Stambrook M, Moore A D, Peters L C, Zubek E, McBeath S, Friesen I C
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
J Clin Exp Neuropsychol. 1991 Jul;13(4):521-30. doi: 10.1080/01688639108401068.
Closed-head injury (CHI) and spinal cord injury (SCI) cause significant permanent alterations in life style, social-role functioning, and psychological status. While the cognitive effects of CHI are well known, there have been questions concerning the psychosocial sequelae from CHI, and whether they are unique to this disability group rather than representing general effects of a life-threatening medical emergency with permanent life-altering consequences. This issue was examined with samples of ambulatory moderate (n = 31) and severe (n = 17) CHI patients and wheelchair-dependent SCI (n = 24) patients. Results indicate that there were no significant differences between the groups on pre- and post injury demographic factors. However, while the moderate CHI and SCI groups were equivalent on many indicators of psychosocial outcome, the severe CHI group was more depressed, angry and hostile, and confused and bewildered. As well, wives of the severe CHI patients rated their husbands as more belligerent, negative, helpless, suspicious, withdrawn and retarded, and with more general psychopathology than did wives of moderate CHI or wives of SCI patients. Implications of these findings for preventative psychosocial rehabilitation are discussed.
闭合性颅脑损伤（CHI）和脊髓损伤（SCI）会导致生活方式、社会角色功能及心理状态发生重大永久性改变。虽然CHI的认知影响众所周知，但对于CHI的心理社会后遗症，以及这些后遗症是否为该残疾群体所特有，而非代表具有永久性改变生活后果的危及生命的医疗紧急情况的一般影响，一直存在疑问。本研究对非卧床的中度（n = 31）和重度（n = 17）CHI患者样本以及依赖轮椅的SCI（n = 24）患者样本进行了调查。结果表明，各组在受伤前后的人口统计学因素上没有显著差异。然而，虽然中度CHI组和SCI组在许多心理社会结果指标上相当，但重度CHI组的抑郁、愤怒和敌意、困惑和迷茫程度更高。此外，重度CHI患者的妻子对其丈夫的评价是，与中度CHI患者的妻子或SCI患者的妻子相比，他们更具攻击性、消极、无助、多疑、孤僻和迟钝，且有更多的一般精神病理学问题。本文讨论了这些发现对预防性心理社会康复的意义。
