Post-traumatic amnesia: a scoping review & content analysis of behavioral disturbances

Figures & data

Figure 1. PRISMA flow diagram.

Note. PRISMA flow diagram outlining study search and selection processes. PTA, post-traumatic amnesia; TBI, traumatic brain injury.

Table 1. Behavioral categories.

Behavior Category (C) Behavioral Subcategory (SC)	Studies Reporting on Behavior Category Using Scales for Assessment (/20) Examples	Studies Reporting on Behavior Category using clinical notes or observation for assessment (/10) Examples
C1: Disinhibition SC1: Impulsive SC2: Perseveration (thought, word and deed) SC3: Restless (pacing, excessive movement) SC4: Verbosity (rapid, loud, excessive talking) SC5: Self-stimulating Behaviors (rocking, rubbing and moaning) SC6: Wandering SC7: Inappropriate Behavior (public masturbation, impinging personal space, levels of intimacy) SC8: Absent Self-monitoring SC9: Distractible SC10: Disordered Communication (disorganized, tangential)	20/20 ‘impulsive, impatient’, ‘rocking, rubbing, moaning and other self-stimulating behaviors’ & ‘restlessness, pacing, excessive movement’ (19) ‘reduced ability to appropriately shift attention to new external stimuli’ (20; p919)	6/10 ‘the patient is physically restless and has an excessive current of speech’ (21; p452) ‘perseveration on the term ‘it’s alright’ and ‘his disorganized, tangential verbal output.’ (22; p1324)
C2: Agitation SC1: Demanding SC2: Resistant to care/Uncooperative SC3: Pulling at tubes SC4: Rapid, loud or excessive talking SC5: Frustrated, impatient and intolerant SC6: Restlessness SC7: Anger	20/20 ‘pulling at tubes or restraints’ & ‘uncooperative, resistant to care, demanding’ (23) ‘frustrated, impatient and intolerant’ (5; p3)	10/10 ‘you couldn’t get medications into her because she’d pull out her nasogastric [tube] and you couldn’t put them in to her because she was just … wriggling and squirming around’ (24; p20) ‘she also developed an irritable and rather antagonistic nature’ (9; p490)
C3: Aggression SC1: Self (beating head against wall) SC2: Others (threatening, abusing) SC3: Verbal (shouting, cursing, threatening) SC4: Physical	16/20 ‘curses viciously, uses foul language in anger, makes moderate threats to others or self’ (20) ‘violent and/or threatening violence toward people or property’ (25)	6/10 ‘became verbally and at times physically aggressing, conceitedly abusing family physically and emotionally’ (9; p490) ‘violent outbreak and began to beat his head against the wall … rapidly drifts into shouting, clamoring for his wife, or he makes a sudden assault.’ (4; p379)
C4: Lability SC1: Sudden Mood Changes/swings SC2: Excessive Crying/laughter SC3: Anxiety	15/20 ‘sudden changes of mood’ & ‘easily initiated or excessive crying and/or laughter’ (7) ‘excitement: increased reactivity’ (26; p722)	5/10 ‘her affect was inappropriate, labile, most dysphoric, and highly suspicious’ (9; p489) ‘as the patient emerges from stupor he is, as a rule, excited, sometimes dazed and bewildered and reacts in a resistive, irritable way to outside interference.’ (27; p1082)
C5: Lethargy/Low Mood SC1: Fatigued SC2: Immobile SC3: Sluggish SC4: Low Arousal SC5: Giving up SC6: Emotional Withdrawal (indifferent) SC7: Isolation SC8: Lack of Spontaneous Interaction SC9: Motor Retardation/Slowed movement and speech SC10: Blunt affect/Reduced intensity of feelings	17/20 ‘Low arousal’ & ‘giving up’ (21; p452) ‘motor retardation (e.g. slowed movement and speech)’ (26; p722)	7/10 ‘fatigued and reluctant to engage’ (22; p1323) ‘sometimes the mood … is indifferent, sometimes there is a rather childish petulant depression.’ (27; p1088)
Category 6 – C6: Perceptual Disturbances/Psychotic like Symptoms SC1: Hallucinations SC2: Illusions SC3: Misinterpretations SC4: Suspicious/Unusual ideation/Delusional Subcategory 5 – SC5: Tangential thought/talking & Incoherent verbalizations not due to aphasia (push of talk) Subcategory 6 – SC6: Disconnected thought process Subcategory 7 – SC7: Unusual thought process	5/20 ‘perceptual disturbances such as misinterpretation, illusions or hallucinations’ (20; p920) ‘unusual though content’ & ‘disconnected thought processes’ (26; p722)	5/10 ‘she would point out the imaginary man, waving her arms threateningly, moving her feet restlessly and loudly shouting at him to ‘go away’ (9; p489) ‘after first return of automatic speech, there is often a considerable push of talk in which words and phrases are well formed but unrelated to one another or to the circumstances – in fact a jargon.’ (27; p1085)
Category 7 – C7: Personality Changes Subcategory 1 – SC1: Altered Personality Subcategory 2 – SC2: Regression (child-like expressions and immature appearance)	0/20	5/10 ‘her voice, manner of speech, vocabulary, prosody, gait, carriage and overall demeanor resembled those of a capricious, arrogant and annoyed young girl’ (9; p490) ‘an exaggeration of preexisting traits in the mood and personality.’ (27; p1090)
Category 8 – C8: Sleep Disturbances	4/20 ‘Sleep Disturbance’ (7; p10) ‘Disturbance of sleep-wake cycle’ (20; p920) (26; p137)	3/10 ‘she couldn’t sleep’ (24; p22) ‘she could only fall asleep when lying between her mother and grandmother.’ (9; p489)

Note. Proposed analytical categories and relevant category items derived from conventional content analysis.

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