Format

Send to

Choose Destination
Arch Phys Med Rehabil. 2015 Aug;96(8):1411-8. doi: 10.1016/j.apmr.2015.04.010. Epub 2015 Apr 28.

Executive functioning and suicidal behavior among veterans with and without a history of traumatic brain injury.

Author information

1
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO. Electronic address: lisa.brenner@va.gov.
2
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
3
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
4
Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Veterans Health Administration, Eastern Colorado Health Care System, Denver, CO.
5
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO.
6
Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.

Abstract

OBJECTIVE:

To examine the relationship between executive dysfunction, as a multidimensional construct (ie, decision-making, impulsivity, aggression, concept formation), and suicide attempt (SA) history in a high-risk sample of veterans with moderate to severe traumatic brain injury (TBI).

DESIGN:

Observational, 2×2 factorial design. To estimate group differences, linear regression was used to model the primary and secondary outcomes of interest as a function of history of SA, TBI, and the interaction between the 2 variables. Additionally, to determine the pattern of performance over the course of the Iowa Gambling Test (IGT), scores were modeled across the 5 IGT blocks by using a varying-coefficient model.

SETTING:

Veterans Health Administration.

PARTICIPANTS:

Veterans (N=133; no SA/no TBI, n=48; no SA/yes TBI, n=51; yes SA/no TBI, n=12; yes SA/yes TBI, n=22) completed the study measures.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

IGT, Immediate and Delayed Memory Test, State-Trait Anger Expression Inventory-2, Wisconsin Card Sorting Test.

RESULTS:

All groups demonstrated learning over the course of the IGT, except for veterans with a history of both SA and TBI. No group differences were identified on other measures of executive functioning.

CONCLUSIONS:

These findings highlight the potential, unique decision-making challenges faced by veterans with a history of TBI and SA. Specialized interventions focused on overall distress reduction and means restriction may be required to prevent future self-directed violence.

KEYWORDS:

Brain injuries; Rehabilitation; Suicide; Veterans

PMID:
25933916
DOI:
10.1016/j.apmr.2015.04.010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center