title: Traumatic brain injury, executive functioning, and suicidal behavior: a brief report.
abstract: OBJECTIVE
  The aim of this pilot study was to explore the relationship between executive dysfunction and suicidal behavior in two groups of participants: (Group 1, n = 18) veterans with traumatic brain injury (TBI) and a history of at least one suicide attempt (SA), and (Group 2, n = 29) veterans with TBI and no history of SA. Controlling for the severity of TBI, it was hypothesized that participants in Group 1 would perform more poorly than those in Group 2 on measures of executive functioning.
  
  
  METHODS
  The primary outcome variable was decision making as assessed by performance on the Iowa Gambling Task (IGT). Secondary outcome variables included laboratory-measured impulsivity as measured by the Immediate and Delayed Memory Test (IMT/DMT), abstract reasoning as measured by the Wisconsin Card Sorting Test (WCST), and aggression as measured by the Lifetime History of Aggression (LHA) scale.
  
  
  RESULTS
  Among those in Group 1, time between TBI and first suicide attempt postinjury varied widely (months to nearly 30 years). Only the WCST perseverative errors score differed significantly between individuals with and without histories of one or more suicide attempts (SAs).
  
  
  CONCLUSIONS
  Suggestions for future study of SA among those with TBI are provided. When working with individuals with TBI, clinicians are encouraged to incorporate suicide risk assessment into their practice. Augmenting this process with a measure of perseveration may be beneficial.
authors.affiliation: VISN 19 Mental Illness Research, Education, and Clinical Center, Denver, Colorado 80220, USA. beeta.homaifar@va.gov
authors.forename: Beeta Y
authors.initials: BY
authors.lastname: Homaifar
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Brenner
authors.forename: Jeri E
authors.initials: JE
authors.lastname: Forster
authors.forename: Herbert
authors.initials: H
authors.lastname: Nagamoto
mesh_terms: D000328:Adult; D000368:Aged; D000374:Aggression / Q000523:psychology; D001930:Brain Injuries / Q000523:psychology*; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010865:Pilot Projects; D011594:Psychometrics; D018570:Risk Assessment / Q000706:statistics & numerical data; D013223:Statistics as Topic; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000523:psychology*; D014728:Veterans / Q000523:psychology*