The cognitive neuropsychological profile of psychosis following traumatic brain injury (PFTBI): comparisons with traumatic brain injury, schizophrenia, and healthy control cohorts

Batty, R 2012, The cognitive neuropsychological profile of psychosis following traumatic brain injury (PFTBI): comparisons with traumatic brain injury, schizophrenia, and healthy control cohorts, Doctor of Philosophy (PhD), Health Sciences, RMIT University.


Document type: Thesis
Collection: Theses

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Title The cognitive neuropsychological profile of psychosis following traumatic brain injury (PFTBI): comparisons with traumatic brain injury, schizophrenia, and healthy control cohorts
Author(s) Batty, R
Year 2012
Abstract Traumatic insanity has been acknowledged since Meyer (1904), yet the relationship between traumatic brain injury (TBI) and psychosis remains poorly understood and under-researched. Patients who are dually-diagnosed with psychosis following traumatic brain injury (PFTBI) suffer significantly as a result of both their injury and illness, however systematic and standardised neuropsychological research of PFTBI has not been undertaken. Instead, a relatively small amount of work relying on retrospective chart reviews, case studies, and loosely defined self-reported TBI has been conducted. Such data is often inconsistent, and reports of intact neurocognition in PFTBI have been made despite substantial evidence of deficits in the literature on TBI and psychosis.

Patients with PFTBI (N=10), injury-matched patients with TBI without psychosis (TBIWP) (N=10), patients with schizophrenia (N=23), and a healthy cohort (N=23), were administered a comprehensive battery of standardised cognitive neuropsychological tests. The data were examined for group-wise differences, relationships with mediating variables identified in the existing TBI and psychosis literature, and the correct classification of the cohorts according to two prominent features of the battery (i.e., RBANS Total [overall neurocognition] and Stroop Colour Trial [processing speed]).

Patients with PFTBI were characterised by a neuropsychological profile that appeared to be cumulative in the degree of impairment relative to their single-diagnosis counterparts, while comparable to schizophrenia with respect to their pattern of deficits. This was further supported by discriminant function analysis (DFA), where the greatest misclassification of the PFTBI cohort was as a schizophrenia patient, and vice versa. In addition, language-specific deficits were uniquely shared by the brain injured cohorts, partially driven by the laterality of language processing. Statistical matching of patient demographics further established that reduced neurocognition in PFTBI is not attributable to mediating characteristics of the injury or illness, however these factors were associated with performance for all patient cohorts.

As the first empirical investigation of the cognitive neuropsychological profile of PFTBI, this research provides a novel and valuable contribution to the existing PFTBI literature, particularly with regard to diagnosis and treatment. The assessment of verbal learning and verbal memory may be an essential diagnostic tool, while the extent of overall impairment indicates that treatment programs should focus on adjunctive therapy, beginning with cognitive remediation as a supplement to the usual antipsychotic treatment.
Degree Doctor of Philosophy (PhD)
Institution RMIT University
School, Department or Centre Health Sciences
Keyword(s) Traumatic brain injury
Psychosis
Cognitive neuropsychology
PFTBI
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Created: Wed, 11 May 2016, 15:02:37 EST by Keely Chapman
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