title: A Conceptual Model of Irritability Following Traumatic Brain Injury: A Qualitative, Participatory Research Study.
abstract: BACKGROUND
  Individuals with a history of traumatic brain injury (TBI) may have chronic problems with irritability, which can negatively affect their lives.
  
  
  OBJECTIVE
  (1) To describe the experience (thoughts and feelings) of irritability from the perspectives of multiple people living with or affected by the problem, and (2) to develop a conceptual model of irritability.
  
  
  METHODS
  Qualitative, participatory research.
  
  
  METHODS
  Forty-four stakeholders (individuals with a history of TBI, family members, community professionals, healthcare providers, and researchers) divided into 5 focus groups.
  
  
  METHODS
  Each group met 10 times to discuss the experience of irritability following TBI. Data were coded using grounded theory to develop themes, metacodes, and theories.
  
  
  METHODS
  Not applicable.
  
  
  RESULTS
  A conceptual model emerged in which irritability has 5 dimensions: affective (related to moods and feelings); behavioral (especially in areas of self-regulation, impulse control, and time management); cognitive-perceptual (self-talk and ways of seeing the world); relational issues (interpersonal and family dynamics); and environmental (including environmental stimuli, change, disruptions in routine, and cultural expectations).
  
  
  CONCLUSIONS
  This multidimensional model provides a framework for assessment, treatment, and future research aimed at better understanding irritability, as well as the development of assessment tools and treatment interventions.
authors.affiliation: Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Departments of Communication Studies (Drs Davis and Mr Hirsch) and Psychology (Dr Cook), University of North Carolina at Charlotte; and Carolinas Rehabilitation, Carolinas Healthcare System, Charlotte, North Carolina (Ms Philbrick and Dr Hirsch).
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.forename: Christine
authors.initials: C
authors.lastname: Davis
authors.forename: James R
authors.initials: JR
authors.lastname: Cook
authors.forename: Peggy
authors.initials: P
authors.lastname: Philbrick
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hirsch
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000523:psychology*; D016022:Case-Control Studies; D005190:Family; D005260:Female; D017144:Focus Groups; D066296:Grounded Theory; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D036301:Qualitative Research; D055815:Young Adult