There is compelling evidence that traditional methods used to address the detrimental impacts of missing data are inadequate. Despite this, researchers have been slow to utilise newer statistical approaches known to be more effective. The aim of the current article is to offer a conceptual explanation of the rationale for using newer missing data techniques, with a focus on multiple imputation (MI). To illustrate the relative efficacy of deletion, single imputation and multiple imputation techniques in the clinical setting, 20 cases were selected randomly from a population study investigating the cognitive sequelae of traumatic brain injury (TBI), and 8 out of 20 cases had scores on one variable deleted to simulate a missing data set. Comparing the parameter estimates obtained by each technique to the known parameters of the complete data set revealed that MI outperformed deletion and single imputation approaches. It is therefore recommended that more sophisticated techniques such as MI should be considered in clinical research.

Objectives: The Griffith Empathy Measure (GEM) is a self-report measure of empathy. The current study aimed to explore the reliability and validity of the Chinese version of the GEM. It also aimed to compare individuals with and without schizotypal personality disorder (SPD) features on various components of empathy.

Methods: 420 college students from Beijing and 526 college students from Guangzhou completed a set of questionnaires that measured empathy and schizotypal personality disorder traits. Cronbach's coefficient alpha was used to evaluate the internal consistency of the GEM. Construct validity was evaluated using exploratory and confirmatory factor analyses (EFA and CFA). Construct validity was also examined by looking at the relationship between the GEM and the Interpersonal Reactivity Index (IRI). Finally, the sensitivity of the GEM was evaluated by comparing the total and factor GEM scores between individuals with and without SPD traits.

Results: The Chinese GEM showed good internal consistency (Cronbach's alpha = 0.83). Results of an exploratory factor analysis suggested a three-factor model consisting of cognitive, affective and behavioural empathy components. Results of a confirmatory factor analysis showed that the three-factor model, as well as the two-factor model found in the English version, were both acceptable. Construct validity (specifically convergent validity) was also corroborated by significant correlations between the IRI subscales and GEM (personal distress: r = .09, p > .05; perspective taking: r = .34, p < .01; fantasy: r = .44, p < .01; empathic concern: r = .51, p < .01). Individuals with SPD traits showed lower scores on the GEM than individuals without SPD traits (t(1,250) = −1.99, p = .05), thus confirming discriminative validity.

Conclusions: These preliminary findings suggest that the Chinese version of the GEM demonstrated satisfactory internal consistency and construct validity. In addition, the findings suggest that the GEM is culturally appropriate and researchers can use it to study empathy in healthy and clinical Chinese participants.

Objectives: Neuropsychological assessment of memory disorders is an important prerequisite in the treatment of patients with alcohol-related cognitive disorders. Although many memory tests are available in clinical practice, a question remains regarding which test is most appropriate for this purpose. Our study's goal was to evaluate the discriminative power of indices of a standard memory test (the California Verbal Learning Test; CVLT) versus the subtests of an ecologically valid everyday memory test (the Rivermead Behavioural Memory Test; RBMT) in patients with alcohol-use disorder.

Method: The patients included 136 with Korsakoff's syndrome (KS), 73 alcoholics with cognitive impairment (CI) not fulfilling the criteria for KS, and 24 cognitively unimpaired alcoholics (ALC).

Results: KS patients performed significantly lower on all RBMT and CVLT variables than CI patients. ALC patients performed significantly better than CI patients on only one RBMT subtest, and had a significantly lower rate of forgetting and higher scores on free recall on CVLT. A combination of RBMT subtests and CVLT indices was able to discriminate KS patients from CI and ALC patients. The RBMT subtests could not significantly distinguish ALC from CI patients. Both rate of forgetting and a comparison between free and cued recall testing on the CVLT showed the largest between-group differences.

Conclusion: Although the RBMT provides information about everyday memory performance, the CVLT indices are better able to distinguish between uncomplicated alcoholics and those with cognitive impairment or KS.

Objective: To examine patterns, predictors and unmet needs of service utilisation and access to mental health and/or drug and alcohol services among community-dwelling adults with severe traumatic brain injury, and compare those who displayed challenging behaviours with those not displaying challenging behaviour.

Design: Retrospective multicentre study.

Subjects: All active clients (n = 507) of the New South Wales (NSW) Brain Injury Rehabilitation Program (BIRP) community rehabilitation teams.

Methods: Clinician-rated data were collected on client challenging behaviours, mental health and functional status, service utilisation and unmet needs. Between-groups analyses (challenging behaviour versus no challenging behaviours) were conducted to examine patterns of service utilisation and unmet needs. Predictors for service utilisation were tested by multiple linear regression.

Results: Challenging behaviours were associated with higher use of BIRP and non-BIRP services and greater levels of unmet needs. Challenging behaviour was an independent predictor of higher levels of service utilisation, in conjunction with pre- and post-injury mental health and drug and alcohol co-morbidities and geographic location. Only 15.3% of the 111 clients with challenging behaviours and co-morbid drug and alcohol problems accessed a drug and alcohol service, while another 32.4% had unmet needs for such services.

Conclusion: Challenging behaviours make an independent contribution to increased levels of service utilisation after severe traumatic brain injury.

Objective: Submissions on recovery of post-stroke motor performance vary, especially in relation to increasing time after stroke. This study examined the trajectory of motor performance over the first 12 months after stroke.

Methods: Consecutive first-incidence stroke survivors (N = 83) were recruited within 1 month of onset from a tertiary health institution in Nigeria. Simplified Fugl Meyer scale (S-FM) was used to assess motor performance at monthly intervals. Changes in overall motor performance, and differences between the affected upper and lower extremities, were examined using Friedman's ANOVA and paired t-tests, respectively.

Results: Significant improvement in motor performance was observed across 12 months (p < .001), with the proportion of stroke survivors with severe impairment at onset (53.3%) decreasing to 20% by 12 months. Lower extremity motor performance scores were significantly higher than for the upper extremity from 1 to 12 months (p <.01 at 3, 4, 5, 6 and 12 months; and p < .05 at the remaining months).

Conclusions: The potential for long-term improvement in motor performance after stroke was observed, suggesting that this can be harnessed by long-term rehabilitation efforts. The comparatively poorer outcome in the upper extremity indicates the need for extra rehabilitation strategies to enhance upper-extremity motor recovery in the first year of stroke.

Objective: The purpose of this study was to examine susceptibility factors in thalamic stroke, as well as outcomes in order to identify rehabilitation needs.

Methods: Ten patients with thalamic stroke were interviewed and administered the Audio Recorded Cognitive Screen. Magnetic resonance imaging (MRI) scans were examined to determine location and size of the lesion, as well as basilar artery size and anatomical variances in the circle of Willis.

Results: Risk factors such as high cholesterol, high blood pressure and pre-existing heart conditions were identified. Circle of Willis variations were found in 6 of the 10 participants, with MR angiography indicating that the posterior communication artery was absent or failed to join the posterior cerebral artery. Basilar artery diameter measurements were no larger than normal. All participants reported post-stroke changes, including decreased coordination and mobility, poor balance, reduced energy, memory deficits and mood changes. Participants’ overall scores on cognitive tests were significantly lower than age-matched norms. Performance on the test domains of memory, fluency, language and attention were all significantly below age norms.

Conclusions: The variability of outcome measures demonstrates the difficulty of defining patterns of relationship between risk factors and severity of functional sequelae in thalamic stroke.

Delayed vasculopathy associated with prior brain irradiation is a known cause of stroke. Radiation is implicated in large-vessel stenosis, cavernous malformations and, rarely, small-vessel disease. There have been no reported cases of fulminant ischaemic and haemorrhagic strokes secondary to radiation vasculopathy. We present the case of a 40-year-old woman with a history of childhood leukaemia and whole-body and cranio-cervical radiation. The patient presented with recurrent acute neurological deficits over a 4-month period resulting from haemorrhagic and ischaemic strokes. Imaging revealed numerous cavernomas and small-vessel acute infarctions. No traditional stroke aetiology was identified. Delayed radiation-induced vasculopathy should be considered in patients with a history of brain irradiation and ischaemic or haemorrhagic strokes, and can present in a fulminant manner with recurrent strokes over a short period of time.

We rely on prospective memory (PM) to carry out intended actions at an appropriate time in the future. This ability is very important for day-to-day functioning, for example, remembering to take medication, attend appointments and pay bills. The literature covering the topic of PM has increased exponentially in the past 20–30 years. This paper will describe this relatively novel form of memory and discuss the debilitating effect PM deficits have on everyday living. It will also examine the populations who experience significantly more frequent and severe PM impairments and explore the causes and mechanisms of PM impairments by reviewing behavioural, clinical, genetic and neuroimaging studies. The paper will conclude by discussing the latest research into ways of treating PM impairments in clinical populations. Where applicable, examples of research conducted by the author and his colleagues will be used to illustrate these topics.