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BACKGROUND: Fatigue is among the most common sequelae of traumatic brain injury (TBI). OBJECTIVES: To summarize the empirical and theoretical literature on Post TBI fatigue (PTBIF) and identify some of the challenges that continue to confront clinicians, researchers and individuals with TBI. METHODS: Qualitative literature review. The epidemiology, characteristics, and correlates of PTBIF are described. Challenges in the operational definition and measurement of fatigue are discussed and the empirical literature on measurement of PTBIF and theoretical models of the potential etiology of PTBIF is summarized. Existing treatments of PTBIF and the research supporting them are reviewed. Future directions for clinical research are presented. RESULTS: Although PTBIF is a high incidence condition after TBI that is related to significant suffering and reduced quality of life, it remains inadequately measured and treated. Its etiology and precipitants are poorly understood and intervention research is inadequate. CONCLUSION: Further research is necessary to develop psychometrically-sound objective and subjective measures of PTBIF and examine the efficacy of treatments for fatigue. Interventions shown to improve fatigue in other populations should be considered in treating PTBIF.

Despite areas of promise, there is insufficient evidence to recommend or contraindicate any treatments of PTBIF. Modafinil is not likely to be effective for PTBIF. Piracetam may reduce it, as may bright blue light. Cognitive behavioral therapy deserves additional study. High-quality research incorporating appropriate definition and measurement of fatigue is required to explore the potential benefits of promising interventions, evaluate fatigue treatments shown to be effective in other populations, and develop new interventions for PTBIF.

The present intergenerational study examined the perceived impact of the recent U.S. economic crisis on a sample of 68 young adult-parent dyads. The relative contribution of perceived economic pressure, reports of adult child-parent relationship quality, and concerns about the economic future in accounting for variation in self-reports of psychological distress for adult children and their middle-aged parents were examined. Parents' concerns about their children's economic future accounted for variation in their reports of anxiety and depressed mood above and beyond that of perceived economic pressures and their views of the parent-child relationship. In contrast, for young adults, reports of personal economic pressure were generally related to self-reported anxiety and depressed mood. Implications of findings for research and practice are discussed.

Despite changes in mental health policies, treatment, and systems of care, the overall lack of significant differences in the content of first-person accounts across the 30-year period suggests an enduring nature to the experiences of individuals coping with schizophrenia. Implications of present findings for research and practice are discussed.