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Impulsive and episodic disorders of aggressive behaviour following traumatic brain injury

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Pages 253-261 | Received 03 Apr 2012, Accepted 08 Oct 2012, Published online: 25 Feb 2013
 

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.

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