Contribution of Psychological Trauma to Outcomes after Traumatic Brain Injury: Assaults versus Sporting Injuries

Abstract

Clinical research into outcomes after traumatic brain injury (TBI) frequently combines injuries that have been sustained through different causes (e.g., car accidents, assaults, and falls), the effect 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 after nonpenetrating TBI in order to determine whether it may be having a differential effect 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 traumatizing) and another as a result of sporting injuries (i.e., nonpsychologically traumatizing), as well as an orthopedic control group (OC). Psychosocial and emotional (postconcussion symptoms, injury-related stress, and depression), cognitive (memory, abstract reasoning, problem solving, and verbal fluency), and functional (general outcome; resumption of home, social, and work roles) outcomes were all assessed. The TBI(assault) group reported significantly poorer psychosocial and emotional outcomes and higher rates of litigation (criminal rather than civil) than both the TBI(sport) and OC groups approximately 6 months postinjury, 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 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.

Blast exposure in the military and its effects on sensory and cognitive auditory processing

“…blast or blast-exposed Service Members have comparatively more exposure to dangerous levels of sound is beyond the scope of this study, but certainly merits further investigation. Although we did not observe any differences blast-exposed and control subjects in either the auditory or visual selective attention measures, there is still evidence pointing to differences in the speed of cognitive processing, a symptom commonly associated with traumatic brain injury(Leininger, Gramling, Farrell, Kreutzer, & Peck, 1990;Mathias, Harman-Smith, Bowden, Rosenfeld, & Bigler, 2014).Collectively, these results suggest that care should be taken to consider more than just audiometric measures alone when treating blast-exposed Service Members with hearing complaints. While it is known that the audiogram does not accurately predict speech-in-noise performance, exposure to blast introduces cognitive considerations when diagnosing and devising treatment strategies for this specialized patient population.…”

Hyper-connectivity of the thalamus during early stages following mild traumatic brain injury

“…For example, it has been shown that victims of assault report greater emotional and psychosocial symptoms compared to those who were injured as a results of sports related injuries (Mathias et al, 2014). This suggests that the mechanism of injury likely influences the length and extent of recovery following mTBI.…”

Screening for Traumatic Brain Injury in Prostituted Women

“…People who sustain a TBI that was caused by interpersonal violence are at higher risk of depression and PTSD than those with TBI from other causes (e.g. motor vehicle or sports accidents, falls; Bombardier et al, 2010;Mathias, Harman-Smith, Bowden, Rosenfeld, & Bigler, 2014). Further, the prevalence of depression is higher among female than male TBI patients (Bombardier et al, 2010), which would increase the risk of depression for women in prostitution who sustain TBI.…”