Research Reports - Contribution of psychological trauma to outcomes after traumatic brain injury: Assaults versus sporting injuries

J Neurotrauma. 2014 Jan 16

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

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 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 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.

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