ptsd Posttraumatic Stress Disorder In Patients With Traumatic Brain Injury And Amnesia For The Event?

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J Neuropsychiatry Clin Neurosci. 1997 Winter;9(1):18-22.

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Posttraumatic stress disorder in patients with traumatic brain injury and amnesia for the event?

Warden DL, Labbate LA, Salazar AM, Nelson R, Sheley E, Staudenmeier J, Martin E.

Defense and Veterans Head Injury Program, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA.

Frequency of DSM-III-R posttraumatic stress disorder (PTSD) was studied in 47 active-duty service members (46 male, 1 female; mean age 27 = 7) with moderate traumatic brain injury and neurogenic amnesia for the event. Patients had attained "oriented and cooperative" recovery level. When evaluated with a modified Present State Examination and other questions at various points from study entry to 24-month follow-up, no patients met full criteria for PTSD or met criterion B (reexperience); 6 (13%) met both C (avoidance) and D (arousal) criteria. Five of these 6 also had organic mood disorder, depressed type, and/or organic anxiety disorder. Posttraumatic amnesia following moderate head injury may protect against recurring memories and the development of PTSD. Some patients with neurogenic amnesia may develop a form of PTSD without the reexperiencing symptoms.

Publication Types:

· Clinical Trial

PMID: 9017524 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=9017524

[timetowinarace]

No on the pension. My SO said my wife makes too much to qualify.

I got my C-file in the mail yesterday. Here is the assessment from the C&P for depression. See what you think.

AXIS I: 1. Rule out cognative disorder, not otherwise specified

2. Major Depressive dissorder secondary to cognative disorder.

AXIS II None

AXIS III Please see above past medical history.

AXIS IV 1. Stressors include current mental disorder and inability to earn income.

2. Social isolation

AXIS V GAF score is 38 for rule out cognative disorder and major depressive disorder secondary to cognative disorder.

He goes on to state that the patient has had significant cognitive disfunction since head trauma in service. And later, " because of this I have asked for Neuro-psychological testing on this patient because it seems obvious that he had suffured some losses. (omit one sentance) I will need to put an adendum on this report after receiving that information."

I never got tested by the VA.

Then it says, "Additionally, the patient is depressed. this depression can be traced back to his head injury,".

"I do not think he is employable at this point"

Last sentance. " Because of his head injury, probable cognative losses and ongoing use of marijuana he is not competent for VA purposes". Is that bad? I'm not sure what that means.

Anyway, I was denied. No records. In 2003 and for this. There are at least two forms in my claims file submitted with my origanal claim in '03 that give the excact date and hospital I was admitted to. The same info I used to find my records. And whats up with deciding my claim when their own examiner requested more information-testing? I can tell you why. In his report the examiner states. "If his cognative losses cannot be demonstrated then I would tend to think more of a chronic fatigue syndrome would be appropriate with a surge for a viral etiology or something of that nature." My claims were to increase my rating for SC chronic fatigue and depression secondary to SC. If I had tested, and cognative dissorder was verified I had new medical evidence to reopen my head trauma claim. If I had tested, and cognative dissorder was ruled out, this examiners report bolsters both my claims that are on the table. In his opinion I am unemployable and not competent. If I am tested, either way, I win. But, the RO decides NOT to develope the veterans claim to his beniffit and decides the claim without all the neccissary evidence because that is the only way to deny the claim. AXIS I 1. Rule out cognative dissorder, not otherwise specified. How much more illegal can you get?

Time

[Wings]

No on the pension. My SO said my wife makes too much to qualify.

I got my C-file in the mail yesterday. Here is the assessment from the C&P for depression. See what you think.

AXIS I: 1. Rule out cognative disorder, not otherwise specified

2. Major Depressive dissorder secondary to cognative disorder.

AXIS II None

AXIS III Please see above past medical history.

AXIS IV 1. Stressors include current mental disorder and inability to earn income.

2. Social isolation

AXIS V GAF score is 38 for rule out cognative disorder and major depressive disorder secondary to cognative disorder.

He goes on to state that the patient has had significant cognitive disfunction since head trauma in service. And later, " because of this I have asked for Neuro-psychological testing on this patient because it seems obvious that he had suffured some losses. (omit one sentance) I will need to put an adendum on this report after receiving that information."

I never got tested by the VA.

Then it says, "Additionally, the patient is depressed. this depression can be traced back to his head injury,".

"I do not think he is employable at this point"

Last sentance. " Because of his head injury, probable cognative losses and ongoing use of marijuana he is not competent for VA purposes". Is that bad? I'm not sure what that means.

Anyway, I was denied. No records. In 2003 and for this. There are at least two forms in my claims file submitted with my origanal claim in '03 that give the excact date and hospital I was admitted to. The same info I used to find my records. And whats up with deciding my claim when their own examiner requested more information-testing? I can tell you why. In his report the examiner states. "If his cognative losses cannot be demonstrated then I would tend to think more of a chronic fatigue syndrome would be appropriate with a surge for a viral etiology or something of that nature." My claims were to increase my rating for SC chronic fatigue and depression secondary to SC. If I had tested, and cognative dissorder was verified I had new medical evidence to reopen my head trauma claim. If I had tested, and cognative dissorder was ruled out, this examiners report bolsters both my claims that are on the table. In his opinion I am unemployable and not competent. If I am tested, either way, I win. But, the RO decides NOT to develope the veterans claim to his beniffit and decides the claim without all the neccissary evidence because that is the only way to deny the claim. AXIS I 1. Rule out cognative dissorder, not otherwise specified. How much more illegal can you get?

Time

In psychaitric nomenclature (language), to "rule out" something means that they have considered the diagnosis as "subthreshold" and want to more closely examine the causitive factors. In other words, your diagnosis IS, in fact, Cognative Disorder (NOS), and they want a specialist or additional testing i.e. blood tests or brain tests/scans to rule out the presence of other conditions. For the time being, consider Cognative Disorder your primary diagnosis. Depression, second. Axis II is for Personality Disorders: you have NONE. Your testing/examination shows an otherwise normal individual with no character disorders/traits, no malingering. Your GAF of 38 means you experience significant occupational and social distress. This was a good report - and s/he wants you to have additional testing. ~Wings

[timetowinarace]

Jay,

I'm aware of the Bell Curve Theory but have not researched it. It was always contraversial and never widely excepted. Modern psychology teaches the disadvantages to using IQ tests. Language is the barrier in any formal testing. A spanish speaking person with engish as a second language is not expected to reach their full potential on an IQ test designed by people with english as a primary language. It is widely excepted that IQ testing, any IQ testing, is flawed by cultural background. It has been less than two years since I tood psychology. At that time the litature suggests that there is NO unbiased full IQ test available. Yes, I would think mathmatics would be an exception to this rule as the symbols are universal worldwide.

The study I mentioned did not refer to the AFQT. Please reread the portion posted. IQ was determined using all ten subsets of the ASVAB. AFQT uses the three subsets that are loaded highest with g. The term 'first factor g' may have originated in the bell curve although I believe it was just used to determine IQ, I do not know. But I do know that g is used in all IQ testing. You are not testing FOR IQ. IQ is a scale. You are testing for g in wich your scores are put on a scale in correlation with the rest of the population. That score is called your IQ.

It is not politically correct for the millitary to test IQ. It is discrimination. But they must be able to prescreen for those that cannot learn. That is allowed. The DoD cannot call the ASVAB an IQ test. It's that simple. All subtests of the ASVAB are highly loaded with the first factor g. This is proven. But the DoD does not convert these scores to an IQ. The AFQT comes closest to this. The DoD does not SCORE IQ from the ASVAB. However, the ASVAB is highly loaded with g and CAN be, and HAS been converted to IQ scores.

I wrote a college paper too.

John C. Price

2/22/04

Intelligence, Cognition and Motivation

There is a lot of debate in the psychology field on just what intelligence is. Though tests have been made to measure intelligence researchers are having a hard time defining it. It is unclear as to how accurate testing is and without a clear definition, what is an I.Q. test measuring? Cognition is the basis for intelligence and just may be the same thing, but add motivation and you have a recipe for success no matter how an individual may rate for intelligence. We all have the same level of intelligence, it’s our individual experiences that make us different.

Studies show that success does not necessarily mean intelligence. Reviewing a study done by Lewis Terman, Don and Sandra Hockenbury (1) found that of a group of children with high test I.Q.'s, the children that were the most successful later in life all had characteristics of being goal oriented, perseverant and self confident. Other children with the same I.Q. but without these traits were slightly above average in income and had normal rates of alcoholism and divorce. So it can be concluded that success is not intelligence. At least, it requires more than intelligence.

Intelligence can be a judgment. People are judged against others on their level of intelligence. People also judge themselves. With each person having their own thinking patterns brought on by a lifetime of learning it is unfair to judge each other on the ideas that each of us can grasp or not grasp. We are all motivated by different things in life and thus, those are the things we concentrate most on. It is much more difficult to learn something that we have little interest in than something we like.

Perhaps intelligence is just another word for cognition. Cognition can be defined as “the mental process or faculty of knowing” or “that which comes to be known.” (2) Cognition is at least the basis of intelligence and is the foundation of learning and problem solving. It is born into each and every one of us. Based on our life experience, motivations, and genetic predispositions it is used in different ways.

Cognitive ability is what is actually tested in an I.Q. test. As socially and culturally biased as these tests are, they are designed to test our learning and problem- solving abilities. Since every one of us has had different life experiences from the time we were born these tests attempt to gauge several different aspects of cognition.

Cognitive development is thought to begin in early childhood, shortly after birth. According to W. Huit & J. Hummel (3) Jean Paiget (1896-1980) “was one of the most influential researchers in the area of developmental psychology during the twentieth century.” Much of what developmental psychologists use today came from the work of Paiget. It is believed that our early childhood experiences form our cognition abilities and as we grow older and gain knew experiences, we “either adapt our views to fit our environment or we adapt our environment to fit our views.”(3)

Learning is one aspect of cognitive abilities. We learn mostly by observation. What we see and experience is compartmentalized, categorized, processed, and remembered. But, how we remember it is directly related to what we have learned earlier in life. We actually see the world through colored lens. A number of individuals watching the same scene will all “see” something different based on their own previous life experience.

It would appear that intelligence is not something that can be measured by itself. If cognitive ability is a learned trait and learning is a continuing process based on the things that have been learned since birth, then all individuals are born with the same capacity for intelligence and only their experiences determine what and how they learn. To determine that one person has a higher intelligence than another is a fallacy. They both have the same intelligence; only they have had different experiences and learn in different ways.

Motivation has an impact on learning, problem solving, success, and all other aspects of intelligence and cognition. In order to learn, an individual must have a reason to do so. According to W. Huit, (4) “cognitive dissonance theory suggests that we will seek balance or homeostasis in our lives and will resist influences or expectations to change.” Without motivation of some kind we will do nothing new.

Many successful people can be considered intelligent. For most of them though, long hours and hard work has made them successful. In our culture, success is almost synonymous with intelligence. It should not be. Any one that works hard enough will be considered both successful and intelligent. A person that is not especially successful may be judged as less intelligent, or judge themselves as such, but should not be. They simply have had different life experience and are motivated in other directions or not motivated at all.

Learning is directly affected by motivation. If a person has a goal in mind and must learn a task in order to accomplish a goal, that person will learn even if it is difficult. The more interested a person is in a subject the easier it is to learn. An individual is more likely to put more time and effort into a project that they enjoy than one they do not. Memory is also enhanced for things that people are motivated to do.

Problem solving is also affected by motivation in the same way as learning. When faced with a particular problem, a person will spend more time and effort into solving the problem if it has a direct interest to them. Many times a problem that is less interesting to an individual will be procrastinated on and in many cases will not get solved. If it is not important to the person it will just be forgotten so that problems that do interest them will get the majority of their attention. It’s not that someone is not intelligent enough to solve the problem, just that they are not motivated to do so.

Other than injury or birth defects all people are born with the same degree of intelligence. Other than injury all people keep the same level of intelligence. The difference people notice in others is the individual life experience of each individual that determines how they perceive ideas, store information, solve problems, and their motivations for doing these things. A person may be unable to learn something, but it is because of motivational and an ingrained process for doing other things that prevents the learning, not a lack of intellect.

References

1. Hockenbury D, Hockenbury S. Does a high IQ score predict success in life? New York: Worth Publishers; 2003. 576 p.

2. American heritage dictionary. New York: Dell Publishing; 1994. 952 p.

3. Huit W, Hummel J. Cognitive Development. [online posting] 2003. Available from URL: http://chiron.valdosta.edu/whuit/col/cogsys/piaget.html. Accessed 2/22/2004

4. Huit W. Motivation. [online posting] 2001. Available from URL: http://chiron.valdosta.edu/whuit/col/motiv...n/motivate.html . Accessed 2/22/2004

If you read it, you know I think IQ is bunk. But, testing is a benchmark.

Time

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John C. Price?

Are you an SO with the DAV?

[timetowinarace]

John C. Price?

Are you an SO with the DAV?

John C. Price, yes. SO, no. Unemployed fitter/welder.