Research Reports - Contribution of psychological trauma to outcomes after traumatic brain injury

J Neurotrauma. 2013 Nov 14

Mathias JL, Harman-Smith Y, Bowden S, Rosenfeld JV, Bigler ED

Clinical research into outcomes after traumatic brain injury (TBI) frequently
combines injuries that have been sustained through different causes (car
accidents, assaults, falls); the impact of which is not well understood. This
study examined the contribution of injury-related psychological trauma - which is
more commonly associated with specific types of injuries - to outcomes following
non-penetrating TBI in order to determine whether it may be having a differential
impact in samples containing mixed injuries. Data from three groups that were
prospectively recruited for two larger studies were compared: one that sustained
a TBI as a result of physical assaults (i.e, psychologically traumatising) and
another as a result of sporting injuries (i.e., non-psychologically
traumatising), as well as an orthopaedic control group (OC). Psychosocial and
emotional (post-concussion symptoms, injury-related stress, depression),
cognitive (memory, abstract reasoning, problem solving, verbal fluency), and
functional (general outcome; resumption of home, social and work roles) outcomes
were all assessed. The TBIassault group reported significantly poorer
psychosocial and emotional outcomes and higher rates of litigation (criminal
rather than civil) than both the TBIsport and OC groups approximately 6 months
post-injury, but there were no differences in the cognitive or functional
outcomes of the three groups. The findings suggest that the cause of a TBI may
assist in explaining some of the differences in the outcomes of people who have
seemingly comparable injuries. Involvement in litigation and the cause of an
injury may also be confounded, which may lead to the erroneous conclusion that
litigants have poorer outcomes.

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