Neuropsychological and Neurobehavioral Correlates of Aggression Following Traumatic Brain Injury
ABSTRACT This study aimed to establish the neuropsychological and neurobehavioral profile of individuals who develop aggression following traumatic brain injury. In a prospective cohort study, 134 brain-injured individuals who exhibited aggression were compared to 153 individuals who had sustained comparable injuries but were not aggressive. In the aggressive group, specific deficits were identified in verbal memory and visuo-perceptual skills. Compared to normative data, this group had impaired executive-attention function. It is tentatively suggested that significant impairment in verbal memory and visuospatial abilities against a background of diminished executive-attention functioning is associated with the development of aggression after brain injury, especially when other risk factors such as low premorbid IQ, low socioeconomic status, and male gender are present.
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- "Though our IQ clusters were associated with PRS outcomes, caution must be noted in using measures of intelligence to predict behavioral outcome in TBI. Though some studies have found associations between IQ and functional outcome (Hawley, 2004; Wood & Liossi, 2006), other studies suggest that IQ may not be as robust a predictor as other cognitive domains such as memory and executive functioning (Kirkwood et al., 2000; Tramontana, Hooper, & Nardolillo, 1988). Indeed, executive functioning has been found to be a strong predictor of outcome (Muscara, Catroppa, & Anderson, 2008; Nadebaum, Anderson, & Catroppa, 2007), whereas the recent study by Allen and colleagues (in press) found significant and differential associations among attention and memory clusters, neurocognitive domains, and behavioral outcomes. "
ABSTRACT: Research suggests that IQ profiles identify subgroups of children with traumatic brain injury (TBI) based on sparing and impairment of cognitive abilities, but little information is available regarding whether these subgroups are differentiated on variables that are important for TBI outcome, such as behavioral functioning. The current study examined behavioral disturbances in 123 children with TBI in association with profiles of intellectual abilities identified using cluster analysis. On the basis of prior research, four clusters were hypothesized. Consistent with the hypothesis, cluster analysis identified four IQ clusters in the current sample. Comparisons among the clusters on behavior variables assessed from the Behavioral Assessment System for Children parent ratings indicated significant differences among the four IQ clusters, with the most impaired cluster exhibiting the severest disturbances. Results of the current study indicate that subgroups of children with TBI can be identified using IQ tests and that these subgroups are stable across different samples, and more importantly are moderately associated with behavioral disturbances that persist during the recovery period.Archives of Clinical Neuropsychology 09/2010; 25(8):781-90. DOI:10.1093/arclin/acq073 · 1.92 Impact Factor
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ABSTRACT: To describe the characteristics and determinants of aggressive behaviour observed within a neurobehavioural unit. Statistical analysis of a database of routinely administered clinical measures, including the Overt Aggression Scale-Modified for Neurorehabilitation. Records of aggressive behaviour shown by 108 patients over 14 days were studied. Patient characteristics were also captured using 23 items from the Rehabilitation Institute of Chicago-Functional Assessment Scale. Four factors were identified: 'communication', 'cognition/function', 'neurobehavioural disability' and 'mood & self-esteem'. Relationships between patient characteristics, external factors and their interactions with aggression were examined. Many (5548) episodes of aggression were recorded. Whilst most comprised verbal aggression, 729 physical assaults were made on others. Aggressive behaviour typically followed staff prompting or no obvious antecedent. Medical intervention was rare, most aggression was managed by staff not reinforcing this behaviour. Over 80% of physical assaults were made by people rated as having severe symptoms of neurobehavioural disability and poor communication. Neurobehavioural units require sufficient staff resources to engage patients in purposeful activities as these were associated with the least severe aggression. Despite increased OAS-MNR usage, a standardized methodology for investigating aggression is required to ensure compatibility between datasets.Brain Injury 08/2007; 21(9):891-911. DOI:10.1080/02699050701543560 · 1.86 Impact Factor
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ABSTRACT: Psychiatric disorders after traumatic brain injury (TBI) are frequent. Researches in this area are important for the patients' care and they may provide hints for the comprehension of primary psychiatric disorders. Here we approach epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI. Finally, the present situation of the knowledge in this field is discussed.Neuropsychiatric Disease and Treatment 09/2008; 4(4):797-816. · 2.15 Impact Factor