This presentation was created as part of a research project to fulfill credits for the masters program at The Chicago School of Professional Psychology.
10. Estimated Average Percentage of AnnualTBI by External Cause in the United States 2002–2006
https://www.cdc.gov/traumaticbraininjury/pdf/bluebook_factsheet-a.pdf
36. Assessment methods may attempt to determine if symptoms
match a previous brain injury...
37.
38.
39.
40.
41.
42.
43. Multiple Choice Questions:
1. One symptom of a mTBI is:
2. It is estimated that there are ______ head injuries
every year in the United States.
3. From 2007 to 2014, the Department of Veterans
Affairs screened nearly 850,000 veterans for brain
injuries. How many brain injuries did they miss during
their first screening?
4. What is the most common cause of a head injury per
the CDC?
5. Which is not a symptom of a brain injury?
6. The DSM categorizes a head injury under:
7. There must be one of the following to diagnose a TBI:
8. Assessment methods for TBI are used to:
9. The issue with assessment methods is:
10. How fast can a mTBI heal?
11. How can you treat a mTBI?
12. What words are found in defining a mTBI?
True or False Questions:
1. There are major inconsistencies among assessing and
diagnosing mTBI.
2. There is a globalized method to assess and diagnose
mTBI.
3. mTBI is also known as concussion.
4. mTBI can be caused by a blast while on the battle
field.
5. The most overlooked aspect of mTBI are the
psychological effects.
6. Once cognition is reestablished, all the other
symptoms go away.
7. The prevalence of mTBI is mostly unknown.
8. When you get a concussion, you will know!
Please refer to your handout to answer these questions:
It is believed that out of all of these prevalence estimations, 80% to 90% of cases are mTBI’s versus TBI’s (Kainin, Forsten, Kotwal, Lutz, & Guskiewicz, 2011, as cited in Levin & Diaz-Arrastia, 2015). However, these estimates of prevalence only account for the injuries that were admitted to a hospital, and those that are not admitted are not factored into the total occurrences.
The VHA typically first screens their veterans on average one to 1.7 years after their discharge, which involves a series of questions relating to their injuries during deployment. However, in follow up screenings that occur on average 27 days after the first, it was found that they had missed 30% to 64% of cases that were later deemed a brain injury had occurred (Belanger, Rodney, Vanderploeg, & Sayer, 2016). By totaling the number of brain injuries diagnosed from the first screening plus the number of the undiagnosed brain injuries that were found in the second screening, this study concluded that up to 85% of the 846,711 veterans screened during this time had sustained some form of brain injury.
In addition to understanding the variations of symptoms presented by mTBI, it is important to note the possibility of preexisting conditions. For example, while mTBI can be a cause of depression, it was found that a baseline diagnosis of depression disorder can cause an increase in depression symptoms as well as anxiety symptoms following a head injury (Yang, Peek-Asa, Covassin, & Torner, 2015). It was found that athletes who had experienced depression at the beginning of the season would have worsened symptoms of depression plus new anxiety symptoms after they had injured a head injury that year. Baseline data may not always be available for mental health professionals when they attempt to understand the cause of a patient’s mental illness, but it is crucial that they understand mTBI can increase the likelihood as well as severity of symptoms. Knowing the difference between a comorbid or co-occurring condition and a secondary disorder caused by the head injury can help mental health professionals create interventions that help their clients.
In a statewide study presented by Whiteneck et al. (2016), Colorado residents were randomly dialed and questioned about the impact their TBI’s had on their daily activities and quality of life by using the CDC’s Behavioral Risk Factor Surveillance System and the 5-item Diener Satisfaction with Life Scale. Results from this study showed that mTBI’s affect the victim’s daily activities by 79% to 179% and result in a low satisfaction of life by 78% to 111% when compared to those who do not have this injury. Additionally, mTBI has been found to increase the risk of suicidal ideation by 6.3% just three months following the injury and 8.2% six months following their injury. With just 3% of the general population contemplating suicide, mTBI can double or nearly triple suicidal ideation (Bethune, da Costa, van Niftrik, & Feinstein, 2016). For mental health professionals, this means paying close attention to their clients who suffer from mTBI in knowing they are at a higher risk for suicidal tendencies even after the traditional recovery period for mTBI.
Depression, Avoidant Personality Disorder – or mTBI
Paranoid Personality Disorder, Schizophrenia – or mTBI
Borderline Personality Disorder, Impulse Control Disorder, Histrionic Personality Disorder – or mTBI
Post Traumatic Stress Disorder – or mTBI
Impulse Control Disorder, Substance Abuse Disorder – or mTBI
Depressive Disorder – or mTBI
Dependent Personality Disorder – or mTBI
In a literature review presented by Levin and Diaz-Arrastia (2015), one source found that confusion could clear within the first day after the injury and post-concussion symptoms can resolve within twelve weeks. Conversely, another source in Levin and Diaz-Arrastia’s literature review found a new onset or intensification of these symptoms could manifest three months after the injury, especially if a pre-existing condition or neuropsychiatric disorder was present. Interestingly, while it was found that athletes can heal faster from the effects of mTBI by Levin and Diaz-Arrastia’s literature review, it was also found that athletes are at a higher risk for reoccurring head injuries and therefor may develop permanent impairment (West & Marion, 2014). Ultimately, organizations such as the American Medical Society for Sports Medicine and the American Academy of Neurology suggests that neurological impairment from mTBI can be chronic and last a lifetime (West & Marion, 2014). Even the Department of Veterans Affair’s screening found symptoms persisting in their veterans when assessed up to three years after their injury (Belanger, Vanderploeg, & Sayer, 2016). The need to understand why there are such varying degrees of recovery is more evident than ever.
