Perspectives on Suicide and Traumatic Brain Injury

The Journal of head trauma rehabilitation (Impact Factor: 2.92). 07/2011; 26(4):241-3. DOI: 10.1097/HTR.0b013e31821fdb86
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    • "Overall, the review found a consistent picture of elevated suicidal behaviours after TBI, but the underlying evidence-base was limited to a small number of studies. In the introduction to a recent special issue on suicide and TBI, Simpson and Brenner (2011) observed that there had been an upsurge in research activity in this field over the previous decade. Since the original 2007 review, several narrative reviews of the suicide literature focusing on TBI among civilians and/or military Veterans have been published (Brenner, Vanderploeg, & Terrio, 2009; Reeves & Brister, 2009; Reeves & Laizer, 2012; Simpson & Tate, 2009; Wasserman et al., 2008). "
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    ABSTRACT: Traumatic brain injury (TBI) is prevalent among many populations and existing data suggest that those with TBI are at increased risk for death by suicide. This systematic review serves as an update to a previous review, with the aim of evaluating the current state of evidence regarding prevalence and risk of suicide deaths, post-TBI suicidal ideation and suicide attempts, and treatments to reduce suicide-related outcomes among TBI survivors. Review procedures followed the PRISMA statement guidelines. In all, 1014 abstracts and 83 full-text articles were reviewed to identify 16 studies meeting inclusion criteria. Risk of bias for individual studies ranged from low to high, and very few studies were designed to examine a priori hypotheses related to suicide outcomes of interest. Overall, findings from this systematic review supported an increased risk of suicide among TBI survivors compared to those with no history of TBI. Evidence pertaining to suicidal thoughts and attempts was less clear, mainly due to heterogeneity of methodological quality across studies. One small randomised controlled trial was identified that targeted suicide prevention in TBI survivors. Further research is needed to identify the prevalence of post-TBI ideation and attempts, and to establish evidence-based suicide prevention practices among TBI survivors.
    Full-text · Article · May 2013 · Brain Impairment

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    ABSTRACT: Purpose: To understand empirically the perceived barriers to accessing crisis intervention services for individuals with acquired brain injury. Method: This action research design encompassed two phases of mixed methods data collection and analysis. Phase one consisted of the electronic distribution of a survey comprised primarily of quantitative items, launched to a nonrandom sample of 226 providers with a response rate of 49% (n = 110). Phase two entailed seven focus group interviews with 25 participants, designed to add explanatory power to phase one results. Results: Quantitative results revealed an array of major barriers significant to persons with brain injury, such as funding for services, coexisting diagnoses, and limited self-advocacy. Organizationally specific barriers included funding for services, limited training and education, and systems resources (e.g., personnel). Adding depth and insight, qualitative findings triangulated with these results, also highlighting the prevalence of the funding barrier and pointing to additional barriers relative to the individual, the family, and external stigma. Conclusions: The need for convenient, cost-effective, and applicable training and education is paramount. Opportunities for interagency cross training and education, particularly around risk assessment, psychosocial adjustment symptoms, and the biomechanical causes of psychiatric symptoms may alleviate perceived disconnections, improve provider confidence, and mitigate crises. Developing interprofessional teams of providers to maximize access to services, either face-to-face or virtual, is integral. These perspectives highlight opportunities to improve access to services and to strengthen relationships across providers and agencies.
    No preview · Article · Oct 2013 · Rehabilitation Psychology