Yelena Goldin

Sexual functioning and the effect of fatigue in traumatic brain injury.

Objectives:The primary objective was to examine specific aspects of sexual functioning (frequency, desired frequency, importance, and satisfaction) and their relationship to fatigue in individuals with traumatic brain injury (TBI) compared with those without brain injury. The relationship of demographic variables, emotional well-being, and health-related quality of life to sexual functioning was also explored. Participants:200 community-dwelling adults with self-reported mild-to-severe TBI and 83 individuals without brain injury. Measures:Participation Objective, Participation Subjective, Fatigue Assessment Instrument, Global Fatigue Index, Beck Depression Inventory, and SF-36 Health Survey. Methods:Data were collected through administration of self-report measures and interviews as part of a larger study of post–TBI fatigue. Results:Several aspects of sexual activity (frequency, desired frequency, and importance) were closely related to specific features of fatigue among individuals with TBI. Women with TBI reported lower frequency and lower importance of sex than men. In individuals without brain injury, the impact of fatigue was limited to the frequency of sexual activity with no sex differences observed. Conclusions:Fatigue plays a different role in the subjective experience of sexual activity for men and women with TBI than for those without brain injuries. Fatigue and sex should be taken into account in future research and interventions focused on sexual function after TBI.

Misconceptions and Misattributions About Traumatic Brain Injury: An Integrated Conceptual Framework.

The objective of the present narrative review was to provide a conceptual framework to address common misconceptions in the field of traumatic brain injury (TBI) and enhance clinical and research practices. This framework is based on review of the literature on TBI knowledge and beliefs. The comprehensive search of the literature included seminal and current texts as well as relevant articles on TBI knowledge and education, misconceptions, and misattributions. Reviewed materials ranged from 1970 to 2013 and were obtained from PubMed and PubMed Central online research databases. Research findings from the reviewed literature were integrated with existing social and cognitive psychological concepts to develop a framework that includes: (1) the identification antecedents of TBI‐related misconceptions and misattribution; (2) understanding of how inaccurate beliefs form and persist as the result of pre‐ and postinjury cognitive operations such as informational cascades and attribution biases; and (3) a discussion of ways in which these beliefs can result in consequences in all domains of a survivors life, including physical and mental health, stigma, and discrimination. This framework is intended to serve as a first stage of development of a model that will improve treatment endeavors and service delivery to individuals with TBI and their families.

Screening for History of Traumatic Brain Injury Among Women Exposed to Intimate Partner Violence

Traumatic brain injury (TBI) is a common chronically debilitating consequence of intimate‐partner violence (IPV). Diagnosis and effective treatment are precluded by poor detection and lack of uniform practice guidelines for TBI screening in IPV. Although there are several TBI‐screening tools commonly used in clinical and research practices, their applicability to this unique and vulnerable population is unclear. In this review paper, we propose a theoretically based framework for screening for history of TBI in women exposed to IPV and apply it to investigate the applicability of TBI‐screening instruments. The framework was developed by examining existing guidelines for working with IPV survivors and applied to evaluate the content of nine currently available TBI screening instruments to determine the extent to which each offers (1) events that can lead to TBI in an IPV situation; (2) safe (without increasing the risk of retaliation) endorsement of an event; and (3) ease of administration. Our evaluation of the currently available TBI‐screening tools determined that no instrument met the proposed framework standards and only 2 (Brain Injury Screening Questionnaire and Ohio State University TBI Identification Method) came close, requiring only minor adjustments to meet the postulated criteria. We make specific content and interview‐based recommendations for revising TBI screening instruments to minimize the weaknesses of currently available screening tools among women exposed to IPV and the knowledge gaps about TBI in this context. The proposed framework and recommendations are intended to guide future work in this area to enhance the capacity of TBI screening tools to safely detect TBI in this population.