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Campbell JK, Howland J, Insalaco B, Lawrence-Soto G. Knowledge, Perceived Competence, and Behaviors Relative to Traumatic Brain Injury Among a Sample of Domestic Violence Emergency Shelter Advocates in a New England State. Violence Against Women 2023:10778012231163577. [PMID: 36942449 DOI: 10.1177/10778012231163577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
This cross-sectional study describes knowledge, perceived competence, and behaviors relative to intimate partner violence (IPV)-related brain injury (BI) among staff in residential domestic violence shelter programs across a New England state. A 23-item questionnaire was administered to registrants of an online IPV-related BI training series. Within this sample, knowledge about IPV-related BI was high, but relative to providing screening, accommodations, and specialized referrals to survivors with BI, perceived competence was low, and behaviors were infrequent. IPV shelter agencies should facilitate IPV-related BI training programs for staff and prioritize developing and implementing BI screening, accommodation, and referral policies and procedures.
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Affiliation(s)
- Julia K Campbell
- Department of Emergency Medicine, Injury Prevention Center, Boston Medical Center, Boston, MA, USA
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Jonathan Howland
- Department of Emergency Medicine, Injury Prevention Center, Boston Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Boston University School of Medicine, Boston, USA
| | - Brie Insalaco
- Statewide Head Injury Program, Massachusetts Rehabilitation Commission, Boston, MA, USA
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2
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Adams Nejatbakhsh N, Dawson D, Hutchison M, Selby P. Association between pediatric TBI and mental health and substance use disorders: A scoping review. Brain Inj 2023; 37:525-533. [PMID: 36871963 DOI: 10.1080/02699052.2023.2184871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
BACKGROUND The relationship between pediatric Traumatic Brain Injury (TBI) and long-term mental health and substance use disorders is not well known, resulting in inadequate prevention and management strategies. The aim of this scoping review is to review the evidence on pediatric TBI and the development of mental health disorders and substance use later in life and to identify gaps in the literature to inform future research. METHODS We searched multiple databases for original articles published between September 2002 and September 2022 on TBI-related mental health and/or substance use disorders in children and youth. Two independent reviewers performed the screening using Arksey and O'Malley and Levac et al.'s scoping review framework. RESULTS A total of six papers are included in this scoping review. Studies included are comprised of cross-sectional and prospective longitudinal cohort studies. DISCUSSION A correlation between pediatric TBI and development of certain mental health disorders and substance use is suggested, although much of the current evidence is mixed and does not account for confounding variables. Future studies should aim to closely examine these links and identify modifiers that can influence these relationships.
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Affiliation(s)
- Nasrin Adams Nejatbakhsh
- Addiction Medicine, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, Canada
| | - Danielle Dawson
- Addiction Medicine, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Peter Selby
- Addiction Medicine, Centre for Addiction and Mental Health, Toronto, Canada.,Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, Canada.,Psychiatry, University of Toronto, Toronto, Canada.,Dalla Lana School of Medicine, University of Toronto, 155 College St, Toronto, Canada
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3
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Klimo KR, Stern-Green EA, Shelton E, Day E, Jordan L, Robich M, Racine J, McDaniel CE, VanNasdale DA, Yuhas PT. Structure and function of retinal ganglion cells in subjects with a history of repeated traumatic brain injury. Front Neurol 2022; 13:963587. [PMID: 36034275 PMCID: PMC9412167 DOI: 10.3389/fneur.2022.963587] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/22/2022] [Indexed: 01/21/2023] Open
Abstract
This study tested whether repeated traumatic brain injuries (TBIs) alter the objective structure or the objective function of retinal ganglion cells (RGCs) in human subjects recruited from an optometry clinic. Case subjects (n = 25) with a history of repeated TBIs (4.12 ± 2.76 TBIs over 0-41 years) and healthy pair-matched control subjects (n = 30) were prospectively recruited. Retinal nerve fiber layer (RNFL) thickness was quantified with spectral-domain optical coherence tomography, and scanning laser polarimetry measured RNFL phase retardation. Measurements of the photopic negative response were made using full-field flash electroretinography. There was no statistically significant difference (p = 0.42) in global RNFL thickness between the case cohort (96.6 ± 9.4 microns) and the control cohort (94.9 ± 7.0 microns). There was no statistically significant difference (p = 0.80) in global RNFL phase retardation between the case cohort (57.9 ± 5.7 nm) and the control cohort (58.2 ± 4.6 nm). There were no statistically significant differences in the peak time (p = 0.95) of the PhNR or in the amplitude (p = 0.11) of the PhNR between the case cohort (69.9 ± 6.9 ms and 24.1 ± 5.1 μV, respectively) and the control cohort (70.1 ± 8.9 ms and 27.8 ± 9.1 μV, respectively). However, PhNR amplitude was more variable (p < 0.025) in the control cohort than in the case cohort. Within the case cohort, there was a strong positive (r = 0.53), but not statistically significant (p = 0.02), association between time since last TBI and PhNR amplitude. There was also a modest positive (r = 0.45), but not statistically significant (p = 0.04), association between time since first TBI and PhNR amplitude. Our results suggest that there were no statistically significant differences in the objective structure or in the objective function of RGCs between the case cohort and the control cohort. Future large, longitudinal studies will be necessary to confirm our negative results and to more fully investigate the potential interaction between PhNR amplitude and time since first or last TBI.
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Affiliation(s)
- Kelly R. Klimo
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | | | - Erica Shelton
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Elizabeth Day
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Lisa Jordan
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Matthew Robich
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Julie Racine
- Department of Ophthalmology, Nationwide Children's Hospital, Columbus, OH, United States
| | | | - Dean A. VanNasdale
- College of Optometry, The Ohio State University, Columbus, OH, United States
| | - Phillip T. Yuhas
- College of Optometry, The Ohio State University, Columbus, OH, United States,*Correspondence: Phillip T. Yuhas
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Young M, Peterson AH. Neuroethics across the Disorders of Consciousness Care Continuum. Semin Neurol 2022; 42:375-392. [PMID: 35738293 DOI: 10.1055/a-1883-0701] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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5
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Bulas AM, Li L, Kumar RG, Mazumdar M, Rosso AL, Youk AO, Dams-O'Connor K. Preinjury Health Status of Adults With Traumatic Brain Injury: A Preliminary Matched Case-Control Study. J Head Trauma Rehabil 2022; 37:E186-E195. [PMID: 34145163 PMCID: PMC8671538 DOI: 10.1097/htr.0000000000000703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To discern whether there is evidence that individuals who sustained a traumatic brain injury (TBI) had the greater odds of preexisting health conditions and/or poorer health behaviors than matched controls without TBI. SETTING Brain Injury Inpatient Rehabilitation Unit at Mount Sinai Hospital. Midlife in the United States (MIDUS) control data were collected via random-digit-dialing phone survey. PARTICIPANTS TBI cases were enrolled in the TBI Health Study and met at least 1 of the following 4 injury severity criteria: abnormal computed tomography scan; Glasgow Coma Scale score between 3 and 12; loss of consciousness greater than 30 minutes; or post-TBI amnesia longer than 24 hours. Sixty-two TBI cases and 171 matched MIDUS controls were included in the analyses; controls were excluded if they reported having a history of head injury. DESIGN Matched case-control study. MAIN MEASURES Self-reported measures of depression symptoms, chronic pain, health status, alcohol use, smoking status, abuse of controlled substances, physical activity, physical health composite score, and behavioral health composite score. RESULTS Pre-index injury depression was nearly 4 times higher in TBI cases than in matched controls (OR= 3.98, 95% CI, 1.71-9.27; P = .001). We found no significant differences in the odds of self-reporting 3 or more medical health conditions in year prior to index injury (OR = 1.52; 95% CI, 0.82-2.81; P = .183) or reporting more risky health behaviors (OR = 1.48; 95% CI; 0.75-2.91; P = .254]) in individuals with TBI than in controls. CONCLUSION These preliminary findings suggest that the odds of depression in the year prior to index injury far exceed those reported in matched controls. Further study in larger samples is required to better understand the relative odds of prior health problems in those who sustain a TBI, with a goal of elucidating the implications of preinjury health on post-TBI disease burden.
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Affiliation(s)
- Ashlyn M Bulas
- Departments of Rehabilitation & Human Performance (Ms Bulas, Drs Kumar, and Dams-O'Connor), Institute for Healthcare Delivery Science, Population Health Science and Policy (Drs Li and Mazumdar), and Neurology (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York; and Departments of Epidemiology (Dr Rosso), Biostatistics (Dr Youk), University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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6
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Olsen CM, Corrigan JD. Does Traumatic Brain Injury Cause Risky Substance Use or Substance Use Disorder? Biol Psychiatry 2022; 91:421-437. [PMID: 34561027 PMCID: PMC8776913 DOI: 10.1016/j.biopsych.2021.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/07/2021] [Accepted: 07/12/2021] [Indexed: 01/22/2023]
Abstract
There is a high co-occurrence of risky substance use among adults with traumatic brain injury (TBI), although it is unknown if the neurologic sequelae of TBI can promote this behavior. We propose that to conclude that TBI can cause risky substance use, it must be determined that TBI precedes risky substance use, that confounders with the potential to increase the likelihood of both TBI and risky substance use must be ruled out, and that there must be a plausible mechanism of action. In this review, we address these factors by providing an overview of key clinical and preclinical studies and list plausible mechanisms by which TBI could increase risky substance use. Human and animal studies have identified an association between TBI and risky substance use, although the strength of this association varies. Factors that may limit detection of this relationship include differential variability due to substance, sex, age of injury, and confounders that may influence the likelihood of both TBI and risky substance use. We propose possible mechanisms by which TBI could increase substance use that include damage-associated neuroplasticity, chronic changes in neuroimmune signaling, and TBI-associated alterations in brain networks.
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Affiliation(s)
- Christopher M Olsen
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin; Neuroscience Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
| | - John D Corrigan
- Department of Physical Medicine & Rehabilitation, Wexner Medical Center, The Ohio State University, Columbus, Ohio
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7
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Baiden P, Morgan MA, Logan MW. Sports- and Physical Activity-Related Concussions, Binge Drinking and Marijuana Use among Adolescents: The Mediating Role of Depression and Suicidal Ideation. Subst Use Misuse 2022; 57:504-515. [PMID: 34967277 DOI: 10.1080/10826084.2021.2019779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although past studies have examined the adverse impact of sports- and physical activity-related concussions (SPACs) on health and mental health outcomes, there is a dearth of research investigating the association between SPACs and binge drinking and marijuana use. OBJECTIVE The objective of this study is to examine the cross-sectional association between SPACs and binge drinking and marijuana use among adolescents and whether symptoms of depression and suicidal ideation mediate this association. METHODS Data for this study came from the 2017 and 2019 National Youth Risk Behavior Survey. An analytic sample of 17,175 adolescents aged 14-18 years (50.2% male) was analyzed using binary logistic regression. RESULTS Of the 17,175 adolescents, 13.7% engaged in binge drinking and 19.3% used marijuana 30 days preceding the survey date. Approximately one in seven (14.1%) adolescents had SPACs during the past year. Upon controlling for the effects of other factors, adolescents who had SPACs had 1.74 times higher odds of engaging in binge drinking (AOR = 1.74, p<.001, 95% CI = 1.47-2.06) and 1.42 times higher odds of using marijuana (AOR = 1.42, p<.001, 95% CI = 1.24-1.62) than those who did not have SPACs. Symptoms of depression and suicidal ideation explained 12% of the association between SPACs and binge drinking, and 19% of the association between SPACs and marijuana use. CONCLUSIONS Understanding the association between SPACs and substance use and mental health could contribute to early identification of adolescents who may engage in substance use.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, Texas, USA
| | - Mark A Morgan
- Department of Criminal Justice & Security Studies, University of Dayton, Dayton, Ohio, USA
| | - Matthew W Logan
- School of Criminal Justice & Criminology, Texas State University, San Marcos, Texas, USA
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8
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Schneider BS, Arciniegas DB, Harenski C, Clarke GJB, Kiehl KA, Koenigs M. The prevalence, characteristics, and psychiatric correlates of traumatic brain injury in incarcerated individuals: an examination in two independent samples. Brain Inj 2021; 35:1690-1701. [PMID: 35067151 PMCID: PMC8884136 DOI: 10.1080/02699052.2021.2013534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PRIMARY OBJECTIVE Identify the prevalence, characteristics, and psychological correlates of traumatic brain injury (TBI) among incarcerated individuals. RESEARCH DESIGN Three aims: (1) Determine the prevalence and characteristics of TBI in 1469 adults incarcerated in Wisconsin state prisons (1064 men, 405 women); (2) Characterize the relationship between mild TBI and mental illness in a sub-sample of men and women; (3) Reproduce the findings from Aim 1 and Aim 2 in an independent sample of 1015 adults incarcerated in New Mexico state prisons (600 men, 415 women). METHODS AND PROCEDURES Standardized TBI assessment with structured clinical interviews and self-report questionnaires. MAIN OUTCOMES AND RESULTS Rates of TBI were approximately five times greater than the general population, with a substantially higher rate of TBI caused by assault. In the Wisconsin sample, mild TBI was associated with greater levels of post-traumatic stress disorder (PTSD) among women (but not among men). In the New Mexico sample, TBI of any severity was associated with greater levels of major depressive disorder (MDD) among women (but not among men). CONCLUSIONS This study thus provides novel data on TBI and its correlates among individuals incarcerated in state prisons, and highlights a specific treatment need within the prison population.
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Affiliation(s)
- Brett S. Schneider
- Department of Psychiatry, University of Wisconsin-Madison, 53719,Department of Psychology, University of Wisconsin-Madison 53706
| | - David B. Arciniegas
- Marcus Institute for Brain Health, University of Colorado-Anschutz Medical Campus, Aurora, Colorado 80045,Department of Psychiatry and Behavioral Sciences, University of New Mexico School of Medicine, Albuqerque, New Mexico 87106
| | - Carla Harenski
- The MIND Research Network, Albuquerque, New Mexico 87106
| | | | - Kent A. Kiehl
- The MIND Research Network, Albuquerque, New Mexico 87106,Departments of Psychology, Neuroscience and Law, University of New Mexico, Albuquerque, New Mexico 87106
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, 53719,Corresponding Author , Michael Koenigs, 6001 Research Park Boulevard, Madison, WI 53719
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9
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Abstract
Traumatic brain injury (TBI) is a common neurological condition that results from an external force altering normal brain function, whether temporarily or permanently. A concussion is one type of TBI. TBIs vary greatly in severity, which concomitantly creates tremendous variability in their manifestation. The fingerprint of TBI is damage to the frontal areas of the brain, which, with sufficient magnitude, results in impairment of a person's ability to regulate cognition, emotion, and behavior. These consequences of TBI make recognition in the context of treating behavioral health conditions of utmost importance. TBI not only causes behavioral health problems but also produces associated deficits that can undermine the effectiveness of treatment for a behavioral health condition. This overview delineates key characteristics of TBI and describes its association with behavioral health conditions. Mechanisms underlying the relationship between TBI and behavioral health are presented, and a series of recommendations for professionals are proposed. This article is intended to raise awareness about TBI and simultaneously introduce key concepts for accommodating the effects of TBI in behavioral health care.
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Affiliation(s)
- John D Corrigan
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus
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10
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Starosta AJ, Adams RS, Marwitz JH, Kreutzer J, Monden KR, Dams O'Connor K, Hoffman J. Scoping Review of Opioid Use After Traumatic Brain Injury. J Head Trauma Rehabil 2021; 36:310-327. [PMID: 34489382 PMCID: PMC8428300 DOI: 10.1097/htr.0000000000000721] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To summarize the current literature to identify what research has been conducted, examine the approaches used, and determine what is presently known about prescription and nonprescription opioid receipts and use among individuals with traumatic brain injury (TBI). DATA SOURCES The search strategy included the following: opioid; opiate; analgesics, opioid; opiate alkaloids; or opioid-related disorders; AND brain injury; brain injuries; brain injuries, traumatic; head injury; head injuries; head injuries, closed; head injuries, penetrating; brain concussion; diffuse axonal injury; diffuse axonal injuries; brain trauma/s; head trauma/s; concussion; craniocerebral trauma/s; or TBI. Filters included English and Adults (19+ years). Study Selection: Inclusion: English language, adults with stable TBI, and prescription opioid receipt or use after TBI. Exclusion: Animal models, populations with other acquired brain injury, acute TBI management, and non-peer-reviewed articles, theses, or conference abstracts. Multiple reviewers screened abstracts and full-text articles for eligibility. In total, 771 abstracts were screened, 183 full texts were reviewed, and 21 met eligibility criteria. Data Extraction: Relevant content was independently extracted by multiple observers, including authors, design, sample identification and data source/s, TBI severity, TBI assessment, opioid assessment, study population (demographics, N), military affiliation, comparison groups, date of data collection, and summary of findings. RESULTS Studies were published between 1987 and 2019; most data were collected prior to 2015. The majority utilized administrative and electronic medical record data from the Department of Veterans Affairs and retrospective cohort designs, and most focused on prescription opioids. There were no studies evaluating interventions to reduce use of opioids in TBI populations. Preliminary findings suggest that prescription opioid receipt is strongly related to psychological symptoms, including comorbid depression, anxiety, and posttraumatic stress disorder. CONCLUSIONS Despite increased awareness of opioid receipt and use following TBI, there is limited investigation on the examination of this issue. Future studies should include more varied patient populations as well as evaluate interventions to reduce opioid use following TBI.
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Affiliation(s)
- Amy J Starosta
- Division of Rehabilitation Psychology, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle (Drs Starosta and Hoffman); Institute for Behavioral Health at the Heller School for Social Policy & Management, Brandeis University, Waltham, Massachusetts (Dr Adams); Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, Colorado (Dr Adams); Division of Rehabilitation Psychology and Neuropsychology (Dr Kreutzer), Department of Physical Medicine and Rehabilitation (Ms Marwitz), Department of Rehabilitation Medicine, University of Minnesota, Minneapolis (Dr Monden); Brain Injury Research Center of Mount Sinai, Departments of Rehabilitation Medicine and Neurology, Icahn School of Medicine at Mount Sinai, New York City, New York (Dr Dams O'Connor)
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11
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Kumar RG, Ornstein KA, Corrigan JD, Sayko Adams R, Dams-O'Connor K. Association between Lifetime History of Traumatic Brain Injury, Prescription Opioid Use, and Persistent Pain: A Nationally Representative Study. J Neurotrauma 2021; 38:2284-2290. [PMID: 33567980 PMCID: PMC8672103 DOI: 10.1089/neu.2020.7496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Pain is common among adults with traumatic brain injury (TBI), yet little data exist regarding prevalence of opioid use in this population. The objective of this retrospective cohort study was to evaluate the association between lifetime TBI exposure, opioid use, and pain in a nationally representative sample of 1022 adults aged 50+ who participated in the Health and Retirement Study (HRS). Our primary exposure was lifetime TBI history measured via the Ohio State University TBI Identification Method. We evaluated three alternate TBI exposures (years since most recent TBI, age at first TBI, and number of lifetime TBIs) in sensitivity analyses. We evaluated two outcomes: recent opioid medication use, and moderate-to-severe pain measured over two HRS waves. We classified three pain groups (persistent, intermittent, and no pain). Prevalences of opioid use among individuals with and without TBI were 19.7% and 13.6%, respectively. After adjustment for age, sex, and race, individuals with TBI had a 52% increased risk for opioid use compared with individuals without TBI (relative risk = 1.52, 95% confidence interval: 1.11, 2.04). Individuals with recent TBI (1-10 years ago), first TBI after age 40+, and 2+ lifetime TBIs had greatest risk for opioid use. Compared with individuals without TBI, individuals with TBI had 4.9-times increased odds for persistent versus no pain, and 1.9-times increased odds of intermittent versus no pain. Persistent pain among adults with lifetime TBI is elevated compared with the general population, which may contribute to increased opioid use among persons with TBI, particularly those with recent injuries or multiple lifetime TBIs.
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Affiliation(s)
- Raj G. Kumar
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Katherine A. Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Medicine, Division of General Internal Medicine, and Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John D. Corrigan
- Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, Ohio, USA
| | - Rachel Sayko Adams
- Heller School, Institute for Behavioral Health, Brandeis University, Waltham, Massachusetts, USA
- Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, Colorado, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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12
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Coxe KA, Lee G, Kagotho N, Eads R. Mental Health Service Utilization among Adults with Head Injury with Loss of Consciousness: Implications for Social Work. HEALTH & SOCIAL WORK 2021; 46:125-135. [PMID: 33954747 DOI: 10.1093/hsw/hlab005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 01/09/2020] [Accepted: 01/25/2020] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to identify factors associated with mental health service utilization among adults with head injury with loss of consciousness (LOC) using Andersen's model of health. This secondary data analysis used the 2011-2014 National Health and Nutrition Examination Survey with data collected from 7,399 adults. Binary logistic regression was conducted to determine odds associated with predisposing, enabling, and needs factors on head injury with LOC and mental health service utilization. A total of 948 (12.8 percent) adults 40 years and older self-reported head injury with LOC. Head injury with LOC was higher among men and people with lower income, illicit drug use history, and moderate to severe depression. Mental health service utilization for people with head injury with LOC was lower among older-age adults and those with no health insurance. However, utilization was higher among adults with military service, history of drug use, and moderate to severe depression. Social workers in health care settings play critical roles serving adults with traumatic brain injury (TBI) through mental health and substance use disorder treatment and bridging gaps in service access. Social workers should recognize the complex needs of clients with TBI and factors affecting mental health service use.
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Affiliation(s)
- Kathryn A Coxe
- PhD candidate, College of Social Work, The Ohio State University, Columbus, OH 43210
| | - Guijin Lee
- postdoctoral fellow, School of Social Work, Wayne State University, Detroit
| | - Njeri Kagotho
- associate professor and chief diversity officer, College of Social Work, The Ohio State University, Columbus, OH
| | - Ray Eads
- PhD candidate, College of Social Work, The Ohio State University, Columbus, OH
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13
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Nardo T, Batchelor J, Berry J, Francis H, Jafar D, Borchard T. Cognitive Remediation as an Adjunct Treatment for Substance Use Disorders: A Systematic Review. Neuropsychol Rev 2021; 32:161-191. [PMID: 33871785 DOI: 10.1007/s11065-021-09506-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 04/06/2021] [Indexed: 11/28/2022]
Abstract
Substance use disorders are associated with diverse neuropsychological impairments, with deficits in memory and executive functioning commonly observed. Cognitive remediation has been shown to be effective in other populations with cognitive impairments in these domains, including those with psychiatric disorders and acquired brain injuries, and it has been hypothesised to be similarly effective for those in treatment for substance use disorders. We aimed to systematically review the evidence for cognitive remediation interventions administered as an adjunct treatment to substance use rehabilitation. Studies were included if participants were receiving substance use treatment, if improving cognitive functioning was the main focus of the intervention and if they used an experimental design with a control condition receiving treatment-as-usual or an active control intervention. Two independent reviewers agreed on the final selection of 32 studies, encompassing cognitive remediation for working memory, memory, executive functioning and general cognition. Significant differences between intervention and control groups for cognitive test results and treatment outcomes were extracted and compared across treatment approaches. The review found considerable heterogeneity across studies, including in the types of interventions, the nature of participants and the outcome measures used. Further, a lack of quality studies with sufficient power meant that limited conclusions could be drawn, highlighting a need for further replication and research. However, findings indicate that cognitive remediation remains a promising potential avenue for improving cognition and treatment outcomes for those in treatment for substance use disorders. Protocol submitted prospectively to PROSPERO 30.09.2019, CRD42020150978.
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Affiliation(s)
- Talia Nardo
- Macquarie University, North Ryde, NSW, 2109, Australia.
| | | | - Jamie Berry
- Macquarie University, North Ryde, NSW, 2109, Australia.,Advanced Neuropsychological Treatment Services, Strathfield South, NSW, 2136, Australia
| | | | - Deyyan Jafar
- Macquarie University, North Ryde, NSW, 2109, Australia
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What's in an "ASAM-based Assessment?" Variations in Assessment and Level of Care Determination in Systems Required to Use ASAM Patient Placement Criteria. J Addict Med 2020; 16:18-26. [PMID: 33395145 DOI: 10.1097/adm.0000000000000804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES When clients begin substance use disorder (SUD) treatment, it is critical to ensure that they receive treatment that matches their needs and preferences. A growing number of payors are requiring the use of multidimensional assessments such as assessments based on the American Society of Addiction Medicine (ASAM) criteria, which describe 6 dimensions that should be used to inform decisions about patient placement. However, ASAM guidance does not list specific questions to ask or instruments to use to elicit this information. This paper evaluates differences among the assessment tools being used by SUD service systems that are required to use ASAM-based assessments to make patient placement decisions. METHODS We analyzed 29 different ASAM-based assessments being used by California counties to make patient placement decisions using conventional and summative content analysis techniques. RESULTS All assessments were organized by the 6 ASAM dimensions. However, some of them only ask 1 or 2 questions per dimension, while others ask over 20, and some ask over 100 depending on patient responses. There is significant heterogeneity in the information the assessments collect and how it is used to generate patient placement decisions. Among the 29 assessments examined, there are 8 different algorithms or instructions on how to translate information from assessments into level of care recommendations. CONCLUSIONS The differences among the ASAM-based assessments examined in this paper suggest a need to implement fidelity standards, enhance training, and create resources to help systems create and utilize assessment and patient placement tools that are consistent across the SUD treatment field.
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15
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Traumatic brain injury and the misuse of alcohol, opioids, and cannabis. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:195-243. [PMID: 33648670 DOI: 10.1016/bs.irn.2020.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Traumatic brain injury (TBI), most often classified as concussion, is caused by biomechanical forces to the brain resulting in short- or long-term impairment in brain function. TBI resulting from military combat, sports, violence, falls, and vehicular accidents is a major cause of long-term physical, cognitive, and psychiatric dysfunction. Psychiatric disorders associated with TBI include depression, anxiety, and substance use disorder, all having significant implications for post-TBI recovery and rehabilitation. This chapter reviews the current preclinical and clinical literature describing the bidirectional relationship between TBI and misuse of three commonly abused drugs: alcohol, opioids, and cannabis. We highlight the influence of each of these drugs on the incidence of TBI, as well as trends in their use after TBI. Furthermore, we discuss factors that may underlie post-injury substance use. Understanding the complex relationship between TBI and substance misuse will enhance the clinical treatment of individuals suffering from these two highly comorbid conditions.
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16
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Trexler LE, Corrigan JD, Davé S, Hammond FM. Recommendations for Prescribing Opioids for People With Traumatic Brain Injury. Arch Phys Med Rehabil 2020; 101:2033-2040. [PMID: 32771395 DOI: 10.1016/j.apmr.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
Our objective was to make recommendations intended to reduce the rate of opioid misuse and overdose for a particularly high-risk group of people with traumatic brain injury (TBI). A consensus process conducted with TBI researchers and expert practitioners developed practical recommendations to inform prescribing of opioids for people with TBI. After determining key general principles for prescribing opioids for people with TBI, 6 TBI-specific recommendations were developed, 1 for acute pain in the agitated patient with TBI, 3 recommendations to be considered before prescribing an opioid, and 2 for follow-up and use by mental health and substance use disorder providers. While there is much needed research to examine the relationship between opioid misuse and TBI, the present recommendations provide at least some clinical considerations that might serve to prevent further deaths among a high-risk group.
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Affiliation(s)
- Lance E Trexler
- Rehabilitation Hospital of Indiana, Indianapolis, Indiana; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana.
| | - John D Corrigan
- Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio
| | - Shashank Davé
- Rehabilitation Hospital of Indiana, Indianapolis, Indiana; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana
| | - Flora M Hammond
- Rehabilitation Hospital of Indiana, Indianapolis, Indiana; Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana
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Hammond FM, Ketchum J, Dams-O'Connor K, Corrigan JD, Miller C, Haarbauer-Krupa J, Faul M, Trexler LE, Harrison-Felix C. Mortality Secondary to Unintentional Poisoning after Inpatient Rehabilitation among Individuals with Moderate to Severe Traumatic Brain Injury. J Neurotrauma 2020; 37:2507-2516. [PMID: 32438850 DOI: 10.1089/neu.2020.7038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Studies have shown reduced life expectancy following moderate-severe traumatic brain injury (TBI) with death from unintentional poisoning (UP) being 11 times higher following TBI than in the general population. The characteristics of those who die of unintentional poisoning are compared with the characteristics of those who die of other causes (OC) in a retrospective cohort who received inpatient rehabilitation following TBI and enrolled in the TBI Model Systems National Database between 1989 and 2017 (n = 15,835 cases with 2,238 deaths recorded). Seventy-eight cases (3.5%) of deaths were the result of UP, 76% were the result of OC, and 20.5% were from an unknown cause. Among the UP deaths, 90% involved drugs (of these, 67% involved narcotic drugs and 14% involved psychostimulants), and 8% involved alcohol. Age-adjusted risk for UP death was associated with: white/non-Hispanic race/ethnicity, living alone, non-institutionalization, pre- and post-injury illicit drug use and alcohol/drug problem use, any alcohol use at last follow-up, better Functional Independence MeasureTM (FIM) scores, history of arrest, moderate disability (vs. severe disability or good recovery), less supervision needed, and greater anxiety. Adults who receive inpatient rehabilitation for TBI who die from UP are distinguishable from those who die of OC. Factors such as pre-injury substance use in the context of functional independence may be regarded as targets for prevention and/or intervention to reduce substance use and substance-related mortality among survivors of moderate-severe TBI. The current findings may have implications for medical care, surveillance, prevention, and health promotion.
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Affiliation(s)
- Flora M Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
| | - Jessica Ketchum
- Research Department, Craig Hospital, Englewood, Colorado, USA.,Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado, USA
| | - Kristen Dams-O'Connor
- Department of Rehabilitation Medicine, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John D Corrigan
- Department of Physical Medicine & Rehabilitation, Ohio State University, Columbus, Ohio, USA
| | - Cate Miller
- National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, Department of Health and Human Services, Washington, DC, USA
| | - Juliet Haarbauer-Krupa
- Traumatic Brain Injury Team, Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mark Faul
- Traumatic Brain Injury Team, Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lance E Trexler
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
| | - Cynthia Harrison-Felix
- Research Department, Craig Hospital, Englewood, Colorado, USA.,Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado, USA
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18
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Ilie G, Trenholm M, Boak A, Mann RE, Adlaf EM, Asbridge M, Hamilton H, Rehm J, Rutledge R, Cusiman MD. Adolescent traumatic brain injuries: Onset, mechanism and links with current academic performance and physical injuries. PLoS One 2020; 15:e0229489. [PMID: 32163445 PMCID: PMC7067417 DOI: 10.1371/journal.pone.0229489] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 02/07/2020] [Indexed: 01/21/2023] Open
Abstract
Background Traumatic brain injuries (TBIs) in adolescence are associated with adverse outcomes, but whether the timing of the onset of TBIs leads to greater deficits has not been determined. We evaluate the relationship between the first and most recent TBI, and current academic performance and medically treated physical injuries. Methods Data were derived from the 2015 Ontario Student Drug Use and Health Survey (OSDUHS) administered to adolescents in grades 7 to 12 (ages 12 to 18). TBI was defined as a head injury that resulted in loss of conscious for at least five minutes or at least one overnight hospitalization. Results One in five students reported having had a history of TBI in their lifetime and were more prevalent in males. Odds ratios were 2 times higher for males to have had their first (or only) and most recent TBI in grades 5 to 8, compared to females. Sports-related TBIs accounted for 41.1% of all TBIs. Hockey related TBIs were more frequent compared to soccer related TBIs. Reports of history of TBI was associated with lower academic performance and more physical injuries. First or only TBI occurring in grades 9–12 (occurring on average between 14 to 19 years of age) had higher significant odds of poorer academic performance than TBIs occurring in earlier grades (younger ages than 14 years old). Students who reported more visits for medical treatment of physical injuries in the past year had higher odds to report a history of TBIs in higher school grades. Conclusions Adverse physical and academic outcomes among young TBI survivors are associated with the onset and frequency of history of lifetime TBI. Prevention efforts to minimize TBIs during youth is critical.
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Affiliation(s)
- Gabriela Ilie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
- * E-mail:
| | | | - Angela Boak
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Robert E. Mann
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Edward M. Adlaf
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Hayley Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Robert Rutledge
- Department of Radiation Oncology, Dalhousie University, Halifax, Canada
| | - Michael D. Cusiman
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Division of Neurosurgery, University of Toronto, Toronto, Canada
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19
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Katzin S, Andiné P, Hofvander B, Billstedt E, Wallinius M. Exploring Traumatic Brain Injuries and Aggressive Antisocial Behaviors in Young Male Violent Offenders. Front Psychiatry 2020; 11:507196. [PMID: 33192641 PMCID: PMC7581682 DOI: 10.3389/fpsyt.2020.507196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 09/11/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Traumatic brain injury (TBI) is a major cause of disabilities and mortality worldwide, with higher prevalence in offender populations than in the general population. Previous research has strongly advocated increased awareness of TBI in offender populations. The aim of this study was to explore the prevalence and characteristics of TBI, and to investigate associations and interactions between TBI, aggressive antisocial behaviors, general intellectual functioning, and substance use disorders (SUD) in a well-characterized group of young violent offenders. Methods: The study investigated a cohort (n = 269) of 18 to 25-year-old male violent offenders in Sweden. Data on TBI (files + self-report), aggressive antisocial behaviors (Life History of Aggression), SUD (clinical interviews), and general intellectual functioning (General Ability Index, Wechsler Adult Intelligence Scales Third Edition) were collected between 2010 and 2012. Parametric (Student's t-test) and non-parametric (Mann-Whitney U-test, Spearman's rho, χ2, Kruskal Wallis test) inferential statistics were applied and effect sizes reported. Results: TBI, both with and without loss of consciousness, was common, with 77.5% of the offenders reporting having suffered at least one TBI during their lifetime. TBI was associated with an increased occurrence of aggressive antisocial behaviors and SUD, and offenders with both TBI and SUD evidenced the largest amount of aggressive antisocial behaviors. No clinically meaningful associations were found between TBI and general intelligence. Effect sizes were in the small to medium range. Conclusions: Our study confirms an increased prevalence of TBI among young violent offenders compared to the general population, as well as associations between TBI, aggressive antisocial behaviors, and SUD. However, it provides no information on the severity of the TBI, nor on the causality of the demonstrated associations. Nevertheless, TBI, and possible related deficits, need to be considered in the assessment and treatment of young violent offenders.
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Affiliation(s)
- Samuel Katzin
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Peter Andiné
- Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Forensic Psychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Forensic Psychiatry, National Board of Forensic Medicine, Gothenburg, Sweden
| | - Björn Hofvander
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Division of Forensic Psychiatry, Trelleborg, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Märta Wallinius
- Lund Clinical Research on Externalizing and Developmental Psychopathology, Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Centre of Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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20
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Cannella LA, Andrews AM, Tran F, Razmpour R, McGary H, Collie C, Tsegaye T, Maynard M, Kaufman MJ, Rawls SM, Ramirez SH. Experimental Traumatic Brain Injury during Adolescence Enhances Cocaine Rewarding Efficacy and Dysregulates Dopamine and Neuroimmune Systems in Brain Reward Substrates. J Neurotrauma 2020; 37:27-42. [PMID: 31347447 PMCID: PMC6921296 DOI: 10.1089/neu.2019.6472] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Although clinical studies identify traumatic brain injury (TBI) as a risk factor for the development of substance use disorder, much remains unknown about the possible underlying pathogenesis and age-specific effects. Thus, the aim of this study is to test the hypothesis that at an age of ongoing maturation, adolescent TBI alters elements of the reward pathway, resulting in increased sensitivity to the rewarding effects of a subthreshold dose of cocaine that does not induce significant behavioral changes in naïve, non-injured mice. Specifically, these results were derived from the combination of the controlled cortical impact model of TBI, performed on either adolescent (6 weeks) or young adult (8 weeks) mice, followed by the cocaine-induced conditioned place preference assay 2 weeks later. Using three-dimensional isosurface rendering and volumetric image analysis, TBI was found to induce neuromorphological changes such as decreased dendritic complexity and reduced spine density in brain regions essential for reward perception and processing of drug-induced euphoria. Further, we demonstrated that these neuronal changes may affect the differential expression of dopamine-associated genes. Our analysis also provided evidence for age-related differences in immune response and the distinct involvement of augmented microglial phagocytic activity in the remodeling of neuronal structures in the adolescent TBI brain. Our studies suggest that TBI during adolescence, a period associated with ongoing maturation of dopaminergic systems, may subsequently enhance the abuse liability of cocaine in adulthood.
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Affiliation(s)
- Lee Anne Cannella
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
| | - Allison M. Andrews
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
| | - Fionya Tran
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
| | - Roshanak Razmpour
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
| | - Hannah McGary
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
| | - Ceryce Collie
- Department of Biology, Lincoln University, Philadelphia Pennsylvania
| | - Tarik Tsegaye
- Department of Biology, Lincoln University, Philadelphia Pennsylvania
| | - Marquis Maynard
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
| | - Marc J. Kaufman
- McLean Imaging Center, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Scott M. Rawls
- Center for Substance Abuse Research, Temple University, Philadelphia Pennsylvania
| | - Servio H. Ramirez
- Department of Pathology and Laboratory Medicine, Temple University, Philadelphia Pennsylvania
- Center for Substance Abuse Research, Temple University, Philadelphia Pennsylvania
- Shriners Hospital for Pediatric Research Center, Temple University, Philadelphia Pennsylvania
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21
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Assessment and Management of Psychiatric Symptoms Among Adults With Mild Traumatic Brain Injury. Concussion 2020. [DOI: 10.1016/b978-0-323-65384-8.00005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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22
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Suicide and Traumatic Brain Injury Among Individuals Seeking Veterans Health Administration Services Between Fiscal Years 2006 and 2015. J Head Trauma Rehabil 2019; 34:E1-E9. [DOI: 10.1097/htr.0000000000000489] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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23
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Alcohol and Drug Use Before and During the First Year After Traumatic Brain Injury. J Head Trauma Rehabil 2019; 33:E51-E60. [PMID: 28926484 DOI: 10.1097/htr.0000000000000341] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To compare individuals with mild and moderate/severe traumatic brain injury (TBI) on alcohol and drug use and substance use disorders before and in the first year post-TBI; to explore sociodemographic and injury-related variables associated with substance use disorders. PARTICIPANTS A total of 225 adults hospitalized in a level I trauma center after TBI. DESIGN Observational cohort study with retrospective (pre-TBI) and prospective (4, 8, and 12 months post-TBI) assessments. MAIN MEASURES Mini International Neuropsychiatric Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS The percentage of participants using alcohol or drug declined shortly after the injury (4 months) but increased closer to preinjury levels by the end of the first year. Post-TBI alcohol use was higher after mild than moderate/severe TBI, but drug use was similar. About 11% of participants met criteria for a substance use disorder in the first year after TBI. Younger age, not being in a relationship, and suspected substance intoxication at the time of TBI were associated with the presence of a post-TBI substance use disorder. CONCLUSION Individuals with milder injuries return to alcohol use earlier than those with more severe injuries. Given that substance use may alter recovery, preventive recommendations and systematic follow-ups are warranted regardless of injury severity and access to rehabilitation.
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24
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Cannella LA, McGary H, Ramirez SH. Brain interrupted: Early life traumatic brain injury and addiction vulnerability. Exp Neurol 2019; 317:191-201. [PMID: 30862466 PMCID: PMC6544498 DOI: 10.1016/j.expneurol.2019.03.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/27/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
Recent reports provide evidence for increased risk of substance use disorders (SUD) among patients with a history of early-life traumatic brain injury (TBI). Preclinical research utilizing animal models of TBI have identified injury-induced inflammation, blood-brain barrier permeability, and changes to synapses and neuronal networks within regions of the brain associated with the perception of reward. Importantly, these reward pathway networks are underdeveloped during childhood and adolescence, and early-life TBI pathology may interrupt ongoing maturation. As such, maladaptive changes induced by juvenile brain injury may underlie increased susceptibility to SUD. In this review, we describe the available clinical and preclinical evidence that identifies SUD as a persistent psychiatric consequence of pediatric neurotrauma by discussing (1) the incidence of early-life TBI, (2) how preclinical studies model TBI and SUD, (3) TBI-induced neuropathology and neuroinflammation in the corticostriatal regions of the brain, and (4) the link between childhood or adolescent TBI and addiction in adulthood. In summary, preclinical research utilizes an innovative combination of models of early-life TBI and SUD to recapitulate clinical features and to determine how TBI promotes a risk for the development of SUD. However, causal processes that link TBI and SUD remain unclear. Additional research to identify and therapeutically target underlying mechanisms of aberrant reward pathway development will provide a launching point for TBI and SUD treatment strategies.
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Affiliation(s)
- Lee Anne Cannella
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Hannah McGary
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Servio H Ramirez
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Shriners Hospitals Pediatric Research Center, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA.
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25
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Schneider-Cline W, Bush E, McKelvey M. Using the OSU TBI-ID method for screening rural, older adults: a mixed methods feasibility study. Brain Inj 2019; 33:899-915. [DOI: 10.1080/02699052.2019.1606450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Erin Bush
- Division of Communication Disorders, University of Wyoming, Laramie, WY, USA
| | - Miechelle McKelvey
- Department of Communication Disorders, University of Nebraska Kearney, Kearney, NE, USA
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26
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Corrigan JD, Adams RS. The intersection of lifetime history of traumatic brain injury and the opioid epidemic. Addict Behav 2019; 90:143-145. [PMID: 30391775 PMCID: PMC6496936 DOI: 10.1016/j.addbeh.2018.10.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/15/2018] [Accepted: 10/20/2018] [Indexed: 12/15/2022]
Affiliation(s)
- John D Corrigan
- Department of Physical Medicine & Rehabilitation, Wexner Medical Center, The Ohio State University, 2145 Dodd Hall, 480 Medical Center Drive, Columbus, OH 43210-1234, United States
| | - Rachel Sayko Adams
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02453-2728, United States.
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27
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Critchfield E, Bain KM, Goudeau C, Gillis CJ, Gomez-Lansidel MT, Eapen BC. A Model of Care for Community Reintegration. Phys Med Rehabil Clin N Am 2019; 30:43-54. [DOI: 10.1016/j.pmr.2018.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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O’Rourke C, Linden MA, Lohan M. Traumatic brain injury and abuse among female offenders compared to non-incarcerated controls. Brain Inj 2018; 32:1787-1794. [DOI: 10.1080/02699052.2018.1539872] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Conall O’Rourke
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Mark A. Linden
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
| | - Maria Lohan
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, UK
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29
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Nagele DA, McCart M, Hooper SR. A call for implementing preferred practices for brain injury screening in youth to improve transition. NeuroRehabilitation 2018; 42:289-298. [PMID: 29660967 DOI: 10.3233/nre-172386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is vital to engage in systematic screening to identify and serve children who may have sustained an acquired brain injury (ABI) - either traumatic or non-traumatic, so they can be successfully transitioned between environments and life stages. This is particularly important for children and adolescents given the impact an ABI can have on learning and social functioning over the course of the neurodevelopmental process. A pattern of repeated, undiagnosed mild brain injuries may lead to mood or behavior disorders, learning problems. Despite increasing awareness of brain injury as a public health issue, there has not been implementation of systematic screening practices in schools or other public health settings similar to other conditions (e.g., vision disorders, Autism Spectrum Disorders). OBJECTIVES What is needed to address this lack of systematic screening for ABI is a rationale for systematic screening for ABI in children and adolescents, including examining successful models of screening for other disorders and conditions. METHODS A review was conducted of available ABI screening methods, including a description of the available screening tools for pediatric ABI, along with supporting research findings. RESULTS A comparison was made of these pediatric ABI screening tools, looking at the purpose of the tool, the populations and settings in which the tool can be used, the time and cost for administering the tool, the evidence basis in the literature supporting the tool, and the types of outcomes that can be attained from using the tool. CONCLUSION Recommendations are made for procedures for systematically implementing ABI screening in pediatric settings including schools, primary care providers, mental health, and juvenile justice systems to improve the access to brain injury services and affording more successful transition of adolescents into the adult roles.
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Affiliation(s)
- Drew A Nagele
- Beechwood NeuroRehab, Langhorne, PA, USA.,Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Melissa McCart
- Center on Brain Injury Research and Training, University of Oregon, Eugene, OR, USA
| | - Stephen R Hooper
- Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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30
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Kurowski BG, Stancin T, Taylor HG, McNally KA, Kirkwood MW, Cassedy A, King E, Sklut M, Narad ME, Wade SL. Comparative effectiveness of family problem-solving therapy (F-PST) for adolescents after traumatic brain injury: Protocol for a randomized, multicenter, clinical trial. Contemp Clin Trials Commun 2018; 10:111-120. [PMID: 30023445 PMCID: PMC6046511 DOI: 10.1016/j.conctc.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 03/30/2018] [Accepted: 04/03/2018] [Indexed: 12/20/2022] Open
Abstract
Introduction The objective of this manuscript is to describe the methodology that will be used to test the comparative effectiveness, feasibility, and acceptability of three formats of family problem solving therapy (F-PST) for improving functional outcomes of complicated mild to severe adolescent TBI. Methods Three-arm comparative effectiveness, randomized clinical trial (RCT) design. We describe the protocol of a three-arm RCT comparing the effectiveness of three modalities of F-PST to reduce executive dysfunction and behavior problems following TBI in adolescence. The RCT will compare the relative effectiveness among face-to-face; online and self-directed; and therapist-supported online modes of treatment. Ethics and dissemination It is anticipated that findings from this work will inform future clinical care practices, with implications for treatment of other patient populations of youth with psychological symptoms arising from neurological conditions. Institutional review board approval will be obtained from all sites prior to commencement of the study.
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Affiliation(s)
- Brad G. Kurowski
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics and Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Corresponding author. Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. MLC 4009, Cincinnati, OH, 45229-3039, USA.
| | - Terry Stancin
- Case Western Reserve University and MetroHealth Medical Center, Cleveland Medical Center, Cleveland, OH, USA
| | - H. Gerry Taylor
- Biobehavioral Health Center, Nationwide Children's Hospital Research Institute, The Ohio State University, Columbus, OH, USA
- Case Western Reserve University, Rainbow Babies & Children's Hospital, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Kelly A. McNally
- Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA
| | - Michael W. Kirkwood
- Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Amy Cassedy
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Eileen King
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - McKenna Sklut
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Megan E. Narad
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Shari L. Wade
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Faruqui SHA, Alaeddini A, Jaramillo CA, Potter JS, Pugh MJ. Mining patterns of comorbidity evolution in patients with multiple chronic conditions using unsupervised multi-level temporal Bayesian network. PLoS One 2018; 13:e0199768. [PMID: 30001371 PMCID: PMC6042705 DOI: 10.1371/journal.pone.0199768] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/13/2018] [Indexed: 11/18/2022] Open
Abstract
Over the past few decades, the rise of multiple chronic conditions has become a major concern for clinicians. However, it is still not known precisely how multiple chronic conditions emerge among patients. We propose an unsupervised multi-level temporal Bayesian network to provide a compact representation of the relationship among emergence of multiple chronic conditions and patient level risk factors over time. To improve the efficiency of the learning process, we use an extension of maximum weight spanning tree algorithm and greedy search algorithm to study the structure of the proposed network in three stages, starting with learning the inter-relationship of comorbidities within each year, followed by learning the intra-relationship of comorbidity emergence between consecutive years, and finally learning the hierarchical relationship of comorbidities and patient level risk factors. We also use a longest path algorithm to identify the most likely sequence of comorbidities emerging from and/or leading to specific chronic conditions. Using a de-identified dataset of more than 250,000 patients receiving care from the U.S. Department of Veterans Affairs for a period of five years, we compare the performance of the proposed unsupervised Bayesian network in comparison with those of Bayesian networks developed based on supervised and semi-supervised learning approaches, as well as multivariate probit regression, multinomial logistic regression, and latent regression Markov mixture clustering focusing on traumatic brain injury (TBI), post-traumatic stress disorder (PTSD), depression (Depr), substance abuse (SuAb), and back pain (BaPa). Our findings show that the unsupervised approach has noticeably accurate predictive performance that is comparable to the best performing semi-supervised and the second-best performing supervised approaches. These findings also revealed that the unsupervised approach has improved performance over multivariate probit regression, multinomial logistic regression, and latent regression Markov mixture clustering.
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Affiliation(s)
- Syed Hasib Akhter Faruqui
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, TX, United States of America
| | - Adel Alaeddini
- Department of Mechanical Engineering, The University of Texas at San Antonio, San Antonio, TX, United States of America
- * E-mail:
| | - Carlos A. Jaramillo
- South Texas Veterans Health Care System, San Antonio, TX, United States of America
| | - Jennifer S. Potter
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States of America
| | - Mary Jo Pugh
- VA Salt Lake City Health Care System, Salt Lake City, UT, United States of America
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Pape TLB, Smith B, Babcock-Parziale J, Evans CT, Herrold AA, Phipps Maieritsch K, High WM. Diagnostic Accuracy of the Veteran Affairs' Traumatic Brain Injury Screen. Arch Phys Med Rehabil 2018; 99:1370-1382. [DOI: 10.1016/j.apmr.2017.11.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 11/02/2017] [Accepted: 11/10/2017] [Indexed: 10/18/2022]
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Mild Traumatic Brain Injury and Substance Use. J Nurse Pract 2018. [DOI: 10.1016/j.nurpra.2018.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Corrigan JD, Yang J, Singichetti B, Manchester K, Bogner J. Lifetime prevalence of traumatic brain injury with loss of consciousness. Inj Prev 2017; 24:396-404. [DOI: 10.1136/injuryprev-2017-042371] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/07/2017] [Accepted: 07/28/2017] [Indexed: 02/06/2023]
Abstract
ObjectiveTo determine the prevalence of lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) among adult, non-institutionalised residents of Ohio.MethodsWe analysed data from 2014 Ohio Behavioral Risk Factor Surveillance System, which included a state-specific module designed to elicit lifetime history of TBI.ResultsOf non-institutionalised adults 18 years and over living in Ohio, 21.7% reported at least one lifetime TBI with LOC, 2.6% experienced at least one moderate or severe such injury, 9.1% experienced a TBI with LOC before age 15 years and 10.8% experienced either TBI with LOC before age 15 years or a moderate or severe injury. Males, those with lower incomes and those unable to work were more likely to have incurred at least one TBI with LOC, multiple TBIs with LOC, a moderate or severe TBI and a TBI with LOC before age15.ConclusionsOne in five adults experienced TBIs of sufficient severity to cause LOC; 3% experienced at least one moderate or severe TBI and almost 10% experienced a first TBI with LOC before the age of 15 years. The prevalence of lifetime TBI in the present study suggests that there may be a substantially greater burden of injury than concluded from previous prevalence estimates.
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Yue JK, Ngwenya LB, Upadhyayula PS, Deng H, Winkler EA, Burke JF, Lee YM, Robinson CK, Ferguson AR, Lingsma HF, Cnossen MC, Pirracchio R, Korley FK, Vassar MJ, Yuh EL, Mukherjee P, Gordon WA, Valadka AB, Okonkwo DO, Manley GT. Emergency department blood alcohol level associates with injury factors and six-month outcome after uncomplicated mild traumatic brain injury. J Clin Neurosci 2017; 45:293-298. [PMID: 28789959 DOI: 10.1016/j.jocn.2017.07.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/21/2017] [Indexed: 10/19/2022]
Abstract
The relationship between blood alcohol level (BAL) and mild traumatic brain injury (mTBI) remains in need of improved characterization. Adult patients suffering mTBI without intracranial pathology on computed tomography (CT) from the prospective Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study with emergency department (ED) Glasgow Coma Scale (GCS) 13-15 and recorded blood alcohol level (BAL) were extracted. BAL≥80-mg/dl was set as proxy for excessive use. Multivariable regression was performed for patients with six-month Glasgow Outcome Scale-Extended (GOSE; functional recovery) and Wechsler Adult Intelligence Scale Processing Speed Index Composite Score (WAIS-PSI; nonverbal processing speed), using BAL≥80-mg/dl and <80-mg/dl cohorts, adjusting for demographic/injury factors. Overall, 107 patients were aged 42.7±16.8-years, 67.3%-male, and 80.4%-Caucasian; 65.4% had BAL=0-mg/dl, 4.6% BAL<80-mg/dl, and 30.0% BAL≥80-mg/dl (range 100-440-mg/dl). BAL differed across loss of consciousness (LOC; none: median 0-mg/dl [interquartile range (IQR) 0-0], <30-min: 0-mg/dl [0-43], ≥30-min: 224-mg/dl [50-269], unknown: 108-mg/dl [0-232]; p=0.002). GCS<15 associated with higher BAL (19-mg/dl [0-204] vs. 0-mg/dl [0-20]; p=0.013). On univariate analysis, BAL≥80-mg/dl associated with less-than-full functional recovery (GOSE≤7; 38.1% vs. 11.5%; p=0.025) and lower WAIS-PSI (92.4±12.7, 30th-percentile vs. 105.1±11.7, 63rd-percentile; p<0.001). On multivariable regression BAL≥80-mg/dl demonstrated an odds ratio of 8.05 (95% CI [1.35-47.92]; p=0.022) for GOSE≤7 and an adjusted mean decrease of 8.88-points (95% CI [0.67-17.09]; p=0.035) on WAIS-PSI. Day-of-injury BAL>80-mg/dl after uncomplicated mTBI was associated with decreased GCS score and prolongation of reported LOC. BAL may be a biomarker for impaired return to baseline function and decreased nonverbal processing speed at six-months postinjury. Future confirmatory studies are needed.
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Affiliation(s)
- John K Yue
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Laura B Ngwenya
- Department of Neurological Surgery, University of Cincinnati, Cincinnati, OH, USA
| | - Pavan S Upadhyayula
- Department of Neurological Surgery, University of California, San Diego, La Jolla, CA, USA
| | - Hansen Deng
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Ethan A Winkler
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - John F Burke
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Young M Lee
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Caitlin K Robinson
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Adam R Ferguson
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Hester F Lingsma
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maryse C Cnossen
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Romain Pirracchio
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA; Division of Biostatistics, University of California, Berkeley, Berkeley, CA, USA
| | - Frederick K Korley
- Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Mary J Vassar
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA
| | - Esther L Yuh
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Pratik Mukherjee
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Wayne A Gordon
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alex B Valadka
- Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - David O Okonkwo
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA; Brain and Spinal Injury Center, San Francisco General Hospital, San Francisco, CA, USA.
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Mitchell T, Theadom A, du Preez E. Prevalence of Traumatic Brain Injury in a Male Adult Prison Population and Its Association with the Offence Type. Neuroepidemiology 2017; 48:164-170. [DOI: 10.1159/000479520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 07/15/2017] [Indexed: 11/19/2022] Open
Abstract
Background: The prevalence of traumatic brain injury (TBI) in prison populations has been found to vary considerably. This study aimed to determine the prevalence of TBI in a prison population in New Zealand and to identify whether age, ethnicity, offence type, security classification and sentence length were linked to TBI prevalence. Methods: All offenders admitted to a new Corrections Facility over a 6-month period (May-November 2015) were screened to understand their history of TBI. Data was merged with demographic information, details of the offence type, sentence length and security classification from the prison database. Binary logistic regression was used to identify the contribution of predictors on TBI history. Results: Of the 1,061 eligible male prisoners, 1,054 (99.3%) completed a TBI history screen. Out of the 672 (63.7%) who had sustained at least one TBI in their lifetime, 343 (32.5%) had experienced multiple injuries. One in 5 participants experienced their first TBI injury before the age of 15 years. A regression model was able to correctly classify 66.9% of cases and revealed that belonging to Māori ethnicity or being imprisoned for violent, sexual or burglary offences were independently predictive of TBI (χ2 = 9.86, p = 0.28). Conclusions: The high prevalence of TBI within male prisoners and a high proportion of injuries sustained in childhood suggest the need for routine screening for TBI to identify prisoners at risk of persistent difficulties. Interventions to support those experiencing persistent difficulties post-TBI are needed to optimise functioning and prevent reoffending.
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Niemeier JP, Leininger SL, Whitney MP, Newman MA, Hirsch MA, Evans SL, Sing RF, Huynh TT, Guerrier TP, Perrin PB. Does history of substance use disorder predict acute traumatic brain injury rehabilitation outcomes? NeuroRehabilitation 2017; 38:371-83. [PMID: 27061165 DOI: 10.3233/nre-161328] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND/OBJECTIVE The study explored whether premorbid substance use disorder (SUD) predicts acute traumatic brain injury (TBI) outcomes. METHODS 143 participants with moderate (34.2%) and severe (65.8%) TBI were enrolled at two Level 1 trauma center inpatient brain injury rehabilitation units. Acute outcomes were measured with the Disability Rating Scale (DRS), the FIMTM; self and informant ratings of the Patient Competency Rating Scale (PCRS); self and family rating of the Frontal Systems Behavioral Scale (FrSBe), and the Neurobehavioral Rating Scale-Revised (NRS-R). RESULTS Hierarchical linear modeling revealed that SUD history significantly predicted trajectories of PCRS clinician ratings, PCRS self-family and PCRS self-clinician discrepancy scores, and more negative FrSBE family ratings. These findings indicate comparatively greater post-injury executive functions (EF) impairments, particularly self-awareness (SA) of injury-related deficits, for those with SUD history. No significant SUD*time interaction effect was found for FIM or NRS-R scores. CONCLUSIONS SUD history and TBI are associated with impaired SA and EF but their co-occurrence is not a consistent predictor of acute post-injury functional outcomes. Pre-morbid patient characteristics and rater expectations and biases may moderate associations between SA and recovery after TBI.
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Affiliation(s)
- Janet P Niemeier
- Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Shelley L Leininger
- Department of Neuropsychology, Carolinas Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Marybeth P Whitney
- Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Mark A Newman
- Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Mark A Hirsch
- Department of Physical Medicine and Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Susan L Evans
- Department of Trauma Surgery, Carolinas Medical Center, Charlotte, NC, USA
| | - Ronald F Sing
- Department of Trauma Surgery, Carolinas Medical Center, Charlotte, NC, USA
| | - Toan T Huynh
- Department of Trauma Surgery, Carolinas Medical Center, Charlotte, NC, USA
| | - Tami P Guerrier
- Department of Neuropsychology, Carolinas Rehabilitation, Carolinas Medical Center, Charlotte, NC, USA
| | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Merkel SF, Cannella LA, Razmpour R, Lutton E, Raghupathi R, Rawls SM, Ramirez SH. Factors affecting increased risk for substance use disorders following traumatic brain injury: What we can learn from animal models. Neurosci Biobehav Rev 2017; 77:209-218. [PMID: 28359860 DOI: 10.1016/j.neubiorev.2017.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/06/2017] [Accepted: 03/26/2017] [Indexed: 11/17/2022]
Abstract
Recent studies have helped identify multiple factors affecting increased risk for substance use disorders (SUDs) following traumatic brain injury (TBI). These factors include age at the time of injury, repetitive injury and TBI severity, neurocircuits, neurotransmitter systems, neuroinflammation, and sex differences. This review will address each of these factors by discussing 1) the clinical and preclinical data identifying patient populations at greatest risk for SUDs post-TBI, 2) TBI-related neuropathology in discrete brain regions heavily implicated in SUDs, and 3) the effects of TBI on molecular mechanisms that may drive substance abuse behavior, like dopaminergic and glutamatergic transmission or neuroimmune signaling in mesolimbic regions of the brain. Although these studies have laid the groundwork for identifying factors that affect risk of SUDs post-TBI, additional studies are required. Notably, preclinical models have been shown to recapitulate many of the behavioral, cellular, and neurochemical features of SUDs and TBI. Therefore, these models are well suited for answering important questions that remain in future investigations.
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Affiliation(s)
- Steven F Merkel
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Lee Anne Cannella
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Roshanak Razmpour
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Evan Lutton
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Ramesh Raghupathi
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, PA 19129, USA
| | - Scott M Rawls
- Department of Pharmacology, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA
| | - Servio H Ramirez
- Department of Pathology and Laboratory Medicine, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Shriners Hospitals Pediatric Research Center, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA; Center for Substance Abuse Research, The Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, USA.
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Abstract
PURPOSE The prevalence of traumatic brain injury (TBI) among offender populations is significantly higher than among the general population. Despite this, no study has yet assessed the knowledge of members of the probation service surrounding TBI. METHOD Knowledge was assessed among members of the Probation Board for Northern Ireland (PBNI) using a cross-sectional online version of the Common Misconceptions about TBI (CM-TBI) questionnaire. Mean total misconception scores, along with scores on four subdomains (recovery, sequelae, insight, and hidden injury) were calculated. Analysis of variance was used to explore differences in misconceptions based on the collected demographic information. RESULTS The overall mean percentage of misconceptions for the group was 22.37%. The subdomain with the highest rate of misconceptions (38.21%) was insight into injury which covered misconceptions around offenders' self-awareness of injuries. Those who knew someone with a brain injury scored significantly higher in the CM-TBI total score, F(1,63) = 6.639, p = 0.012, the recovery subdomain, F(1,63) = 10.080, p = 0.002, and the insight subdomain, F(1,63) = 5.834, p = 0.019. Additionally, significant training deficits around TBI were observed among the probation service. CONCLUSIONS This study is the first of its kind to examine the level of understanding around TBI within probation services. The findings reflect potential barriers to identification and rehabilitation of TBI for offenders coming into contact with the criminal justice system. A lack of identification coupled with misconceptions about TBI could lead to inaccurate court reporting with a subsequent impact on sentencing. Implications for Rehabilitation Despite being one of the first points of contact for offenders entering the criminal justice system, members of the probation service reported having no formal training on traumatic brain injury (TBI). The subdomain with the highest rate of misconceptions (insight into injury) revealed an over-reliance on survivors of brain injury to identify, understand, and communicate the extent and severity of their injuries. Probation service personnel require training on TBI to improve awareness of the potential outcomes of the condition, ensuring injuries are identified and referred to the appropriate care pathways.
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Affiliation(s)
- Conall O'Rourke
- a School of Nursing and Midwifery, The Queen's University of Belfast , Belfast , UK
| | - Mark A Linden
- a School of Nursing and Midwifery, The Queen's University of Belfast , Belfast , UK
| | - Maria Lohan
- a School of Nursing and Midwifery, The Queen's University of Belfast , Belfast , UK
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Sayko Adams R, Corrigan JD, Mohr BA, Williams TV, Larson MJ. Traumatic Brain Injury and Post-Deployment Binge Drinking among Male and Female Army Active Duty Service Members Returning from Operation Enduring Freedom/Operation Iraqi Freedom. J Neurotrauma 2016; 34:1457-1465. [PMID: 27762655 DOI: 10.1089/neu.2016.4693] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study examines whether the relationship between traumatic brain injury (TBI) and post-deployment binge drinking is independent of screening positive for mental health problems among male and female service members. Data are from the Substance Use and Psychological Injury Combat Study of Army members returning from deployment to Afghanistan or Iraq in fiscal years 2008-2011. The sample consists of 240,694 male and 26,406 female active duty members who completed initial and follow-up questionnaires. The initial questionnaire, completed at the end of deployment, included screens for TBI and mental health problems (post-traumatic stress disorder, depression, harmful thoughts). The dependent variable, frequent binge drinking (six or more drinks on one occasion, at least monthly), was assessed on the follow-up questionnaire on average 3-9 months post-deployment. More than 21% of males and 7% of females reported frequent binge drinking. Male members were more likely to screen positive for TBI, compared with females (7.5% vs. 4.4%). Females with both TBI and mental health positive screens had more than double the risk of frequent binge drinking, compared with those without either problem (15.8% vs. 6.6%), and males with both problems had almost double the risk, compared with males with neither problem (33.6% vs. 19.7%). In multivariable logistic regression models, having a TBI and a comorbid positive mental health screen was associated with increased odds of frequent binge drinking among both males and females (adjusted odds ratio [AOR] = 1.59, CI: 1.50-1.69, and AOR = 2.11, CI: 1.57-2.83, respectively), compared with those with neither condition. More research is needed on the interaction of gender and binge drinking, especially when TBI and mental health problems co-exist.
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Affiliation(s)
- Rachel Sayko Adams
- 1 The Heller School for Social Policy and Management, Brandeis University , Waltham, Massachusetts
| | - John D Corrigan
- 2 Department of Physical Medicine and Rehabilitation, the Ohio State University , Columbus, Ohio
| | - Beth A Mohr
- 1 The Heller School for Social Policy and Management, Brandeis University , Waltham, Massachusetts
| | | | - Mary Jo Larson
- 1 The Heller School for Social Policy and Management, Brandeis University , Waltham, Massachusetts
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Combat-Acquired Traumatic Brain Injury, Posttraumatic Stress Disorder, and Their Relative Associations With Postdeployment Binge Drinking. J Head Trauma Rehabil 2016; 31:13-22. [PMID: 25310293 DOI: 10.1097/htr.0000000000000082] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine whether experiencing a traumatic brain injury (TBI) on a recent combat deployment was associated with postdeployment binge drinking, independent of posttraumatic stress disorder (PTSD). METHODS Using the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel, an anonymous survey completed by 28 546 personnel, the study sample included 6824 personnel who had a combat deployment in the past year. Path analysis was used to examine whether PTSD accounted for the total association between TBI and binge drinking. MAIN MEASURES The dependent variable, binge drinking days, was an ordinal measure capturing the number of times personnel drank 5+ drinks on one occasion (4+ for women) in the past month. Traumatic brain injury level captured the severity of TBI after a combat injury event exposure: TBI-AC (altered consciousness only), TBI-LOC of 20 or less (loss of consciousness up to 20 minutes), and TBI-LOC of more than 20 (loss of consciousness >20 minutes). A PTSD-positive screen relied on the standard diagnostic cutoff of 50+ on the PTSD Checklist-Civilian. RESULTS The final path model found that while the direct effect of TBI (0.097) on binge drinking was smaller than that of PTSD (0.156), both were significant. Almost 70% of the total effect of TBI on binge drinking was from the direct effect; only 30% represented the indirect effect through PTSD. CONCLUSION Further research is needed to replicate these findings and to understand the underlying mechanisms that explain the relationship between TBI and increased postdeployment drinking.
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Gargaro J, Gerber GJ, Nir P. Brain Injury in Persons With Serious Mental Illness Who Have a History of Chronic Homelessness: Could This Impact How Services Are Delivered? ACTA ACUST UNITED AC 2016. [DOI: 10.7870/cjcmh-2016-034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Holloway M, Tyrrell L. Acquired Brain Injury, Parenting, Social Work, and Rehabilitation: Supporting Parents to Support Their Children. ACTA ACUST UNITED AC 2016; 15:234-259. [DOI: 10.1080/1536710x.2016.1220883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Allely CS. Prevalence and assessment of traumatic brain injury in prison inmates: A systematic PRISMA review. Brain Inj 2016; 30:1161-80. [DOI: 10.1080/02699052.2016.1191674] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Albicini M, McKinlay A. Internalizing disorders in adults with a history of childhood traumatic brain injury. J Clin Exp Neuropsychol 2016; 37:776-84. [PMID: 26299189 DOI: 10.1080/13803395.2015.1053843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION While the presence of externalizing behavioral problems following traumatic brain injury (TBI) has been well established in the literature, less is known regarding internalizing disorders, and more specifically anxiety disorders, in such a population. This study explored the presence, rate, and incidence of internalizing behavior problems, including anxiety, depression, somatic complaints, avoidant personality symptomatology, and overall internalizing behavior problems in university students aged 18-25 years. METHOD A convenience sample of 247 university students (197 non-TBI, 47 mild TBI, 2 moderate TBI, 1 severe TBI) aged 18-25 years was utilized. Participants completed a self-report measure on behavioral functioning, the Adult Self Report (ASR), to identify internalizing behaviors, and a questionnaire to identify TBI history. RESULTS Raw scores of behavior indicated that participants with a history of childhood TBI reported significantly higher levels of withdrawal, somatic complaints, and internalizing behavioral problems than the non-TBI participants. When analyzing standardized T-scores for borderline and clinically elevated ASR syndromes and Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales, individuals in the TBI group were significantly more likely to have higher rates of borderline anxiety, somatic complaints, avoidant personality problems, and overall internalizing disorders, and clinically elevated somatic complaints. Adults with a history of childhood TBI were also significantly more likely to report at least 1 or more DSM disorders. CONCLUSION These results clearly suggest that individuals with a childhood history of TBI are at a heightened risk for a range of internalizing disorders in early adulthood, which is particularly troubling in a university sample pursuing tertiary education.
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Affiliation(s)
- Michelle Albicini
- a Faculty of Medicine, Nursing and Health Sciences, School of Psychology and Psychiatry , Monash University , Clayton , VIC , Australia
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Associations Between Traumatic Brain Injury, Suspected Psychiatric Conditions, and Unemployment in Operation Enduring Freedom/Operation Iraqi Freedom Veterans. J Head Trauma Rehabil 2016; 31:191-203. [DOI: 10.1097/htr.0000000000000092] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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O'Rourke C, Linden MA, Lohan M, Bates-Gaston J. Traumatic brain injury and co-occurring problems in prison populations: A systematic review. Brain Inj 2016; 30:839-54. [PMID: 27088426 DOI: 10.3109/02699052.2016.1146967] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND A growing body of epidemiological research suggests high rates of traumatic brain injury (TBI) in prisoners. The aim of this review is to systematically explore the literature surrounding the rates of TBI and their co-occurrences in a prison population. METHODS Six electronic databases were systematically searched for articles published between 1980-2014. Studies were screened for inclusion based on pre-determined criteria by two researchers who independently performed data extraction. Study quality was appraised based on a modified quality assessment tool. RESULTS Twenty-six studies were included in this review. Quality assessment ranged from 20% (poor) to 80% (good), with an overall average of 60%. Twenty-four papers included TBI prevalence rates, which ranged from 5.69-88%. Seventeen studies explored co-occurring factors including rates of aggression (n = 7), substance abuse (n = 9), anxiety and depression (n = 5), neurocognitive deficits (n = 4) and psychiatric conditions (n = 3). CONCLUSIONS The high degree of variation in TBI rates may be attributed to the inconsistent way in which TBI was measured, with only seven studies using valid and reliable screening tools. Additionally, gaps in the literature surrounding personality outcomes in prisoners with TBI, female prisoners with TBI and qualitative outcomes were found.
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Affiliation(s)
- Conall O'Rourke
- a School of Nursing & Midwifery , The Queen's University of Belfast , Belfast , NI , UK
| | - Mark A Linden
- a School of Nursing & Midwifery , The Queen's University of Belfast , Belfast , NI , UK
| | - Maria Lohan
- a School of Nursing & Midwifery , The Queen's University of Belfast , Belfast , NI , UK
| | - Jackie Bates-Gaston
- b Northern Ireland Prison Service Headquarters, Dundonald House , Stormont Estate , NI , UK
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48
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Ongoing daytime behavioural problems in university students following childhood mild traumatic brain injury. Int J Rehabil Res 2015; 39:77-83. [PMID: 26704343 DOI: 10.1097/mrr.0000000000000149] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sleep is often disrupted in traumatic brain injury (TBI) and may be related to persistent behaviour problems; however, little is known about this relationship in young adults. This study explored associations between TBI, behavioural problems and sleep disturbances in 247 university students (197 non-TBI, 47 mild TBI, two moderate TBI, one severe TBI) aged 18-25 years, who completed validated measures for behaviour, sleep quality and history of TBI. Because of small group numbers, participants reporting moderate to severe TBI were excluded from the analyses. Results indicated that students with mild TBI reported higher levels of daytime dysfunction, somatic complaints, withdrawal, other behavioural complaints and internalizing behaviours compared with students with no TBI history. A correlational analysis indicated a moderate relationship between the above significant variables. Our results suggest that university students with a history of mild TBI are more likely to experience certain ongoing daytime behavioural problems, which are likely to negatively influence their academic functioning in tertiary education. This study highlights the importance of research on long-term problems following mild TBI in young adults aged 18-25 years--an age group often overlooked within the literature.
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49
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Weil ZM, Karelina K, Gaier KR, Corrigan TED, Corrigan JD. Juvenile Traumatic Brain Injury Increases Alcohol Consumption and Reward in Female Mice. J Neurotrauma 2015; 33:895-903. [PMID: 26153729 DOI: 10.1089/neu.2015.3953] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Traumatic brain injury (TBI) is closely and bi-directionally linked with alcohol use, as by some estimates intoxication is the direct or indirect cause of one-third to one-half of all TBI cases. Alcohol use following injury can reduce the efficacy of rehabilitation and increase the chances for additional injury. Finally, TBI itself may be a risk factor for the development of alcohol use disorders. Children who suffer TBIs have poorer life outcomes and more risk of substance abuse. We used a standardized closed-head injury to model mild traumatic brain injuries. We found that mice injured as juveniles but not during adulthood exhibited much greater alcohol self-administration in adulthood. Further, this phenomenon was limited to female mice. Using behavioral testing, including conditioned place preference assays, we showed that early injuries increase the rewarding properties of alcohol. Environmental enrichment administered after injury reduced axonal degeneration and prevented the increase in drinking behavior. Additionally, brain-derived neurotrophic factor gene expression, which was reduced by TBI, was normalized by environmental enrichment. Together, these results suggest a novel model of alterations in reward circuitry following trauma during development.
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Affiliation(s)
- Zachary M Weil
- 1 Department of Neuroscience and Group in Behavioral Neuroendocrinology, the Ohio State University Wexner Medical Center , Columbus, Ohio
| | - Kate Karelina
- 1 Department of Neuroscience and Group in Behavioral Neuroendocrinology, the Ohio State University Wexner Medical Center , Columbus, Ohio
| | - Kristopher R Gaier
- 1 Department of Neuroscience and Group in Behavioral Neuroendocrinology, the Ohio State University Wexner Medical Center , Columbus, Ohio
| | - Timothy E D Corrigan
- 1 Department of Neuroscience and Group in Behavioral Neuroendocrinology, the Ohio State University Wexner Medical Center , Columbus, Ohio
| | - John D Corrigan
- 2 Department of Physical Medicine and Rehabilitation, the Ohio State University Wexner Medical Center , Columbus, Ohio
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50
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Wolf GK, Kretzmer T, Crawford E, Thors C, Wagner HR, Strom TQ, Eftekhari A, Klenk M, Hayward L, Vanderploeg RD. Prolonged Exposure Therapy With Veterans and Active Duty Personnel Diagnosed With PTSD and Traumatic Brain Injury. J Trauma Stress 2015. [PMID: 26201688 DOI: 10.1002/jts.22029] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The present study used archival clinical data to analyze the delivery and effectiveness of prolonged exposure (PE) and ancillary services for posttraumatic stress disorder (PTSD) among Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn veterans (N = 69) with histories of mild to severe traumatic brain injury (TBI). Data from standard clinical assessments of veterans and active duty personnel treated in both inpatient and outpatient programs at 2 Department of Veteran Affairs medical centers were examined. Symptoms were assessed with self-report measures of PTSD (PTSD Checklist) and depression (Beck Depression Inventory-II) before and throughout therapy. Mixed linear models were utilized to determine the slope of reported symptoms throughout treatment, and the effects associated with fixed factors such as site, treatment setting (residential vs. outpatient), and TBI severity were examined. Results demonstrated significant decreases in PTSD, B = -3.00, 95% CI [-3.22, -2.78]; t(210) = -13.5; p < .001, and in depressive symptoms, B = -1.46, 95% CI [-1.64, -1.28]; t(192) = -8.32; p < .001. The effects of PE treatment did not differ by clinical setting and participants with moderate to severe injuries reported more rapid gains than those with a history of mild TBI. The results provide evidence that PE may well be effective for veterans with PTSD and TBI.
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Affiliation(s)
- Gregory K Wolf
- Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA
| | - Tracy Kretzmer
- Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA
| | - Eric Crawford
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Christina Thors
- Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA
| | - H Ryan Wagner
- VA Mid-Atlantic Region Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Thad Q Strom
- Mental Health Services for Minneapolis, Department of Veterans Affairs Medical Center, Minneapolis, Minnesota, USA.,Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Afsoon Eftekhari
- Dissemination and Training Division, National Center for PTSD, VA Palo Alto HCS, Menlo Park, California, USA
| | - Megan Klenk
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
| | - Laura Hayward
- Department of Psychology, Syracuse VA Medical Center, Syracuse, New York, USA
| | - Rodney D Vanderploeg
- Mental Health & Behavioral Sciences, James A. Haley Veterans Affairs Medical Center, Tampa, Florida, USA.,Departments of Psychiatry and Neurosciences, and Psychology, University of South Florida, Tampa, Florida, USA
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