PURPOSE/OBJECTIVE:Brain injuries often have lifelong consequences that include long-term impairments and disability. Policy-, community-, and society-level interventions are a critical path to survivor impact. A recent qualitative study highlighted the potential of a new tool, Brain Injury Identification Cards, for enhancing survivor safety, self-advocacy, and well-being. The primary purpose of our study was to conduct a quantitative assessment of perceived benefits and self-reported credibility, expectancy, and acceptability to inform future trials. RESEARCH METHOD/DESIGN:In this cross-sectional study, we assessed the impressions of current owners (N = 99) of Brain Injury Identification Cards. We administered online self-report questionnaires and characterized perceived experiences, acceptability, and utility using descriptive statistics. RESULTS:Most (>67%) had favorable impressions about their own use of the Brain Injury Identification Cards, although approximately 19% perceived the cards as stigmatizing or embarrassing, and 22% said the cards were not helpful for their stress and anxiety surrounding traumatic brain injury symptoms. Overall, participants rated treatment credibility and expectancy as high, and all respondents who completed survey items (n = 96) indicated that they would recommend cards to others with traumatic brain injury and other medical conditions. CONCLUSIONS/IMPLICATIONS:Our findings highlight the perceived benefits of using a Brain Injury Identification Card among established Card owners. Future studies in representative samples of survivors assessing user experiences before and after the receipt of Brain Injury Identification Cards are needed to assess potential intervention effects. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BACKGROUND:Despite the profound impact of "brain fog" and/or cognitive impairment in relatively young people with Long COVID, no interventions with demonstrated efficacy are currently available. We conducted a pilot randomized controlled trial investigating the preliminary outcomes of a cognitive rehabilitation (CR) intervention adapted for persons with post-COVID cognitive impairment. METHODS:Participants were ≥18 years of age, English-speaking, had history of SARS-CoV-2, and had cognitive impairment on objective measures. Eligible participants were randomized to a 12-week CR intervention or a time - and attention-matched control arm. Objective and subjective cognitive functioning was assessed at pre - and within 2-weeks post-intervention, utilizing validated neuropsychological measures across multiple domains. We compared pre vs. post intervention changes in cognitive scores in intervention vs. control groups. RESULTS:The mean change in the intervention group compared to the controls in measures of processing speed, learning, memory, language, and of executive function did not reach the threshold for futility. In comparison to controls, the intervention group self-reported significant improvements in cognitive functioning. CONCLUSIONS:We found that an adapted CR intervention for Long COVID may improve post-COVID cognitive impairment in comparison to a time - and attention-matched control group and should be evaluated in a larger trial. Trial registration: ClinicalTrials.gov identifier: NCT05498493. Registered on 08/10/2022.

Background and Objective:Traumatic encephalopathy syndrome (TES) is the proposed clinical manifestation of chronic traumatic encephalopathy (CTE) neuropathologic change secondary to repetitive head impacts (RHI). The prevalence of TES and its component symptoms is not known in individuals with single TBI, a subset of whom also have RHI. We used prospectively collected data to operationalize TES criteria and test the hypothesis that the core clinical features of TES are common among those with TBI, regardless of RHI exposure status and other demographic and injury characteristics. Methods:Secondary analysis of data from the Late Effects of TBI (LETBI) study, a community-based study of individuals with complicated mild, moderate, or severe TBI. Participants were categorized by TBI severity and presence of RHI, creating 6 groups (those with isolated mild, moderate, and severe TBI, with and without RHI). Chi-squared tests were used to compare the proportion of each group that met each of the core clinical criteria overall TES diagnosis. Binary logistic regression models were used to examine associations of demographic and injury characteristics on TES diagnosis. Results:In 295 participants with TBI, mean (SD) age 52.6(15.6) years and 35.6% female, 138 (46.8%) had RHI exposure meeting the TES criteria exposure threshold. In the full sample, 56.9%, 32.9% and 45.8% of participants met TES core criterion of cognitive impairment, neurobehavioral dysregulation, and progressive course of clinical features, respectively. Overall, 14.9% of the LETBI sample had substantial RHI exposure and met all 3 clinical features, meeting consensus-based TES criteria. When RHI exposure criterion was lifted, 33.5% of the LETBI sample with isolated TBI met all core clinical criteria. No injury or demographic variables predicted the likelihood of meeting TES Core Criteria (OR=3.02, p=0.10). Discussion:Rates of TES clinical features are high among TBI survivors with and without RHI, across injury severity groups. Presence of TES core clinical features was greatest among those with no RHI, suggesting that chronic and sometimes progressive clinical sequelae of TBI resemble TES, but may reflect a distinct pathobiological process. Limitations include possible selection of participants with chronic symptoms. Findings emphasize the centrality of RHI exposure to TES diagnostic criteria.

PURPOSE/OBJECTIVE:Brain injuries are often "invisible" injuries that can have lifelong consequences including changes in identity, functional independence, relationships, and reduced participation in daily activities. Survivors of brain injury experience stigma and challenges related to the misattribution of symptoms to other causes that are significant barriers to recovery and adjustment. Changes in policy and other large-scale interventions are cited as an underexplored, yet critical path to reducing the impact of brain injury. The present study sought to comprehensively characterize the impact of one such initiative-Brain Injury Identification Cards-among survivors to further refine the resource. RESEARCH METHOD/DESIGN:In this cross-sectional qualitative focus group study, we recruited 16 individuals with a history of brain injury via email listservs of individuals who registered for a Brain Injury Identification Card. We used rapid data analysis with a hybrid of deductive and inductive analytic strategies to identify themes within a priori domains. RESULTS:We extracted themes within four domains: (a) process and reasons for obtaining cards; (b) overall impressions of the cards; (c) uses of the cards; and (d) feedback and proposed changes. Participants described the process of obtaining cards as straightforward and shared wide-ranging benefits across domains, including improving survivors' sense of safety, self-advocacy, and ability to participate in daily activities. CONCLUSIONS/IMPLICATIONS:Findings highlight the utility of Brain Injury Identification Cards for improving community understanding of brain injury symptoms and how injury-related challenges may manifest in daily life. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objectives: To evaluate associations between depression, anxiety, and cognitive impairment among individuals with complicated mild to severe traumatic brain injury (TBI) 1 year after injury. Setting: Multiple inpatient rehabilitation units across the United States. Participants: A total of 498 adults 16 years and older who completed inpatient rehabilitation for complicated mild to severe TBI. Design: Secondary analysis of a prospective, multicenter, cross-sectional observational cohort study. Main Measures: Assessments of depression (Traumatic Brain Injury Quality of Life [TBI-QOL] Depression) and anxiety (TBI-QOL Anxiety) as well as a telephone-based brief screening measure of cognitive functioning (Brief Test of Adult Cognition by Telephone [BTACT]). Results: We found an inverse relationship between self-reported depression symptoms and the BTACT Composite score (β = −0.18, P < .01) and anxiety symptoms and the BTACT Composite score (β = −0.20, P < .01). There was no evidence this relationship varied by injury severity. Exploratory analyses showed depression and anxiety were negatively correlated with both BTACT Executive Function factor score and BTACT Memory factor score. Conclusions: Both depression and anxiety have a small but significant negative association with cognitive performance in the context of complicated mild to severe TBI. These findings highlight the importance of considering depression and anxiety when interpreting TBI-related neuropsychological impairments, even among more severe TBI.

Objective:Insomnia affects 30-45% of the world population, is related to mortality (i.e., auto accidents and job-related accidents), and is related to mood and affect disorders such as anxiety and depression. Better understanding of insomnia via increased research will decrease the burden on insomnia. The neurocognitive model of sleep proposes that conditioned somatic and cognitive hyperarousal develop in response to repeated pairings of sleep-related stimuli with insomnia-related wakefulness. The purpose of this study was to examine the neurocognitive model of sleep using a novel laboratory paradigm, the Sleep Approach Avoidance Task (SAAT). It was hypothesized that individuals who report symptoms of insomnia will display a bias for negative sleep-related images from the SAAT, which is presumably a reflection of cognitive, behavioral and physiological processes associated with hyperarousal. It was also hypothesized that participants who report poor sleep would provide different subjective ratings for negative images (i.e., stronger valence and arousal) than individuals who reported better sleep.Participants and Methods:An initial sample of 66 healthy college-aged participants completed the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI) the Dysfunctional Attitudes and Beliefs about Sleep (DBAS) scale and the Epworth Sleepiness Scale (ESS). Participants also completed the SAAT. The SAAT was developed to assess sleep-related bias in adults. The SAAT is a visual, joystick controlled reaction time task that measures implicit bias for positive and negative sleep-related images. At the end of the task the participants are also asked to rate each image along three dimensions included valence, arousal and dominance.Results:There was a positive correlation between the SAAT and the ISI [r(61) = .30, p = .01], indicating that symptoms of insomnia are related to negative approach-related bias for sleep-related images. No other correlations were observed between the SAAT and self-report sleep measures. With regard to rating of images, higher dominance ratings for negative images were correlated with the SAAT [r(62) = .24, p = .03], which indicates that the approach bias for negative images is associated with “being in control.” Multiple linear regression was used to test if ISI scores and dominance ratings for negative images significantly predicted SAAT bias scores. The overall regression was statistically significant [r2 = .13, F(2, 58) = 4.15, p = .02]. ISI scores significantly predicted SAAT scores (ß = .27, p = .04), whereas dominance ratings for negative images did not significantly predict SAAT scores (ß = .20, p = .11). Exploratory correlational analyses were also completed for ratings of images and other sleep self-report measures. Valence ratings for positive sleep-related images were positively correlated with the ESS [r(64) = .36, p = .01], whereas valence ratings for negative sleep-related images were negatively correlated with the ESS [r(64) = -.24, p = .03].Conclusions:Hypotheses were partially supported with the ISI being the only self-report measure associated with negative bias for sleep-related images. While ratings of dominance are associated with bias for negative sleep-related images, these ratings do not provide unique variance. These findings indicate a cognitive processing bias for sleep-related stimuli among young adult poor sleepers. Limitations, implications for assessment and intervention are discussed.

Objective: To examine the utility of the sleep disturbance item of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for insomnia among individuals with moderate to severe traumatic brain injury (TBI). Setting: Telephone interview. Participants: A sample of 248 individuals with a history of moderate to severe TBI participated in an interview within 2 years of their injury. Design: Observational, cross-sectional analysis. Main Measures: The PHQ-9 was administered along with the Insomnia Severity Index, Pittsburgh Sleep Quality Index, Sleep Hygiene Index, Epworth Sleepiness Scale, and the Insomnia Interview Schedule. Results: Receiver operating characteristic curve analysis was conducted for the PHQ-9 sleep item rating against a set of insomnia criteria to determine an optimal cutoff score. A cutoff of 2 on the PHQ-9 sleep item maximized sensitivity (76%) and specificity (79%), with an area under the curve of 0.79 (95% CI, 0.70-0.88). The 2 groups formed using this cutoff differed significantly on all sleep measures except the Epworth Sleepiness Scale. Conclusions: The PHQ-9 sleep item may serve as a useful screener to allow for detection of potential sleep disturbance among individuals with moderate to severe TBI. Those who screen positive using this item included in a commonly used measure of depression can be prioritized for further and more comprehensive assessment of sleep disorders.

Background There is a growing body of evidence on racial and ethnic disparities within traumatic brain injury (TBI) care. The aim of this paper was to conduct a narrative review of the literature, demonstrating how racial and ethnic disparities manifest across the full spectrum of the TBI experience in civilian populations: injury, acute care and diagnosis, post-TBI recovery and adjustment, and long-term outcomes. Methods We searched five electronic databases (Scopus, APA PsychNet, PubMed/MEDLINE, and Google Scholar) using the search terms traumatic brain injury, head trauma, concussion, health disparities, ethnic minority, racial minority, race ethnicity, racial ethnic, prevalence, incidence, diagnosis, rehabilitation, recovery, and outcomes. Boolean search modifiers AND, NOT, and OR were used to produce relevant results. Additional resources were included by the authors, as deemed relevant to the investigation. Results Our narrative review of 39 articles elucidated numerous ways in which racial and ethnic disparities span the TBI continuum of care, including acute care and diagnosis, post-TBI recovery and adjustment, and long-term outcomes. Conclusions Understanding racial and ethnic disparities is a first step in ensuring equitable care for all individuals with TBI, including raising awareness among clinicians and guiding the development of tailored interventions for racial and ethnic minority populations.

Traumatic brain injury (TBI) refers to damage to the brain from a physical force. This can include falls, car accidents, or gunshots, among other causes. TBI can cause difficulties with cognition (thinking) and function (movement). More than 2.5 million Americans experience a TBI each year. Many individuals with TBI do not complete regular physical activity. •Physical activity is any bodily movement produced by skeletal muscles that results in the expenditure of energy•Exercise is a physical activity that is planned, structured, repetitive, and performed to improve health or fitness•The Health and Human Services Physical Activity Guidelines1US Department of Health and Human ServicesPhysical activity guidelines for Americans. 2nd ed. US Department of Health and Human Services, Washington, DC2018Google Scholar provide recommendations about the time and intensity of physical activity needed to maintain health and well-being•The Health and Human Services Physical Activity Guidelines1US Department of Health and Human ServicesPhysical activity guidelines for Americans. 2nd ed. US Department of Health and Human Services, Washington, DC2018Google Scholar advise individuals to get at least:○150 minutes of moderate activity (eg, walking briskly, dancing, gardening) per week OR○75 minutes of vigorous physical activity (eg, running, tennis, hiking uphill, heavy housework) per week AND○2 or more days of strength training per week •Physical activity increases the release of growth factors in the brain that help build new brain cells2Wogensen E. Malá H. Mogensen J. The effects of exercise on cognitive recovery after acquired brain injury in animal models: a systematic review.Neural Plast. 2015; 2015: 830871Google Scholar and increase brain size,3Erickson K.I. Voss M.W. Prakash R.S. et al.Exercise training increases size of hippocampus and improves memory.Proc Natl Acad Sci U S A. 2011; 108: 3017-3022Google Scholar which leads to:○Decreased memory decline4Richards M. Hardy R. Wadsworth M.E.J. Does active leisure protect cognition? Evidence from a national birth cohort.Soc Sci Med. 2003; 56: 785-792Google Scholar○Improved ability to make decisions5Chin L.M. Keyser R.E. Dsurney J. Chan L. Improved cognitive performance following aerobic exercise training in people with traumatic brain injury.Arch Phys Med Rehabil. 2015; 96: 754-759Google Scholar,6Colcombe S.J. Kramer A.F. Erickson K.I. et al.Cardiovascular fitness, cortical plasticity, and aging.Proc Natl Acad Sci U S A. 2004; 101: 3316-3321Google Scholar○Increased processing speed, which is how quickly you can think5Chin L.M. Keyser R.E. Dsurney J. Chan L. Improved cognitive performance following aerobic exercise training in people with traumatic brain injury.Arch Phys Med Rehabil. 2015; 96: 754-759Google Scholar,7Grealy M.A. Johnson D.A. Rushton S.K. Improving cognitive function after brain injury: the use of exercise and virtual reality.Arch Phys Med Rehabil. 1999; 80: 661-667Google Scholar○Improved learning and memory7Grealy M.A. Johnson D.A. Rushton S.K. Improving cognitive function after brain injury: the use of exercise and virtual reality.Arch Phys Med Rehabil. 1999; 80: 661-667Google Scholar•Social benefits of physical activity8Eime R.M. Young J.A. Harvey J.T. Charity M.J. Payne W.R. A systematic review of the psychological and social benefits of participation in sport for adults: informing development of a conceptual model of health through sport.Int J Behav Nutr Phys Act. 2013; 10: 135Google Scholar○Improved life satisfaction○Decreased stress•Social benefits of group physical activity8Eime R.M. Young J.A. Harvey J.T. Charity M.J. Payne W.R. A systematic review of the psychological and social benefits of participation in sport for adults: informing development of a conceptual model of health through sport.Int J Behav Nutr Phys Act. 2013; 10: 135Google Scholar○Social interaction with peers○Opportunities to build new friendships○Increased communication skills•Physical health benefits of physical activity○Maintain healthy weight9Swift D.L. Johannsen N.M. Lavie C.J. Earnest C.P. Church T.S. The role of exercise and physical activity in weight loss and maintenance.Prog Cardiovasc Dis. 2014; 56: 441-447Google Scholar○Prevent falls10Kovács E. Sztruhár Jónásné I. Karóczi C.K. Korpos A. Gondos T. Effects of a multimodal exercise program on balance, functional mobility and fall risk in older adults with cognitive impairment: a randomized controlled single-blind study.Eur J Phys Rehabil Med. 2013; 49: 639-648Google Scholar○Increase bone density11Jain R.K. Vokes T. Physical activity as measured by accelerometer in NHANES 2005-2006 is associated with better bone density and trabecular bone score in older adults.Arch Osteoporos. 2019; 14: 29Google Scholar○Improve your heart and lung function12Chin L.M.K. Chan L. Woolstenhulme J.G. Christensen E.J. Shenouda C.N. Keyser R.E. Improved cardiorespiratory fitness with aerobic exercise training in individuals with traumatic brain injury.J Head Trauma Rehabil. 2015; 30: 382-390Google Scholar,13Hassett L. Moseley A.M. Harmer A.R. Fitness training for cardiorespiratory conditioning after traumatic brain injury.Cochrane Database Syst Rev. 2017; 12: CD006123Google Scholar There are many reasons why you may find it challenging to be physically active.14Driver S. Ede A. Dodd Z. Stevens L. Warren A.M. What barriers to physical activity do individuals with a recent brain injury face?.Disabil Health J. 2012; 5: 117-125Google Scholar,15Hassett L.M. Tate R.L. Moseley A.M. Gillett L.E. Injury severity, age and pre-injury exercise history predict adherence to a home-based exercise programme in adults with traumatic brain injury.Brain Inj. 2011; 25: 698-706Google Scholar Table 1 identifies some of the barriers and potential solutions.Table 1Possible solutions to overcome barriers to physical activityBarriers to Physical ActivityPotential SolutionsTransportation•Use public transportation or ride sharing applications•Ask family or friendsAccess to fitness center•Complete activity in a large room in your home•Go to the local parkCost•Find low cost or free activities such as brisk walking•Use resistance bands or household items as weightsDo not know how to exercise•Ask a certified inclusive fitness trainer or physical therapist•Talk with your doctorCognition and memory•Keep a consistent routine•Use a planner to schedule physical activity•Set reminders on electronic devices such as your phone•Use written step-by-step directionsPoor motivation•Find a partner or group•Explore what inspires or motivates you and othersFatigue•Participate during times you have more energy•Start with tasks at home that do not cause fatigue•Know your limits and schedule rest breaks Open table in a new tab The key is to be as active as you can—do what you can when you can. Even if you can only tolerate a few minutes of physical activity at a time, try to do it 2 to 3 times per day. Gradually increase your activity goal to 30 minutes daily. Table 2 lists example activities and ways to modify them according to your fitness and functional levelsTable 2Examples of activities and modifications.ActivitiesModificationImprove EnduranceWalkIf too easy: increase the speed, time, or distanceIf too hard: slow down, take shorter walks more oftenBicycleIf too hard: use a stationary bicycle with a back rest to help with balanceImprove Leg StrengthSquats: stand with legs shoulder-width apart and lower your buttocks toward the ground slowly before coming back upIf too easy: add weights or try 1 leg at a timeIf too hard: practice standing up from a chairHeel raises: stand up on your tip toesIf too easy: do 1 leg at a timeIf too hard: hold on to the wall or a table for balanceImprove Arm StrengthBicep curls: hold a weighted object (such as a can of soup) in each hand at your side and bring up to the shoulder while bending your elbowIf too easy: increase the weight or use a resistance band by standing on the band with your feetIf too hard: do without a weightShoulder abduction: hold a weighted object in each hand at your side and move your arms away from the body until they are parallel to the groundIf too easy: increase the weight or use a resistance band by standing on the band with your feetIf too hard: do without a weightPushups: keep your hands on the ground next to your shoulders and toes on the floor. Push up from the ground keeping your body straightIf too easy: increase the number you doIf too hard: put your knees on the ground when completing the movement. You can also do when standing next to a wall and push off from the wallImprove BalanceYoga, tai chi, and leg strength exercisesIf too easy: close your eyesIf too hard: use a chair or the wall for challenging poses Open table in a new tab •Consult your physician if you are unsure how to safely start adding more physical activity into your daily life•Physical therapists are rehabilitation professionals who diagnose and treat a variety of movement impairments associated with health-related conditions or injuries to improve quality of life•Certified inclusive fitness trainers have advanced training and can help safely adapt physical activities for individuals with physical, sensory, and cognitive disabilities •Move United (www.moveunitedsport.org/sports/adaptive-sports)•National Center on Health, Physical Activity and Disability (www.nchpad.org)•LoveYourBrain Yoga (www.loveyourbrain.com/yoga)•YMCA provides memberships with sliding scale payment (www.ymca.net) This page was developed by Shanti M. Pinto, MD (e-mail address: [email protected] ); Eric M. Watson, PhD; Wendy A. Contreras, MD; Kaitlin A. Luffman, PT, DPT, CBIS; and Mark A. Newman, PhD, MPH. This information is not meant to replace the advice of a medical professional and should not be interpreted as a clinical practice guideline. This Information/Education Page may be reproduced for noncommercial use for health care professionals and other service providers to share with their patients or clients. Any other reproduction is subject to approval by the publisher. Supported by the Brain Injury-Interdisciplenary Special Interest Group (BI-ISIG) Chronic Brain Injury Task Force.

Importance: A significant limitation of many neuroimaging studies examining mild traumatic brain injury (mTBI) is the unavailability of pre-injury data.Objective: We therefore aimed to utilize pre-injury ultra-high field brain MRI and compare a collection of neuroimaging metrics pre- and post-injury to determine mTBI related changes and evaluate the enhanced sensitivity of high-resolution MRI.Design: In the present case study, we leveraged multi-modal 7 Tesla MRI data acquired at two timepoints prior to mTBI (23 and 12 months prior to injury), and at two timepoints post-injury (2 weeks and 8 months after injury) to examine how a right parietal bone impact affects gross brain structure, subcortical volumetrics, microstructural order, and connectivity.Setting: This research was carried out as a case investigation at a single primary care site.Participants: The case participant was a 38-year-old female selected for inclusion based on a mTBI where a right parietal impact was sustained.Main outcomes: The main outcome measurements of this investigation were high spatial resolution structural brain metrics including volumetric assessment and connection density of the white matter connectome.Results: At the first scan timepoint post-injury, the cortical gray matter and cerebral white matter in both hemispheres appeared to be volumetrically reduced compared to the pre-injury and subsequent post-injury scans. Connectomes produced from whole-brain diffusion-weighted probabilistic tractography showed a widespread decrease in connectivity after trauma when comparing mean post-injury and mean pre-injury connection densities. Findings of reduced fractional anisotropy in the cerebral white matter of both hemispheres at post-injury time point 1 supports reduced connection density at a microstructural level. Trauma-related alterations to whole-brain connection density were markedly reduced at the final scan timepoint, consistent with symptom resolution.Conclusions and Relevance: This case study investigates the structural effects of traumatic brain injury for the first time using pre-injury and post-injury 7 Tesla MRI longitudinal data. We report findings of initial volumetric changes, decreased structural connectivity and reduced microstructural order that appear to return to baseline 8 months post-injury, demonstrating in-depth metrics of physiological recovery. Default mode, salience, occipital, and executive function network alterations reflect patient-reported hypersomnolence, reduced cognitive processing speed and dizziness.

Sleep problems after traumatic brain injury (TBI) affect anywhere between 30%-70% of survivors. Moreover, sleep problems can have a tremendous effect on physical health, the ability to think, and emotional well-being. The purpose of this fact sheet is to provide people living with TBI a quick reference about common sleep problems and things you can do at home to manage these problems and help improve your sleep.

Objectives: To compare characteristics of those who do and do not sustain subsequent traumatic brain injuries (TBIs) following index TBI and to identify reinjury risk factors. Design: Secondary data analysis of an ongoing longitudinal cohort study. Setting: TBI Model Systems Centers. Participants: In total, 11 353 individuals aged 16+ years. Main Outcome Measures: Ohio State University TBI Identification Method. Results: In total, 7.9% of individuals reported sustaining a TBI post-index TBI. Twenty percent of reinjuries occurred within a year of the index TBI. Reinjury risk followed an approximate U-shaped distribution such that risk was higher in the first year, declined 2 to 10 years postinjury, and then increased after 10 years. A multivariable Weibull model identified predictors of reinjury: younger (<29 years) and middle-aged and older (50+ years) age at index TBI relative to middle age, pre-index TBI, pre-index alcohol and illicit drug use, incarceration history, and less severe index TBI. Conclusions: A subset of individuals who receive inpatient rehabilitation for TBI are at an increased risk for reinjury, and an injury-prone phenotype may be characterized by engagement in risk behaviors. Factors associated with reinjury risk may differ for younger versus middle-aged and older adults. Findings underscore the need for empirically informed risk stratification models to identify TBI survivors at risk for reinjury.

An estimated 55 million individuals worldwide live with chronic disability associated with traumatic brain injury (TBI), which may include cognitive, behavioral, and social impairments. Reduced participation in social activities is common after TBI; however, few studies have evaluated loneliness among survivors of TBI. The current study aimed to evaluate the association between history of TBI and loneliness and to identify mediators of this association.

To explore the temporal relationships between depression, anxiety, and cognitive functioning in individuals with moderate-severe traumatic brain injury at one- and two-years post-injury.