ABSTRACT
Primary Objective: Survey TBI literature to identify evidence of risk for post-injury suicide.Literature Selection: Search terms ((traumatic brain injury OR TBI) AND (suicidality OR suicidal behaviour OR suicidal ideation)) entered in PubMed, OVID Medline, PsychInfo, and Web of Science for papers published in print 01/01/1997 to 06/30/2019.Analysis of Literature: Authors screened abstracts, excluding duplicates and articles not meeting inclusion/exclusion criteria. Full papers were reviewed to make final exclusions. Data were extracted from 40 papers included co- and premorbid disorders, demographics, injury-related and psychological factors.Results: Persons with TBI have a higher risk for suicide than the general population. Reviewed articles reported comorbid depression and/or PTSD as risk factors for post-TBI suicide. Co- or premorbid substance misuse, sex, and sleep disturbance moderate risk. Quality of the literature was limited by sample size, the predominance of male participants, and inconsistency in reporting of findings.Conclusions: Comorbid depression and PTSD are significant post-TBI risk factors for suicide. Several variables combine to moderate or mediate TBI's connection with suicide. Civilian and military clinician cross-talk and consistent reporting of results from reproducible studies of post-TBI suicide risk factors could improve prevention and treatment efforts in veterans and civilians.
Subject(s)
Brain Injuries, Traumatic , Military Personnel , Stress Disorders, Post-Traumatic , Suicide , Veterans , Brain Injuries, Traumatic/complications , Brain Injuries, Traumatic/epidemiology , Humans , Male , Risk Factors , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/etiology , Suicidal IdeationABSTRACT
OBJECTIVE: To examine the predictive validity of a brief neuropsychologic test battery consisting of the Galveston Orientation and Amnesia Test, the California Verbal Learning Test-II, Trail-Making Test (TMT), Symbol Digit Modalities Test, grooved pegboard, phonemic and categorical word generation tasks, the Wechsler Test of Adult Reading (WTAR), and the Wisconsin Card Sorting Test-64 relative to functional outcome at 1 year in persons with traumatic brain injury. DESIGN: Inception cohort study. Follow-up period of 12 months. SETTING: Seven Traumatic Brain Injury Model System centers. Neuropsychologic testing was conducted during the acute inpatient rehabilitation stay and functional outcome measures were obtained at 1-year outpatient follow-up. PARTICIPANTS: Adults (N=174) who met criteria for admission to inpatient brain injury rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FIM instrument, Disability Rating Scale, Supervision Rating Scale, Satisfaction With Life Scale (SWLS), and Glasgow Outcome Scale-Extended. RESULTS: Multiple regression analyses revealed that performance on the neuropsychologic test battery was predictive of outcome at 1 year postinjury for all outcome measures, except FIM motor scores and the SWLS. Cognitive performance using this battery was found to predict 1-year outcomes above and beyond functional variables and injury severity variables collected during inpatient rehabilitation, thereby indicating incremental validity for this test battery. Individual tests that were found to be significant predictors of 1-year outcomes included the WTAR and TMT part B. CONCLUSIONS: These findings support the clinical utility and ecological validity of this battery with respect to level of disability, functional independence, and supervision required.
Subject(s)
Brain Injuries/rehabilitation , Neuropsychological Tests , Adolescent , Adult , Aged , Aged, 80 and over , Brain Injuries/psychology , Disability Evaluation , Female , Humans , Inpatients , Male , Middle Aged , Outcome Assessment, Health Care , Predictive Value of Tests , Prognosis , Psychometrics , Regression AnalysisABSTRACT
The current study was designed to examine the predictive validity of several factors that are common to spinal cord injury (SCI) and traumatic brain injury (TBI) populations to overall life satisfaction. We examined several demographic and functional predictors (1) within each group separately and (2) using both groups while controlling for unique predictors within groups. Participants included 190 and 57 individuals with SCI and TBI, respectively. To minimize the influence of injury duration, we assessed life satisfaction at 1-year postinjury in both groups. Functional disability (Functional Impairment Measure [FIM]) was the only common predictor within groups. For the TBI group, marital status was also a significant predictor of life satisfaction. None of the other predictors examined was significant among the SCI group. After functional disability and marital status were controlled, overall life satisfaction did not differ between groups. Total explained variance in life satisfaction was low in both groups, 9% and 25% in the SCI and TBI groups, respectively. Future directions are discussed.
