Study: People with TBI have significantly more difficulty with gist reasoning

focus-on-what-mattersFrom News Medical, this older announcement:

A new study reveals that individuals with traumatic brain injury (TBI) have significantly more difficulty with gist reasoning than traditional cognitive tests. Using a unique cognitive assessment developed by researchers at the Center for BrainHealth at The University of Texas at Dallas, findings published Friday in the Journal of Clinical and Experimental Neuropsychology indicate that an individual’s ability to “get the gist or extract the essence of a message” after a TBI more strongly predicts his or her ability to effectively hold a job or maintain a household than previously revealed by traditional cognitive tests alone. The study also further validates the Center for BrainHealth’s gist reasoning assessment as an informative tool capable of estimating a broad range of daily life skills.

When I found about this, earlier this year, it was like a light went on for me. I knew my neuropsych eval scores put me in an “intelligent” range, and by far, the majority of my test scores came back looking good — some above average, some far above average — and according to my neuropsychologist, there was really no reason I couldn’t have the quality of life I desired.

But I’d been having so many difficulties putting things together. And the story my test results told simply was not consistent with my difficulties. There was no way it was all emotional. Something else had to be “up”. Hell if I could communicate that to my neuropsychologist, however. Like being frozen in place, mute and motionless… unable to get the words out.

A telltale piece of the puzzle was the gist reasoning exercise I’d done at the start — it was a fairly detailed picture that could have been boiled down to a basic narrative of a few sentences, but when I was asked to describe everything I saw, I wrote two full pages in very small handwriting — and I could have written more, had I not decided that I was really going on far too long. My evaluator attempted to explain to me how my answer was wrong, but I fought them on it. As far as I was concerned, I’d done as I was told — write down everything I saw happening there. I’d completely missed the gist of it.

The next time I did  the test, I was shown the same picture. If I’d done as I wished, I’d have written four pages of small-print description about what I saw there, but I knew the task was about communicating the gist of things in a few succinct sentences. So, that’s what I did. I summed it up briefly, and I passed the test as having excellent gist reasoning. (Note: I still have arguments with the way that part of the test was administered, and there are much better ways to elicit details about someone’s gist reasoning, but then, I’m not a testing expert, so I’ll save it for later, when I can deliver a well-formed proposal.)

In any case, my ability to sum up the contents of that picture correlated well with my increased ability to function. The degree to which I’d improved in understanding what was expected of me, as well as how to deliver the most meaning in the fewest words, was a good indicator of how much better I was functioning in my life, and how much it was improved over the years before.

I wonder, now,  how I’d do.  But of course, it wouldn’t be a fair comparison, because I understand the question, I know how to game the test, and nobody from here on out is going to get a genuinely usable result from my response to that test.

Benefits/Results/Outcomes After Discovering This Research

To say that I benefited from this research would be an understatement. I credit it with:

  1. Confirming my pre-existing suspicions that my test results were not reflecting the reality of my situation and the degree of my difficulties. As a result, I felt far more confident of my self-assessments. That confidence led to a more settled sense of myself and more self-assurance — which ultimately contributed to me finding a better job at a 30% increase in pay (and a 30% increase in the taxes I now pay into the system). The IRS can thank UT Dallas for that 😉
  2. Indicating that, if lacking gist reasoning was connected to poor functioning, then improving my gist reasoning might improve my overall functioning. I developed some gist reasoning exercises (click to see them) for myself and others to use. I focused my attention on doing gist reasoning exercises for some time, which I felt had a noticeable effect in how I thought about things. Knowing that my ability to piece things together effectively and derive meaning from them, was directly related to my ability to function re-oriented me in ways that have helped me perform well in my new job.
  3. Improving my overall state of mind and quality of life. Again, the taxes have contributed to society… and also a more stable home life, for myself and my spouse. Having this piece of the puzzle, gives me a greater sense of agency and capability and self-determination. When I”m struggling with the logistics of my daily life, I can check in with how I’m understanding the world around me, and work a little harder at extracting the gist from my day-to-day. Granted, it’s not exactly a double-blind controlled study, but the arguments and depressive spells have become less frequent, so that’s a measurable result.

In any case, this research makes excellent reading for anyone who wants to better understand some of the complications of TBI — as well as get some insight into why people who appear to be perfectly intelligent and capable can screw things up so badly, and be so inconsistent in their performance.

I strongly recommend it as almost-required reading.

Read the news article here:

And you can read the original paper from the Center for BrainHealth at The University of Texas at Dallas here:


Author: brokenbrilliant

I am a long-term multiple (mild) Traumatic Brain Injury (mTBI or TBI) survivor who experienced assaults, falls, car accidents, sports-related injuries in the 1960s, '70s, '80s, and '90s. My last mild TBI was in 2004, but it was definitely the worst of the lot. I never received medical treatment for my injuries, some of which were sports injuries (and you have to get back in the game!), but I have been living very successfully with cognitive/behavioral (social, emotional, functional) symptoms and complications since I was a young kid. I’ve done it so well, in fact, that virtually nobody knows that I sustained those injuries… and the folks who do know, haven’t fully realized just how it’s impacted my life. It has impacted my life, however. In serious and debilitating ways. I’m coming out from behind the shields I’ve put up, in hopes of successfully addressing my own (invisible) challenges and helping others to see that sustaining a TBI is not the end of the world, and they can, in fact, live happy, fulfilled, productive lives in spite of it all.

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