Abstract
Background: Aggressive behaviour is a frequent legacy of traumatic brain injury (TBI) and a major obstacle to psychosocial recovery. Aggression can take many forms and there is currently no uniform method of assessment that distinguishes aggressive sub-types in a way that can assist decisions for treatment.
Review: This paper attempts to provide a framework that will help distinguish two primary sub-types of aggression following TBI, impulsive and episodic aggression, based on their most prominent clinical characteristics. It is hoped that, by providing a description of the phenomenology associated with each form of aggression, together with an explanation of the probable neuropathology underpinning each sub-type, the clinical classification of these two forms of aggression will improve, leading to a commensurate improvement in the choice of treatment interventions, resulting in better psychosocial outcomes.
Acknowledgements
Professor Wood acknowledges the influence of Dr Peter Eames, a colleague, friend and mentor, who for many years was a driving force in traumatic brain injury rehabilitation and raised awareness of the nature of episodic disorders of aggression after TBI and their treatment. His clinical observations have provided a framework for much of what is contained in this paper.
Declaration of Interest: Professor Wood has been supported in this work by a grant from St Andrews Healthcare Research Trust. Dr Thomas has been supported by the National Institute for Social Care and Health Research, through the Wales Academic Clinical Academic Training scheme.