Rehabilitation professionals should stress the importance of caregivers and families of persons with TBI seeking and obtaining adequate social support.

Social support is an important determinant of adjustment following traumatic brain injury (TBI) sustained by a family member. The present study examined the extent to which social support moderates the influence of characteristics of the person with injury on caregiver subjective well-being. Sixty pairs of individuals who had sustained a moderate to severe TBI and their caregivers (N=120) participated. Years postinjury ranged from 0.3 to 9.9 ( M=4.8, SD=2.6). Cognitive, functional, and neurobehavioral functioning of participants with TBI were assessed using neuropsychological tests and rating scales. Caregiver life satisfaction and perceived social support were assessed using self-report questionnaires. Results indicated that time since injury was unrelated to life satisfaction. Neurobehavioral disturbances showed an inverse relation with life satisfaction. Social support emerged as an important moderator of life satisfaction. Only among caregivers with low social support was cognitive dysfunction adversely related to life satisfaction. Similarly, a trend suggested that patient unawareness of deficit was associated with caregiver life dissatisfaction only among caregivers with low social support. In contrast, these characteristics were unrelated to life satisfaction among caregivers with adequate social support.

Neurologic events associated with antiphospholipid antibodies (aPAs) include transient ischemic attack, stroke, and vascular dementia in individuals much younger than is typically observed with these disorders. The present study evaluated 27 non-elderly adults with aPAs but without concurrent disease processes or history of neurologic event and 27 age- and education-matched controls. MANOVA (p <.01) indicated group differences in executive functioning, verbal learning and memory, and visuospatial ability. In contrast, gross attentional processes and fine motor skills appeared unaffected by the syndrome. Moreover, the frequency of impaired neuropsychologic performance was greater among individuals with aPAs than among controls (p <.01). The presence of cognitive deficits in otherwise asymptomatic patients with aPAs indicates a preclinical phase of neurologic involvement and may prove to be the most sensitive markers of the syndrome.

The diagnostic accuracy of California Verbal Learning Test (CVLT) indices to detect malingered head injury was examined using a simulation paradigm that included naive malingerers, malingerers provided with information about head injury, and normal controls (N = 90). The application of diagnostic cutoff scores for Recognition Discriminability and Recognition Hits derived from populations of individuals with bona fide head injury and individuals suspected of malingering (Millis et al., 1995) proved highly sensitive and modestly specific in detecting feigned head injury among both simulation groups. Results of analyses of variance and logistic regression support previous findings that malingerers overestimate memory impairment associated with mild head injury; however, they indicate that exposure to a simple instructional set may render insensitive many indices of malingering. In contrast, indices based on more subtle principles of learning theory hold promise in the detection of malingering, even in the presence of an instructional set.