Journal of Head Trauma Rehabilitation最新文献

{"title":"Association Between Neighborhood Characteristics and Parent-Reported Lifetime History of Concussion Among Adolescents in the United States.","authors":"Kiran Thapa, Divya Jain, Nathan E Cook, Grant L Iverson, Altaf Saadi","doi":"10.1097/HTR.0000000000001209","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001209","url":null,"abstract":"<p><strong>Objective: </strong>Examine the association between neighborhood characteristics and parent-reported lifetime concussion history.</p><p><strong>Setting: </strong>National Survey of Children's Health, a nationally representative survey of parents of children ages 0-17 years in the United States.</p><p><strong>Participants: </strong>Parent/guardian(s) (hereafter: parents) with children ages 0-17 years.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Main measures: </strong>Neighborhood disorder was assessed via items asking whether the child's neighborhood had (1) sidewalks or walking paths, (2) a park or playground, (3) a recreation center/community center/Boys & Girls Club, (4) a library or bookmobile, (5) litter or garbage on the streets or sidewalks, (6) poorly kept or rundown housing, and (7) vandalism such as broken windows or graffiti. Neighborhood cohesion was assessed via items asking whether (1) people in the neighborhood help each other out, (2) neighbors watch out for each other's children, (3) children live in a safe neighborhood, (4) families know where to go for help in the community when difficulties arise, and (5) children are safe at school. Lifetime concussion was assessed with a parent-reported response to a single question.</p><p><strong>Results: </strong>Parent responses for 119 008 children and adolescents (mean age 11.6 years; 48.9% girls) were included. Overall, 5.2% of children and adolescents had a parent-reported history of concussion. The mean neighborhood disorder and cohesion scores were 1.7 (SD = 1.5) and 17.0 (SD = 2.8), respectively. In a multivariable model including both neighborhood disorder and cohesion while adjusting for age, sex, race/ethnicity, household socioeconomic status, past-year sports participation, lifetime ADHD diagnosis, greater neighborhood cohesion was associated with lower odds of lifetime concussion (adjusted odds ratio [95% confidence interval] = 0.96 [0.94-0.98], P < .001).</p><p><strong>Conclusions: </strong>Safer and more supportive built environments, and greater community social cohesion, may help reduce concussion risk. Future longitudinal studies are needed to clarify causal pathways and identify potential community-level intervention targets to reduce concussion risk disparities.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Brain Injury in First Responders: From Hidden Burden to Occupational Health Action.","authors":"Jaclyn B Caccese, W Huw Williams, Nicholas Smith","doi":"10.1097/HTR.0000000000001227","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001227","url":null,"abstract":"<p><p>Traumatic brain injury (TBI), including concussion, is an important but often underrecognized occupational injury among first responders. Despite frequent exposure to circumstances that increase the risk of TBI, law enforcement officers, firefighters, and emergency medical services personnel often lack consistent pathways for injury recognition, reporting, clinical assessment, rehabilitation, and safe return to duty. This topical issue of the Journal of Head Trauma Rehabilitation brings together emerging evidence on TBI prevalence, underrecognition, mental health, functional recovery, and occupational reintegration in first responder populations. Collectively, the articles demonstrate a substantial burden of TBI, persistent gaps in diagnosis and treatment, and the complex relationships among TBI history, psychological health, and occupational functioning. They also highlight the limited evidence available to guide rehabilitation and determine readiness to resume safety-sensitive duties. A multidisciplinary consensus statement included in this issue offers 28 recommendations addressing recognition and reporting, early assessment, return to duty, mental health, prevention, and organizational policies. Although first responder-specific evidence remains limited, these recommendations provide a practical framework for improving care while identifying priorities for future research. Advancing TBI care in first responders will require coordinated efforts among healthcare professionals, first responder organizations, researchers, and policymakers to establish supportive reporting systems, improve access to appropriate care, and develop and evaluate occupation-specific return-to-duty pathways. Addressing TBI in first responders requires moving beyond individual injury management toward a coordinated occupational health approach that protects first responders and the communities they serve.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions Supporting Functional Recovery After Traumatic Brain Injury in Public Safety Personnel: A Systematic Review of Outcomes and Work Reintegration Considerations.","authors":"Maryam Shahzad, Sana Siddiqui, Raihana Premji, Jonathan Jiesheng Liu, Yiting He, Javier Mencia Ledo, Sharada Nandan, André Luiz Fagundes Avila Dos Santos, Hong Ki Chloe Lau, Nazaninzahra Afkhamiaghda, Adeel Haq, Minahil Haq, Sobiah Khan, Linna Tam-Seto, R Nicholas Carleton, Behdin Nowrouzi-Kia","doi":"10.1097/HTR.0000000000001219","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001219","url":null,"abstract":"<p><strong>Background: </strong>Public safety personnel (PSP) face a heightened risk of traumatic brain injury (TBI) and barriers in resuming daily activities and returning to work (RTW). Despite these risks, evidence on interventions targeting functional recovery and participation in this population is scarce.</p><p><strong>Objective: </strong>To synthesize evidence on interventions targeting functional recovery and RTW in PSP with TBI.</p><p><strong>Design: </strong>MEDLINE, CINAHL, EMBASE, PsycINFO, and Scopus on January 23, 2026. Eligible studies included PSP with TBI such as armed forces and/or military personnel and law enforcement personnel. Randomized controlled trials, quasi-experimental studies, observational studies, case studies, and mixed methods designs were included. Outcomes were classified using the International Classification of Functioning, Disability, and Health framework and synthesized narratively. Risk of bias was assessed using Joanna Briggs Institute tools, and certainty of evidence was evaluated using GRADE.</p><p><strong>Results: </strong>Twenty-one studies were included (9 randomized controlled trial, 5 cohort, 4 quasi-experimental, 3 case studies). Most studies focused on military populations, with only 2 civilian PSP studies (firefighters and police). Interventions included cognitive rehabilitation, psychological/mental health, interdisciplinary programs, simulation-based training, and physical rehabilitation. Narrative synthesis showed mixed but generally positive, improvements in body function outcomes, and cognitive function within the activity domain. Participation-level outcomes such as RTW were inconsistently defined and underreported. Certainty of evidence ranged from very low for participation outcomes to moderate for functional cognition.</p><p><strong>Conclusion: </strong>Interventions for PSP with TBI may support modest, but consistent, improvements in cognitive function; however, there remains low certainty of evidence for meaningful improvements in the participation domains (eg, RTW). The evidence is highly heterogeneous in outcomes and focused on military populations, limiting generalizability across PSP roles.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Symptom Severity Is Positively Associated With Rehabilitation Needs in Veterans and Service Members With Polytrauma, Including Mild Traumatic Brain Injury: A Veterans Affairs Traumatic Brain Injury Model Systems Study.","authors":"Natalie Gilmore, Shannon R Miles, Mitch Sevigny, Daniel Klyce, Karen M Skop, Jacob Finn, Eric Munger, Paul B Perrin, Jessica L Ryan, Risa Nakase-Richardson, Marc A Silva","doi":"10.1097/HTR.0000000000001207","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001207","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relationship between rehabilitation needs and mental health symptoms in Veterans and Service Members with polytrauma, including history of mild traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Five Veterans Affairs (VA) Intensive Evaluation and Treatment Programs.</p><p><strong>Participants: </strong>Veterans and Service Members enrolled in the VA TBI Model Systems study who completed a follow-up greater than 6 months postprogram.</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Main measures: </strong>Primary regression analyses included rehabilitation needs (Rehabilitation Needs Survey) and post-traumatic stress symptoms (PTSD Checklist-Civilian version). Age, sex, months from rehabilitation to follow-up interview, preinjury mental health, disability level (Glasgow Outcome Scale-Extended), and number of comorbidities were included as covariates. Secondary analyses applied the same model structure to assess the relationship between rehabilitation needs and anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9) symptoms.</p><p><strong>Results: </strong>Most Veterans and Service Members with polytrauma, including mild TBI, reported a current need for services to control physical symptoms (55%) and greater than one-third endorsed a current need for services to improve memory (46%), manage emotions (45%), improve health (44%), manage daily stress (42%), and solve daily problems (38%). Adjusted regression analyses revealed that rehabilitation needs were significantly and positively associated with post-traumatic stress, anxiety, and depression self-report symptoms. These relationships were maintained when analyses were repeated with mental health-related items removed from the Rehabilitation Needs Survey, suggesting the finding was not solely because of mental health needs. Higher comorbidity burden and disability were also independently associated with higher rehabilitation needs.</p><p><strong>Conclusions: </strong>Veterans and Service Members with polytrauma, especially those with elevated post-traumatic stress, anxiety, and/or depressive symptoms in the context of mild TBI, could benefit from ongoing access to evidence-based psychotherapies and other specialty care, rehabilitation, and support services to manage long-term care and rehabilitation needs in the chronic phase of injury.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing an Empirically Derived Head Trauma Burden Assessment Score for Intimate Partner Violence-related Neurotrauma.","authors":"Nicola L de Souza, Divya Jain, Eamonn Kennedy, Ella Carlsson, C Lexi Baird, Emily E Carter, Spencer Chase, Emma Clark, Andrew Cwiek, Katherine Dorman, Maria Kajankova, Xinhui Lan, Faith V Lockhart, Adriana P Méndez-Fernández, Hollie A Mullin, Madelyn Olis, Emma N Read, Elizabeth Rebuck, McKenna S Sakamoto, Carmen Velez, Maya Andersen, Inga K Koerte, David F Tate, Amy D Marshall, Alexander P Lin, Frank G Hillary, Elisabeth A Wilde, Carrie Esopenko","doi":"10.1097/HTR.0000000000001213","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001213","url":null,"abstract":"<p><strong>Objective: </strong>To develop a statistically derived and clinically informed intimate partner violence-related head trauma (IPV-HT) Burden Assessment Score that accounts for diverse brain injury mechanisms (eg, nonfatal strangulation, blunt force), exposure chronicity, and injury severity.</p><p><strong>Setting: </strong>Community-based sample.</p><p><strong>Participants: </strong>Females (N = 146; 38.7 ± 10.2 years old, 56.8% White/Non-Hispanic) reporting at least 1 IPV-HT on the Brain Injury Screening Questionnaire IPV module (BISQ-IPV).</p><p><strong>Design: </strong>Cross-sectional analysis.</p><p><strong>Main measures: </strong>Candidate variables representing injury mechanism, frequency, severity, and IPV relationship history were extracted from the BISQ-IPV. Multicollinearity screening and multivariable linear regression selected variables predicting Rivermead Postconcussion Symptoms Questionnaire (RPQ) total scores. Leave-one-out elimination identified the most predictive variables determined by change in R2 when removed. Retained variables were standardized and combined to calculate the IPV-HT Burden Assessment Score, normalized to range 1-100 (low-to-high burden). Scores were correlated with Adverse Childhood Experiences questionnaire (ACEs), Headache Impact Test (HIT-6), cognition subscale of the Quality of Life in Neurological Disorders (NeuroQoL), Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Generalized Anxiety Disorder (GAD-Q-IV), and Center for Epidemiologic Studies Depression Scale (CES-D).</p><p><strong>Results: </strong>Five variables were retained in the final model, achieving 25% explainability of RPQ total scores (R2 = 0.25; adjusted R2 = 0.22). Count of unique IPV-related brain injury mechanisms explained most RPQ variance (∼19%), followed by number of IPV relationships, and duration of the 3 most severe relationships. The model also retained the proportion of injuries due to nonfatal strangulation meeting brain injury criteria and the average brain injury severity. The final IPV-HT Burden Assessment Score (mean = 31.7 ± 18.24, range = 2-86) positively correlated with ACEs (r = 0.17, P = 0.043), HIT-6 (r = 0.27, P = 0.001), PCL-5 (r = 0.23, P = 0.006), GAD-Q-IV (r = 0.17, P = 0.043), and CES-D (r = 0.29, P < 0.001) and negatively correlated with NeuroQoL T-scores (r = -0.30, P < 0.001).</p><p><strong>Conclusions: </strong>The IPV-HT Burden Assessment Score captures diverse IPV-HT exposures and shows preliminary validity through associations with psychosocial and neurological outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Persistent Postconcussion and Post-traumatic Stress Symptomology in UK Police Officers Using Clustering and Classification Algorithms.","authors":"Nicholas I J Smith, W Huw Williams, Lee Hogarth, Edward Keedwell","doi":"10.1097/HTR.0000000000001218","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001218","url":null,"abstract":"<p><strong>Background: </strong>Police officers frequently operate in dynamic, high-stress environments involving exposure to violence, accidents, and other critical incidents, placing them at heightened risk for traumatic brain injuries (TBIs), persistent postconcussion symptoms (PPCS), post-traumatic stress disorder (PTSD), and complex PTSD (C-PTSD).</p><p><strong>Methods: </strong>A total of 573 currently serving frontline officers across England, Scotland, and Wales completed the online cross-sectional \"Policing & Living Well\" survey between January and August 2023. Participants self-reported PPCS using the Rivermead Postconcussion Symptoms Questionnaire and PTSD symptoms using the International Trauma Questionnaire. Unsupervised clustering (K-means) identified distinct symptom profiles, and random forest analysis determined key variables that most strongly distinguished the derived clusters.</p><p><strong>Results: </strong>Two symptom-based clusters emerged, one with a low symptom load (n = 357) and a high symptom load group with elevated PPCS, PTSD, and C-PTSD symptoms (n = 216). Influential symptoms included the social impact of C-PTSD, feeling socially distant, feelings of failure, social-emotional disconnection, and worthlessness. The random forest model achieved 94% classification accuracy (precision = 0.93, recall = 0.91 for the high symptom load group). Membership in the high symptom load group was associated with single marital status, being ranked as a Uniform Inspector, and a history of single and multiple TBIs from motor vehicle accidents, falls, or assaults, particularly those involving loss of consciousness and occurring on active duty.</p><p><strong>Conclusions: </strong>UK police officers could be differentiated into low and high symptom burden groups. Social-emotional symptoms were the strongest contributors to symptom burden differentiation. Probable TBI history was also associated with the high symptom load group, highlighting the importance of considering both psychological and injury-exposure factors when assessing officer well-being.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Further Revisiting of the Common Misconceptions About Traumatic Brain Injury Scale: Is It Time for the Common Misconceptions About Traumatic Brain Injury-III?","authors":"Karen A Sullivan","doi":"10.1097/HTR.0000000000001217","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001217","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) misconceptions are widely held, hampering prevention and recovery. However, measuring misconceptions has proved challenging. This study examined the component structure and constructed validity of selected items from the Common Misconceptions About Traumatic Brain Injury (CM-TBI) scale, including recently proposed concussion- and social-focused items.</p><p><strong>Methods: </strong>One hundred sixty-one Australian adults completed 28 TBI misconception items and 2 standardized construct validation scales: the Head Injury Knowledge Scale (HIKS) and the Social Interaction Scale (SIS).</p><p><strong>Results: </strong>Eight CM-TBI items were removed using standard diagnostics and conceptual evaluation. Twenty items were examined in a principal components analysis. With Promax rotation, the interpreted solution had 2 components, explaining 36% of total variance. Total scores for component 1 (recovery) and component 2 (sequelae) were significantly and moderately correlated (rs ∼0.3 Ps < .001) with at least 1 validation measure.</p><p><strong>Conclusion: </strong>Consistent with past studies of CM-TBI structure, the principal components analysis identified 2 components, labelled recovery and sequelae. This structure emerged with updated items and coverage, including concussion- and social-focused content, and yielded subscales with promising construct validity.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thirty-Five Years of Change: Shifts in Demographic and Injury Profiles of Traumatic Brain Injury Cases Enrolled in the Traumatic Brain Injury Model Systems (1988-2024): A NIDILRR TBIMS National Database Study.","authors":"Jessica M Ketchum, Candace Tefertiller, Cynthia L Beaulieu, Yelena G Bodien, Librada Callender, Kristen Dams-O'Connor, Joseph T Giacino, Flora M Hammond, Robin Hanks, Cindy B Ivanhoe, Shanti M Pinto, Jenny J Zhang","doi":"10.1097/HTR.0000000000001216","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001216","url":null,"abstract":"<p><strong>Objective: </strong>To characterize long-term changes in demographic and injury profiles among individuals with traumatic brain injury (TBI) admitted to inpatient rehabilitation and enrolled in the TBI Model Systems (TBIMS) National Database (NDB).</p><p><strong>Setting: </strong>Twenty-three inpatient rehabilitation hospitals participating in the TBIMS program.</p><p><strong>Participants: </strong>20 990 persons 16 years and older with TBI who received inpatient rehabilitation and enrolled in the TBIMS NDB between 1988 and 2024.</p><p><strong>Design: </strong>Repeated cross-sectional analysis of a prospectively collected longitudinal database across 7 admission cohorts.</p><p><strong>Main measures: </strong>Sociodemographic characteristics (age, sex, race/ethnicity, education, employment, marital status, payor source) and injury characteristics (etiology, Glasgow Coma Scale [GCS], command following, post-traumatic amnesia [PTA], Functional Independence Measure [FIM], acute and rehabilitation length of stay [LOS]).</p><p><strong>Results: </strong>Mean age at injury increased from 34.6 years in 1988-1994 to 48.4 in 2020-2024, accompanied by a rise in fall-related injuries, a decline in violence-related injuries, and a shift in vehicular injuries from earlier increases to more recent declines. The proportion of participants who were retired increased substantially, while the proportion who were unemployed declined. Racial/ethnic minority representation declined from 1988-1994 to 2000-2004 and then increased through 2020-2024, particularly among younger individuals. Medicare coverage increased while Medicaid coverage declined. The proportion of participants with complicated mild TBI increased while moderate and severe classifications declined, accompanied by shorter time to command following and PTA duration. Despite these indicators of decreasing injury severity, FIM motor scores at rehabilitation admission declined modestly. Acute LOS declined slightly while rehabilitation LOS declined substantially.</p><p><strong>Conclusions: </strong>Over the past 35 years, the TBIMS population has shifted toward an older cohort, accompanied by changes in demographic patterns associated with aging, mechanisms of injury, functional profiles, payor source, and lengths of stay. These changes should be considered when interpreting TBIMS longitudinal outcomes, evaluating representativeness, translating prior research findings to contemporary populations, and planning rehabilitation services for individuals with TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Patterns of Mental Health Comorbidities Among Those With Blast or Blunt Mechanism TBI: Leveraging Total Brain Diagnostics Data.","authors":"Molly J Sullan, Kate Clauss, Maya O'Neil, Sara Vlajic, William Baker-Robinson, Ryan Holliday, Adam R Kinney, Catherine B Fortier, David X Cifu, William P Milberg, Lisa A Brenner","doi":"10.1097/HTR.0000000000001214","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001214","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) is associated with postinjury mental health (MH) sequelae, yet associations between injury-related risk factors (eg, injury mechanism, multiple injuries) and outcomes remain poorly understood. We leveraged a newly harmonized national dataset to evaluate relationships between TBI characteristics and MH outcomes.</p><p><strong>Data sources: </strong>We analyzed data from the Total Brain Diagnostics (TBD) dataset, a harmonized data source including 2 large, multisite, longitudinal prospective cohort studies: the Long-term Impact of Military-relevant Brain Injury Consortium's (LIMBIC) and the Translational Research Center for TBI and Stress Disorders (TRACTS).</p><p><strong>Participants: </strong>Veterans and Service Members (n = 3771).</p><p><strong>Design: </strong>Pooled cross-sectional analyses of harmonized data.</p><p><strong>Main measures: </strong>TBI Characteristics (Predictors): Number of TBIs, whether the participant had experienced a blast-related TBI, and whether the participant had experienced loss of consciousness secondary to a TBI. Mental Health Conditions/Symptoms (Outcomes): Probable post-traumatic stress disorder (PTSD), probable depression, probable anxiety, suicidal ideation, suicide attempts, and probable unhealthy alcohol use.</p><p><strong>Results: </strong>Blast TBI was associated with greater odds of probable PTSD (OR 1.85, P < .001, 95% CI: 1.57-2.17), probable depression (OR 1.66, P < .001, 95% CI: 1.42-1.95), and probable anxiety (OR 1.73, P < .001, 95% CI: 1.45-2.05) compared with blunt TBI. Post-hoc analyses suggested differences in the frequency of co-occurring MH outcomes among those with blast versus blunt TBIs.</p><p><strong>Conclusions: </strong>Findings suggest unique MH outcomes driven by blast injury mechanism, highlighting potential differences in underlying etiology.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Data-Driven Profiles of Psychopathology After Moderate-Severe Traumatic Brain Injury.","authors":"Jai Carmichael, Lucas Thoma, Gershon Spitz, Jennie Ponsford","doi":"10.1097/HTR.0000000000001220","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001220","url":null,"abstract":"<p><strong>Objective: </strong>To identify data-driven profiles of psychopathology among adults with moderate-severe traumatic brain injury (TBI) using a transdiagnostic assessment battery, and to exploratorily examine demographic, injury-related, and clinical correlates of profile membership.</p><p><strong>Setting: </strong>Community survey.</p><p><strong>Participants: </strong>Participants (513 enrolled, 397 analyzed) were sampled from a larger cohort previously admitted consecutively for inpatient rehabilitation. They took part in this study on average 12.63 years postinjury (range 0.40-35.42).</p><p><strong>Design: </strong>Observational, cross-sectional.</p><p><strong>Main measures: </strong>A comprehensive battery of psychiatric questionnaires, including the Inventory of Depression and Anxiety Symptoms-Expanded Version, Somatic Symptom Scale-8, Comprehensive Assessment of Traits Relevant to Personality Disorders, and Externalizing Spectrum Inventory-Brief Form. This battery was previously validated in the same sample to assess 7 transdiagnostic dimensions of psychopathology: 4 internalizing (Detachment, Dysregulated Negative Emotionality, Somatic Symptoms, Compensatory, and Phobic Reactions) and 3 externalizing (Self-Harm and Psychoticism, Rigid Constraint, Harmful Substance Use).</p><p><strong>Results: </strong>Latent profile analysis identified 5 profiles: Average Internalizing (29% of participants most resembled this profile), Lower Psychopathology (25%), Elevated Internalizing (21%), Substance Use (16%), and Elevated Psychopathology (10%). In exploratory multivariable analyses, younger age, greater self-reported functional disability, lower life satisfaction, and mental health treatment were consistently associated with more severe psychopathology profiles. Male sex and unemployment were consistently associated with the Substance Use profile. Education, Glasgow Coma Scale scores, post-traumatic amnesia duration, and comorbid orthopedic injuries showed no significant associations with psychopathology profiles.</p><p><strong>Conclusions: </strong>A data-driven categorical approach identified psychopathology profiles following moderate-severe TBI that differed primarily in overall severity. Profiles reflecting greater psychopathology were associated with poorer functioning and subjective well-being, providing some validation. However, clinically relevant variation in post-TBI psychopathology may not readily reduce to a small number of qualitatively discrete categories.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}