This Position Statement is a summary of the literature and learning regarding current issues raised by the occurrence, treatment, and study of traumatic brain injury in military service members and veterans. The Report has been approved by the American Academy of Clinical Neuropsychology (AACN), Divisions 40 (Neuropsychology) and 22 (Rehabilitation Psychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN), with the goal of providing information of relevance on an important public policy matter within their respective areas of expertise. The Report is not intended to establish guidelines or standards for the professional practice of psychology, nor has it been adopted as official policy by the American Psychological Association or any other division or subunit of APA.
The clinical presentation of electrical injury commonly involves physical, cognitive, and emotional complaints. Neuropsychological studies, including case reports, have indicated that electrical injury (EI) survivors may experience a broad range of impaired neuropsychological functions, although this has not been clarified through controlled investigation. In this study, we describe the neuropsychological test findings in a series of 29 EI patients carefully screened and matched to a group of 29 demographically similar healthy electricians. Participants were matched by their estimated premorbid intellectual ability. Multivariate analysis of variance was used to assess group differences in the following neuropsychological domains: attention and mental speed, working memory, verbal memory, visual memory, and motor skills. EI patients performed significantly worse on composite measures of attention/mental speed and motor skills, which could not be explained by demographic differences, injury parameters, litigation status, or mood disturbance. Results suggest that cognitive changes do occur in patients suffering from electrical injury.
Initial differences in premorbid cognitive function possibly contribute to disparate clinical outcomes, including a greater proportion of blacks exhibiting subnormal neurocognitive performance. Blacks evidencing lower premorbid ability may be at greater vulnerability for poorer functional outcomes (eg, coping skills, medical compliance and employment) if they experience disease-related cognitive dysfunction.
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