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AbstractObjective: Obstructive sleep apnea (OSA) has been associated with structural and functional brain changes and cognitive impairment in sleep clinic samples. Persons with traumatic brain injury (TBI) are at increased risk of OSA compared to community samples, and many experience chronic cognitive disability. However, the impact of OSA on cognitive outcome after TBI is unknown. The purpose of this study was to examine the relationship between polysomnographic sleep parameters on neuropsychological performance 2 years following TBI. We hypothesized that oxygen desaturation, sleep fragmentation, and sleep depth would predict neuropsychological performance. Method: Participants (N = 123) were persons with moderate-to-severe TBI who underwent Type 1 Polysomnography during acute neurorehabilitation. At 2 years post-TBI, participants completed telephone-based neuropsychological testing (the Brief Test of Adult Cognition by Telephone). General linear models were fit to investigate the relationship between sleep parameters and neuropsychological performance, controlling for demographics and posttraumatic amnesia. Results: When controlling for demographics, injury characteristics, and other sleep parameters, greater percent of Stage 1 sleep time predicted poorer cognitive performance (Overall BTACT composite, p = 0.0078, ηp2 = 6.6%; Verbal Memory composite, p = 0.0407, ηp2 = 3.9%; Executive Function composite, p = 0.0215, ηp2 = 4.9%). Oxygen desaturation, cortical arousals, Stage 3 sleep, and the obstructive apnea-hypopnea index were not significantly associated with cognitive outcome. Conclusions: Reduced sleep depth was associated with cognitive outcome in persons with TBI; these findings require replication. Future research should examine whether improving sleep (e.g. increasing deep sleep) during acute recovery can improve cognitive recovery following TBI. [ABSTRACT FROM AUTHOR]

Background: TBI is a leading cause of disability among veterans and active duty military personnel, and presents an obstacle to community reintegration. Prior studies examining adult survivors of TBI pursuing postsecondary education have methodological flaws that limit the understanding the scope and severity of sequelae experienced by persons with TBI who attend college. Objective: To describe (a) physical and cognitive functioning, and (b) postconcussion and mental health symptoms in veterans and military personnel (V/M) with traumatic brain injury (TBI) enrolled in postsecondary education programs after discharge from rehabilitation. Method: Cross-sectional study. Participants were recruited from five Veterans Affairs (VA) Polytrauma Rehabilitation Centers, enrolled in the VA TBI Model Systems parent study, and attending school during follow-up (N = 155). Outcome measures included the Functional Independence Measure (FIM), Neurobehavioral Symptom Inventory (NSI), Post-traumatic Stress Disorder (PTSD) Checklist-Civilian version (PCL-C), Patient Health QuestionnaireDepression (PHQ-9), and Generalized Anxiety Disorder Questionnaire (GAD-7). Findings: Participants were mostly male (92.9%) and White (81.4%), with mild (40.0%), moderate (11.5%), severe (34.5%), or very severe TBI (23.0%). Depression, anxiety, PTSD, and postconcussion symptoms were lowest in participants with very severe TBI and highest in those with mild TBI. There were no significant differences in FIM across TBI severity levels. Conclusion: This study supports the need for rehabilitation counselors, educators, and administrators to prepare future practitioners to deliver tailored services to student V/M with TBI. These services can facilitate successful community reintegration and transition into civilian school settings. Symptom profiling may inform personalized cognitive interventions to enhance these students' academic success.

This study evaluates the use of the crosswalk between the PTSD Checklist–Civilian (PCL-C) and PTSD Checklist for DSM-5 (PCL-5) designed by Moshier et al. (2019) in a sample of service members and veterans (SM/V; N = 298) who had sustained a traumatic brain injury (TBI) and were receiving inpatient rehabilitation. The PCL-C and PCL-5 were completed at the same time. Predicted PCL-5 scores for the sample were obtained according to the crosswalk developed by Moshier et al. We used three measures of agreement: intraclass correlation coefficient (ICC), mean difference between predicted and observed scores, and Cohen's κ to determine the performance of the crosswalk in this sample. Subgroups relevant to those who have sustained a TBI, such as TBI severity, were also examined. There was strong agreement between the predicted and observed PCL-5 scores (ICC =.95). The overall mean difference between predicted and observed PCL-5 scores was 0.07 and not statistically significant (SD = 8.29, p =.89). Significant mean differences between predicted and observed PCL-5 scores calculated between subgroups were seen in Black participants (MD = −4.09, SD = 8.41, p =.01) and those in the Year 5 follow-up group (MD = 1.77, SD = 7.14, p =.03). Cohen's κ across subgroups had a mean of κ = 0.76 (.57–1.0), suggesting that there was moderate to almost perfect diagnostic agreement. Our results suggest the crosswalk created by Moshier et al. can be applied to SM/V who have suffered a TBI. Public Significance Statement: The crosswalk for the PTSD Checklist–Civilian and PTSD Checklist for DSM-5 versions created by Moshier et al. (2019) can be applied to service members and veterans who have suffered a traumatic brain injury. Research studies and clinical programs that have been using the PTSD Checklist–Civilian can transition to the updated PTSD Checklist for DSM-5 without losing longitudinal data. [ABSTRACT FROM AUTHOR]

The current study examined the relationships among parenting styles experienced in childhood, anxiety, motivation, and academic success in college students. Results suggested that fathers' authoritative parenting was related to decreases, whereas mothers' authoritarian parenting was related to increases, in college students' anxiety. Further, mothers' and fathers' authoritative parenting, mothers' authoritarian parenting, and college students' anxiety and motivation were related to college students' grade point averages. In addition, college students' motivation served a mediational role in the relationship between their anxiety and grade point averages. Results suggested that college students may be more likely to experience improvements in their academic performance with interventions that address college students' perceptions of the parenting that they received during their childhood, their anxiety, and their motivation to do well academically. The role of such interventions deserves to be studied further.