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Traumatic brain injury, executive functioning, and suicidal behavior: a brief report.

Beeta Y Homaifar1, Lisa A Brenner, Jeri E Forster

  • 1VISN 19 Mental Illness Research, Education, and Clinical Center, Denver, Colorado 80220, USA. beeta.homaifar@va.gov

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Veterans with traumatic brain injury (TBI) and a history of suicide attempts (SA) showed differences in executive functioning, specifically in perseverative errors on the Wisconsin Card Sorting Test (WCST). This suggests a link between TBI, executive dysfunction, and SA.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Rehabilitation Medicine

Background:

  • Traumatic brain injury (TBI) is prevalent in veterans.
  • Executive dysfunction is a common consequence of TBI.
  • Suicidal behavior (SA) is a significant concern in veteran populations.

Purpose of the Study:

  • To investigate the relationship between executive dysfunction and suicidal behavior in veterans with TBI.
  • To compare executive functioning in veterans with TBI and a history of SA versus those with TBI but no SA history.

Main Methods:

  • Pilot study comparing two groups of veterans with TBI.
  • Group 1: history of at least one SA (n=18).
  • Group 2: no history of SA (n=29).
  • Assessed executive functioning using the Wisconsin Card Sorting Test (WCST), Iowa Gambling Task (IGT), and Immediate and Delayed Memory Test (IMT/DMT).
  • Controlled for TBI severity.

Main Results:

  • The Wisconsin Card Sorting Test (WCST) perseverative errors score was the only significant difference between groups.
  • Individuals with a history of SA exhibited more perseverative errors on the WCST compared to those without SA history.
  • No significant differences were found in decision-making (IGT) or impulsivity (IMT/DMT).

Conclusions:

  • Perseverative errors on the WCST may be a potential indicator of suicidal behavior in veterans with TBI.
  • Clinicians should incorporate suicide risk assessment for individuals with TBI.
  • Measuring perseveration could enhance suicide risk evaluations in this population.