Browsing by Author "Smith, Stephen M."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Change in internalized stigma and social functioning among persons diagnosed with severe mental illness
    (Elsevier, 2012) Yanos, Philip T.; West, Michelle L.; Gonzales, Lauren; Smith, Stephen M.; Roe, David; Lysaker, Paul H.; Psychiatry, School of Medicine
    This study examined the relationship between change in internalized stigma and social functioning over time. Thirty-five individuals with severe mental illness completed measures of self-stigma, social functioning and symptoms at baseline, 4 months, and 7 months. Change in self-stigma was significantly negatively related to change in social functioning, controlling for negative symptoms.
  • Thumbnail Image
    Item
    Group-Based Treatment for Internalized Stigma among Persons with Severe Mental Illness: Findings from a Randomized Controlled Trial
    (American Psychological Association, 2012) Yanos, Philip T.; Roe, David; West, Michelle L.; Smith, Stephen M.; Lysaker, Paul H.; Psychiatry, School of Medicine
    Elevated internalized stigma is common and is linked to subjective and objective outcomes for severe mental illness. The authors developed a manualized group-based intervention (Narrative Enhancement/Cognitive Therapy; NECT) to address internalized stigma in severe mental illness. The purpose of the present study was to evaluate the feasibility and effectiveness of NECT. In total, 144 individuals were screened at two sites to evaluate if they met criteria for "elevated" internalized stigma; 39 and were eligible were randomized to NECT or to treatment as usual (TAU) and were assessed at baseline, posttreatment, and 3-month follow-up. Fifteen of the 21 individuals assigned to NECT were classified as "exposed" to treatment. Intent-to-treat analyses found no significant difference between the NECT and TAU groups. A comparison of exposed versus unexposed participants noted trends for exposed participants to have improved more in two aspects of self-stigma as well as insight. We conclude that NECT is feasible and tolerable, but findings did not support the hypothesis that NECT was more effective than TAU, although small sample size and significant dropout may have restricted the ability to detect an effect.
  • Thumbnail Image
    Item
    Viscoelastic Testing and Coagulopathy of Traumatic Brain Injury
    (MDPI, 2021-10-28) Bradbury, Jamie L.; Thomas, Scott G.; Sorg, Nikki R.; Mjaess, Nicolas; Berquist, Margaret R.; Brenner, Toby J.; Langford, Jack H.; Marsee, Mathew K.; Moody, Ashton N.; Bunch, Connor M.; Sing, Sandeep R.; Al-Fadhl, Mahmoud D.; Salamah, Qussai; Saleh, Tarek; Patel, Neal B.; Shaikh, Kashif A.; Smith, Stephen M.; Langheinrich, Walter S.; Fulkerson, Daniel H.; Sixta, Sherry; Neurological Surgery, School of Medicine
    A unique coagulopathy often manifests following traumatic brain injury, leading the clinician down a difficult decision path on appropriate prophylaxis and therapy. Conventional coagulation assays—such as prothrombin time, partial thromboplastin time, and international normalized ratio—have historically been utilized to assess hemostasis and guide treatment following traumatic brain injury. However, these plasma-based assays alone often lack the sensitivity to diagnose and adequately treat coagulopathy associated with traumatic brain injury. Here, we review the whole blood coagulation assays termed viscoelastic tests and their use in traumatic brain injury. Modified viscoelastic tests with platelet function assays have helped elucidate the underlying pathophysiology and guide clinical decisions in a goal-directed fashion. Platelet dysfunction appears to underlie most coagulopathies in this patient population, particularly at the adenosine diphosphate and/or arachidonic acid receptors. Future research will focus not only on the utility of viscoelastic tests in diagnosing coagulopathy in traumatic brain injury, but also on better defining the use of these tests as evidence-based and/or precision-based tools to improve patient outcomes.