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Projects of the TBINDC Registry by Researchers Last Name
The Reciprocal Relationship of Survivor and Caregiver Emotional Adjustment: Implications for Community Reintegration.
Abstract: The purpose of this study is to identify characteristics of persons with brain injury and their caregivers associated with survivor distress and family dysfunction. We will investigate outcome within the framework of a traditional model, which views caregiver well-being as influenced by stresses associated with caring for a person with TBI, and within the framework of a dynamic systems model, in which the well-being of persons with TBI and their caregivers influence each other in a reciprocal manner. We will examine change in these processes as time from injury increases. A final objective is to identify areas for practical interventions designed to alleviate adverse outcomes experienced by all members of the family affected by TBI. In... more
Investigators: Hanks R, Rapport L, Vangel S, Black K view full
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Lead Center: Rehabilitation Institute of Michigan
Peer-Mentoring for Survivors of TBI and their Significant Others: A Model of Social Support
Abstract: This study is a randomized controlled trial of a peer-mentoring program for both survivors and their caregivers. The focus of this study is to determine the efficacy of a peer-mentoring program and to examine the relationship of this mentoring program to three main outcome areas: 1) knowledge and skills regarding access to resources and services; 2) quality of life; and 3) community integration. Moderators of successful peer-mentoring such as injury severity, co-morbid physical disease, education, neuropsychological status of the survivor, coping style, and personality/emotional factors will also be examined. A participatory action framework will be employed for the program, as well as for implementation, dissemination, and evaluation.... more
Investigators: Hanks R, Black K, Wertheimer J, Rapport L, Koviak C, Wood D view full
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Lead Center: Rehabilitation Institute of Michigan
Social support moderates caregiver life satisfaction following traumatic brain injury.
Abstract: 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... more
Investigators: Ergh T, Hanks R, Rapport L, Coleman R view full
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Lead Center: Rehabilitation Institute of Michigan
Severe Penetrating Head Injury: A Follow-up Study
Abstract: This study examines and describes the functional status of persons surviving a severe penetrating head injury, resulting from a gunshot wound (GSW), who require inpatient rehabilitation. Data was collected prospectively at four different time periods: rehabilitation admission and discharge, year 1and year 2 post-injury. Twenty-seven persons were enrolled in the study. Follow-up data were available at years 1 and 2 post-injury for 16 of these study participants. Results indicated functional improvements on the Disability Rating Scale and Functional Independence Measure from rehabilitation admission to discharge. Follow-up data revealed continued improvements on these measures with the greatest improvement in recovery occurring during the... more
Investigators: Wertheimer J, Wood D, Zafonte R, Hanks R view full
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Lead Center: Rehabilitation Institute of Michigan
Driving after Brain Injury: Barriers, Fitness to Drive, and Community Integration
Abstract: This study examines the resumption of driving a motor vehicle and the extent to which driving influences community integration following TBI. Barriers to resuming driving, the role of significant others, and the relative validities of different assessments of fitness to drive (neuropsychological, driving simulator, and on-road evaluations) will be examined.... more
Investigators: Rapport L, Coleman R, Hanks R, Black K view full
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Lead Center: Rehabilitation Institute of Michigan
Long-term Medical Care Utilization and Costs among Traumatic Brain Injury Survivors
Abstract: Examine billing patterns and predictors of health care utilization and costs associated with traumatic brain injury (TBI).

Design: Retrospective cohort study of health care billings.

Participants: 63 persons with TBI were followed over a 19-month period, in state-sponsored Medicaid pogram.

Main Outcome Measures: The relationship of indicators of injury severity and disability to such billings was investigated.

Results: Mean age at time of injury was 33 years. Mean highest Glasgow Coma Scale (GCS) rating immediately post brain injury was 8. A total of $795,635 was billed to Medicaid for 3,950 services and medications used. Motor deficits at discharge from inpatient rehabilitation (FIM Motor Score) showed inverse relationships... more
Investigators: Vangel S, Rapport L, Hanks R, Black K view full
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Lead Center: Rehabilitation Institute of Michigan
Blame Attribution in Violent and Non-Violent TBI: Effects on Psychosocial Adjustment
Abstract: Violence is a significant cause of TBI, especially in urban areas. In other populations, violence-related injury has been studied with respect to blame attribution. Previous work suggests that self-blame may be associated with better coping and more favorable outcome compared to blame of other persons. Those with TBI due to violence may therefore be at risk for worse psychological outcomes. In this project we are measuring blame attribution in the acute stages of both violent and non-violent injury and again at 1-year follow-up, along with outcome assessment, to determine the effects of blame attribution on psychosocial outcome. In the first phase of the study we demonstrated that blame attribution is reliable and valid in persons with... more
Investigators: Hart T, Bogner J, Whyte J, Polansky M, Hanks R, Esselman P view full
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Lead Center: Moss Rehabilitation Research Institute
Collaborating Centers: Ohio State University, University of Washington, Rehabilitation Institute of Michigan
Generalizability of the Wechsler Malingering Detection Principle
Abstract: The detection of malingering or incomplete effort on the Wechsler adult scales (WAIS-R & WMS-R) has been successfully replicated using a malingering index, both with simulated malingers and clinical patients with financial incentive. Analysis of these studies suggests that their success derives from examinees' misconception that tasks of immediate attention span are more affected by traumatic brain injury (TBI) than empirical data reveal. We demonstrate this generalization, using the Memory Assessment Scale (MAS), creating a General Memory minus Short Term Memory difference score. Forty-three patients with equivocal TBI involved in injury-related litigation were compared with 45 patients not involved in litigation, with moderate to... more
Investigators: Newman P, Fichtenberg N, Kauder B, Hanks R view full
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Lead Center: Rehabilitation Institute of Michigan
Determinants of Driving Status Following Brain Injury
Abstract: Requirements to safely operate a motor vehicle require a complex interaction of skills (including motor skills, perceptual abilities, and cognitive abilities). TBI patients have a lower rate of relicensure than other impaired groups. Neuropsychological batteries used in the assessment of driving have not focused on higher order cognitive abilities (i.e., executive functioning). 71 adults who sustained moderate to severe brain injuries and their significant others (N = 142) where administered a Neuropsychological test battery, as well as the Patient Competency Rating Scale which was administered to the patient and the caregiver. Contrary to the skepticism regarding the utility of neuropsychological performance in the prediction of driving... more
Investigators: Coleman R, Ergh T, Rapport L, Hanks R, Millis S, Ricker J, Koviak C view full
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Lead Center: Rehabilitation Institute of Michigan
Collaborating Centers: Kessler Medical Rehabilitation Research and Education Corporation
Predictors of Family Functioning and Distress Among Caregivers of Patients with TBI
Abstract: The extent to which patient and caregiver characteristics predicted caregiver psychological distress was examined among 60 pairs of former patients who had sustained a moderate to severe traumatic brain injury (TBI) and their caregivers (N = 120). Time since injury ranged from 4 months to 10 years. The former patients' current neurobehavioral and affective functioning, alcohol use, awareness of deficit, and time since injury, and the caregivers' perceived social support were entered into a standard multiple regression with caregiver psychological distress as the outcome. Results revealed that the predictor model accounted for 34% of the variance in caregiver distress. Neurobehavioral and affective functioning of the patient was the best... more
Investigators: Ergh T, Coleman R, Rapport L, Hanks R view full
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Lead Center: Rehabilitation Institute of Michigan
Feasibility of administration of a brief neuropsychological battery for use during acute inpatient rehabilitation after TBI
Abstract: Previous investigations have studied the association of early neuropsychological test performance with late outcome in patients who were initially evaluated during inpatient rehabilitation. However, in these previous investigations, neuropsychological test findings have been confounded with patient injury severity. Neuropsychological assessment was performed at resolution of PTA and PTA duration is a well-recognized index of injury severity. Clinical experience would suggest that a patient who reaches a given level of neuropsychological functioning at one month post injury will have a better long term outcome than another patient who takes 3 months to reach the same level of neuropsychological functioning. By basing timing of testing... more
Investigators: Kalmar K, Giacino J, Novack T, Sherer M, Nakase-Thompson R, Frol A, Hanks R, Millis S, Gordon W, Ricker J view full
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Lead Center: JFK Johnson Rehabilitation Institute
Collaborating Centers: University of Alabama, Methodist Rehabilitation Center, North Texas Traumatic Brain Injury Model System, Rehabilitation Institute of Michigan, Mount Sinai School of Medicine, University of Pittsburgh
Outcomes of Patients with Both Spinal Cord Injury and Traumatic Brain Injury
Abstract: This study will evaluate the outcomes of people who have both spinal cord injury (SCI) and traumatic brain injury (TBI). The TBI Model Systems (TBIMS) National Database includes spinal cord injury as a variable. A number of centers hold both SCI and TBIMS grants from NIDRR, allowing for the identification of subjects that are enrolled in both. Level of injury and ASIA classification can therefore be obtained from the SCI Model Systems database, while severity of TBI can be determined from the TBI Model Systems database. Thus, the influence of severity of SCI and TBI, as well as other known predictors as age, education, and employment can be assessed with respect to outcome variables such as FIM, DRS, CHART, CHIEF, and CIQ.

The analysis... more
Investigators: Glenn M, Williams S, Karpakjian C, Richards S, Bushnik T, Goldstein R, Harrison-Felix C, Hanks R, Hammond F, Bell K, High Jr. W view full
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Lead Center: Spaulding Rehabilitation Hospital
Effect of blood alcohol level on neurpsych outcome from TBI
Abstract: 1) To resolve contradictory reports in the literature regarding adverse effects of acute blood alcohol level (BAL) on neuropsychological outcome from traumatic brain injury (TBI). 2) 459 adults with nonpenetrating TBI who were inpatients at one of 6 rehabilitation centers in the TBI Model Systems project, whose BAL had been measured at hospital arrival, and who emerged from post-traumatic amnesia (PTA) and underwent neuropsychological testing before rehabilitation discharge. 3)15 neuropsychological tests were administered after resolution of post-traumatic amnesia and at one year post-injury. 4) BAL was classified as 1) negative vs. positive and 2) intoxicated (BAL > 100 mg/dl) vs. non-intoxicated. The effect of BAL on neuropsychological... more
Investigators: Boake C, High Jr. W, Sander A, Kreutzer J, Macciocchi S, Stringer A, Hammond F, Rosenthal M, Bogner J, Hanks R view full
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Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Emory University/Shepherd Center, Ohio State University, Rehabilitation Institute of Michigan, Carolinas Rehabilitation, Kessler Medical Rehabilitation Research and Education Corporation, Virginia Commonwealth University/Medical College of Virginia


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