title: Miserable minority: emotional risk factors that influence the outcome of a mild traumatic brain injury.
abstract: Emotional risk factors are explored in four case studies, each of whom had sustained a mild traumatic brain injury (MTBI). Selected pre-existing personality traits that compounded the symptom presentation included over-achievement, dependency, grandiosity and borderline personality traits. Premorbid risk factors are described and their influence on co-morbid and post-morbid difficulties is discussed. We also touched upon the therapeutic issues involved in our cases. General treatment considerations are highlighted for dealing with grandiosity, narcissistic features and borderline traits. Over-achievement and perfectionism are discussed in the context of providing treatment for stress management. Finally, the effect of pre-existing emotional trauma combined with the MTBI is discussed.
authors.affiliation: San Francisco Neuropsychiatric Associates, CA 94109, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Ruff
authors.forename: L
authors.initials: L
authors.lastname: Camenzuli
authors.forename: J
authors.initials: J
authors.lastname: Mueller
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000523:psychology*; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000523:psychology*; D003674:Defense Mechanisms; D005260:Female; D016489:Head Injuries, Closed / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010348:Patient Care Team; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology*; D012307:Risk Factors; D012803:Sick Role; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology