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VIOLENCE NOT KEY FACTOR IN RECOVERY FROM BRAIN INJURY
COLUMBUS, Ohio - Victims of violence who suffer traumatic brain injuries (TBI) do just as well at rehabilitation as do other TBI victims -- unless they are substance abusers.
While substance abuse and violence-related brain injuries often go together, an Ohio State University study found that it is the substance abuse that determines how well people recover from those injuries.
The research appears in a recent issue of the journal Archives of Physical Medicine and Rehabilitation.
Bogner and her colleagues reviewed the medical records of 351 adult TBI patients admitted to a specialized TBI rehabilitation unit in the Midwest. Of these patients, 53 had been injured by violent means, such as from an assault or a gunshot wound.
Seventy-nine percent of the 53 patients had a history of substance abuse, determined through interviews and observations by psychologists and social workers. In comparison, only 55 percent of those whose injuries were not violence-related had a history of substance abuse
The researchers followed up with the patients one year after discharge from rehabilitation. About half (168) of the patients completed telephone surveys on life satisfaction, while 202 patients from the original group completed questionnaires on community integration. The researchers were unable to track down the remaining patients. Also, severe cognitive problems prohibited some patients from answering subjective questions on life satisfaction.
The researchers found that patients with a history of substance abuse were less satisfied with life one year after the injury and were also less productive - that is, they were less likely to hold a job or to be involved in their community.
While the specific type of violent injury - blunt vs. penetrating (such as a gunshot wound) - may have different physiological effects on recovery, psychosocial outcomes are better predicted by patterns of substance abuse, she said.
"The fact that an injury resulted from violent means does not appear to have a strong effect on a person's rehabilitation," Bogner said.
"The recovery process can continue for years, and each point in recovery is associated with new problems in finding the services to address vocational, community, psychosocial and financial needs."
A grant from the U.S. Department of Education's National Institute on Disability and Rehabilitation Research supported this research.
Bogner co-authored the study with John Corrigan, W. Jerry Mysiw, Daniel Clinchot and Lisa Fugate, all with the department of physical medicine and rehabilitation of Ohio State's College of Medicine and Public Health.