Neurobehavioural symptoms 1 year after traumatic brain injury: A preliminary study of the relationship between race/ethnicity and symptoms

Arango‐Lasprilla, Juan Carlos; Ketchum, Jessica M.; Drew, Allison; Hammond, Flora M.; Powell, Janet M.; Kreutzer, Jeffrey S.; Lim, Paul Chuwn; Carr, Caroline

doi:10.3109/02699052.2012.655360

Cited by 27 publications

(15 citation statements)

References 22 publications

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“…Neurobehavioral symptoms are more likely to occur in the context of chronic emotional disruptions [e.g., depression (12–15)] that are common in the general population and after TBI (16, 17). Symptom-reporting after injury may also differ based on age (18, 19), gender (20, 21), education (22), race or ethnicity (23), and injury severity (24, 25), though differences in symptom reporting by these personal factors are present in other clinical populations and the general population as well. A nationwide epidemiological study on TBI-related emergency department visits concluded that many of the common neurobehavioral symptoms after TBI may be more related to pre-existing psychiatric conditions (e.g., post-traumatic stress disorders, substance use disorders) and personality features (e.g., impulse control problems, high-risk behaviors) that put an individual at greater risk for sustaining a TBI, rather than to just the injury itself (17).…”

Section: Introductionmentioning

confidence: 99%

Neurobehavioral Symptoms in Community-Dwelling Adults With and Without Chronic Traumatic Brain Injury: Differences by Age, Gender, Education, and Health Condition

2019

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Neurobehavioral symptoms after Traumatic Brain Injury (TBI) are prevalent, persist for many years, and negatively affect long-term health, function, and quality of life. Symptoms may differ based on age, gender, education, race, ethnicity, and injury severity. To better understand neurobehavioral functioning after TBI, we need a comprehensive picture of emotional, cognitive, and behavioral symptoms in the context of personal factors that may affect these symptoms. We also need to understand the extent to which these symptoms are specific to TBI, shared across other neurological conditions, or attributable to factors outside of the injury itself. We collected neurobehavioral symptoms via the self-reported Behavioral Assessment Screening Tool (BAST) in a National Cohort of English (n = 2,511) and Spanish speaking (n = 350) community-dwelling adults with and without chronic TBI and other neurological and mental health conditions. The primary focus of the present study was to comprehensively describe neurobehavioral symptoms in adults with and without TBI, broken down by gender and health conditions and then further by age group or educational attainment. As expected, participants with TBI reported more symptoms than Healthy Controls. Regardless of condition, women reported more fatigue, while men reported more substance abuse and impulsivity. Hispanic participants reported more neurobehavioral symptoms than non-Hispanic participants did across health conditions, though primarily Spanish-speakers reported fewer symptoms than English-speakers, suggesting that level of acculturation may contribute to symptom reporting. These data provide a comprehensive characterization of neurobehavioral symptoms in adults with TBI and adults without TBI (healthy controls, adults with other neurological conditions, and adults with mental health conditions).

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Section: Introductionmentioning

confidence: 99%

Neurobehavioral Symptoms in Community-Dwelling Adults With and Without Chronic Traumatic Brain Injury: Differences by Age, Gender, Education, and Health Condition

2019

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“…[16][17][18] Study design has been described previously. 16,17 In brief, inclusion criteria were severe, non-penetrating, traumatic brain injury requiring neurointensive care, with acute Glasgow Coma Scale score of [3][4][5][6][7][8]19 in adult patients aged 18-65 years. Exclusion criteria were death or expected death within 3 weeks of injury.…”

Section: Methodsmentioning

confidence: 99%

“…A variety of terms have been used to describe these behavioural changes. [5][6][7][8][9] Descriptions in the literature pertaining to TBI include variations of "neurobehavioral symptoms", 5 "neuropsychatric consequences" 6 as well as standard definitions of psychiatric disorders (e.g. according to Diagnostic System Manual DSM 10 or International Classification of Disease ICD criteria), 11 applied to patients after traumatic brain injury.…”

Section: Introductionmentioning

confidence: 99%

Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study

et al. 2016

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Objective: To investigate the occurrence of behavioural problems in patients with severe traumatic brain injury during the first year after injury and potential associations with outcome. An additional post hoc objective was to analyse the frequency of behaviours with need for intervention from staff. Design and setting: In a prospective population based cohort study 114 patients with severe traumatic brain injury were assessed at three weeks, three months and one year after injury. Main measures: Assessments included clinical examination and standardised instruments. Agitation was assessed with the Agitated Behaviour Scale, the course of recovery by the Rancho Los Amigo Scale and outcome by Glasgow Outcome Scale Extended. Results: Agitation were most common at 3 weeks post injury and 28% (n=68) of the patients showed at least one agitated behaviour requiring intervention from staff. Presence of significant agitation at 3 weeks after injury was not associated with poor outcome. At 3 months agitation was present in 11% (n=90) and apathy in 26 out of 81 assessed patients. At 3 months agitation and apathy were associated with poor outcome at one year. Conclusions: Most agitated behaviours in the early phase are transient and are not associated with poor outcome. Agitation and apathy are uncommon at three months but when present are associated with poor outcome at one year after injury. In the early phase after a severe traumatic brain injury agitated behaviour in need of interventions from staff occur in a substantial proportion of patients.

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“…Neurobehavioral symptoms, including aggression, disinhibition, lack of motivation, and difficulty planning/executing actions (1,2), are common after traumatic brain injury (TBI) and adversely affect participation and quality of life even many years after injury (3)(4)(5)(6)(7)(8)(9). Race and/or ethnicity (10), education (11), and gender (12,13) may also contribute to differences in neurobehavioral symptoms after TBI. Racial and ethnic minority groups report more psychiatric symptoms and cognitive deficits after TBI than non-Hispanic white individuals (10,(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

“…Race and/or ethnicity (10), education (11), and gender (12,13) may also contribute to differences in neurobehavioral symptoms after TBI. Racial and ethnic minority groups report more psychiatric symptoms and cognitive deficits after TBI than non-Hispanic white individuals (10,(14)(15)(16). Racial and ethnic minorities also experience healthcare disparities after brain injury (14,(16)(17)(18)(19)(20)(21)(22) that can magnify the long-term consequences of injury (14,(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

Cohort Differences in Neurobehavioral Symptoms in Chronic Mild to Severe Traumatic Brain Injury

2020

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Our understanding of neurobehavioral symptoms after traumatic brain injury (TBI) largely relies on data gathered in studies conducted at academic medical centers or large clinical centers with research infrastructure. Though this often provides a well-characterized clinical sample, it may also introduce bias based on geographic locations served by these institutions and personal factors associated with patient access to these institutions. We collected neurobehavioral symptoms via the self-reported Behavioral Assessment Screening Tool (BAST) in a National TBI Cohort (n = 263) and a Medical Center TBI Cohort (n = 218) of English-speaking community-dwelling adults with chronic TBI. The primary focus of the present study was to compare demographics and neurobehavioral symptom reporting across the two cohorts and to discuss the implications of any such differences on interpretation of symptom scores. Across all BAST subscales (Negative Affect, Fatigue, Executive Function, Impulsivity, and Substance Abuse), participants in the National TBI Cohort reported significantly more frequent symptoms than those in the Medical Center TBI Cohort (p's < 0.001). Participants in the National TBI Cohort were more likely to be non-White and Hispanic compared to the Medical Center TBI Cohort, and those with mild TBI in the National TBI Cohort were more likely to have less than a high school education than those with mild TBI in the Medical Center TBI Cohort. Individuals with TBI recruited through academic and clinical institutions may not be representative of individuals with TBI living across the United States.

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Neurobehavioural symptoms 1 year after traumatic brain injury: A preliminary study of the relationship between race/ethnicity and symptoms

Cited by 27 publications

References 22 publications

Neurobehavioral Symptoms in Community-Dwelling Adults With and Without Chronic Traumatic Brain Injury: Differences by Age, Gender, Education, and Health Condition

Neurobehavioral Symptoms in Community-Dwelling Adults With and Without Chronic Traumatic Brain Injury: Differences by Age, Gender, Education, and Health Condition

Behavioural problems in the first year after Severe traumatic brain injury: a prospective multicentre study

Cohort Differences in Neurobehavioral Symptoms in Chronic Mild to Severe Traumatic Brain Injury

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