice effects and test score changes of the WAIS-R in recovering traumatically brain-injured survivors

Abstract A group of adult TBI subjects who were tested at approximately 2, 4, 8, and 12 months postinjury with the WAIS-R were compared with a matched control group of similar adult TBI survivors who were tested twice with the WAIS-R at approximately 2 and 12 months postinjury. No significant differences were noted between the two groups on numerous preinjury, injury, or postinjury variables. Both groups demonstrated significant gains in both IQ and subtest scaled scores at 1 year postinjury. Significantly greater change scores were demonstrated in the experimental group than in the control group, suggesting possible test-retest practice effects in Performance IQ and several subtests. Trend analyses detected both linear and quadratic recovery curves, with recovery slowing by the third evaluation. Implications of results for clinical practice are discussed.

A 20-Year Longitudinal Perspective on the Vocational Experiences of Persons with Spinal Cord Injury

The vocational experiences of 50 individuals 22 to 45 years after a spinal cord injury are recounted based on interviews conducted in 1974 and 1994. As a group, their work records exceeded that of most samples reported in the literature; all except 7 have engaged in remunerative employment. At the time of the last interview, 58% were working full time and 16% were working part time. Factors that contributed to the vocational accomplishments of this sample include early work experiences, comprehensive rehabilitation services, and work ethic.

Traumatic brain injury/chronic pain syndrome: a case comparison study.

OBJECTIVE To identify the pretreatment characteristics and progress in treatment and outcomes of chronic pain patients, with and without concomitant traumatic brain injury (TBI). DESIGN AND PATIENTS Retrospective cohort study of 12 consecutive patients in a chronic pain treatment program who were discovered to have previously untreated brain injury and a cohort of 12 chronic pain patients from the same program matched for age and sex who did not have brain injury. SETTING Interdisciplinary university-based outpatient rehabilitation medicine clinic. MAIN OUTCOME MEASURES Length of time in treatment and vocational outcomes. RESULTS A surprising number of patients referred for treatment of chronic pain were found to have history and symptoms indicative of previously untreated or undiagnosed mild traumatic brain injury (n = 21 of 65). Of these, 12 received therapy for both their brain injury and chronic pain. The 12 treated, dual diagnosed patients did not differ in terms of education, employment status, or marital status from the chronic pain patients. Those with TBI were more likely to have sustained an automobile injury and less likely to have a work-related injury. On admission, 25% of each group were working, and at discharge, that proportion reached 75% for each group. Those with TBI required significantly longer treatment (459 consecutive days) from intake to discharge compared with the control group (295 days). CONCLUSION Patients who exhibit memory or concentration problems, who express confusion about their diagnosis, who were injured in an automobile accident, or who complain of pain in the head, neck, or arms should be questioned about the possibility of concurrent TBI. Most of these patients can achieve successful employment outcomes, however, the TBI group may require a longer treatment time.