Aggressive behavior following traumatic brain injury: how common is common?
OBJECTIVE
To assess the prevalence and predictors of aggressive behavior among traumatic brain injury (TBI) survivors at 6, 24, and 60 months postdischarge.


METHODS
Mixed cross-sectional and longitudinal data from a 5-year follow-up study of discharged TBI patients analyzed retrospectively.


METHODS
A specialized Brain Injury Rehabilitation Service of a tertiary referral hospital.


METHODS
Two hundred twenty-eight (228) patients with moderate to severe TBI.


METHODS
The Overt Aggression Scale; injury-related variables (in particular, Glasgow Coma and Outcome scales and posttraumatic amnesia duration); and a battery of postdischarge questionnaires (Beck Depression Inventory, Trauma Complaints List, General Health Questionnaire, etc).


RESULTS
At any given follow-up period, 25% of the participants were classified as aggressive. Aggression, where present, was consistently associated with depression, concurrent traumatic complaints, younger age at injury, and low satisfaction with life rather than with injury, demographic, or premorbid characteristics. Depression was the factor that was most significantly associated with aggressive behavior at all times postinjury, followed by a younger age at the time of injury.


CONCLUSIONS
Aggression is a common, fluctuating, and long-term problem following TBI. The underlying association between aggression and psychosocial variables lends support to the provision of ongoing outreach services and psychological and behavioral interventions for all affected TBI survivors.
Baguley
Ian J
IJ
Brain Injury Rehabilitation Service, Westmead Hospital, Sydney, NSW, Australia. ianb@biru.wsahs.nsw.gov.au
Cooper
Joanne
J
Felmingham
Kim
K
D000328:Adult; D000374:Aggression; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011581:Psychological Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012920:Social Behavior Disorders / Q000453:epidemiology* / Q000209:etiology; D015599:Trauma Severity Indices