DEPRESSION AFTER TRAUMATIC BRAIN INJURY - CONCEPTUALIZATION AND TREATMENT CONSIDERATIONS

The understanding and treatment of depression that develops following traumatic brain injury (TBI) is still unclear and likely to be the res ult of a complex variety of interacting factors. Past researchers have developed ways to classify important variables related to patients' d epression into broad domains such as: Pre-injury assets and liabilitie s, the nature and severity of brain injury; and reaction to difficulti es. However, a better conceptualization of the problem is required in order to guide the assessment and treatment considerations for depress ed patients with TBI. This review provides this conceptualization by p ostulating six theoretical relationships between depression and TBI. T he degree of empirical support provided in the literature for there li nks is indicated. Research findings suggested that an individual with TBI is the most susceptible to depression when any of the following co nditions exist: a pre-existing psychiatric disturbance is exacerbated; the injury sustained involved the left anterior region of the brain; and when her individual has poor insight into her deficits, attempts t o resume her pre-injury roles and experiences significant failure. For each relationship, a likely outcome is predicted if the recommended t reatment plan is not conducted. The present conceptualization and trea tment considerations will be of substantial benefit to clinicians work ing in the area.