Are emotional outbursts common in TBI patients?

If you are the parent or caregiver of someone with a traumatic brain injury, chances are that you are all too familiar with their periodic explosive outbursts.

In about half of the cases of TBI, the person will experience periods of intense agitation that can culminate in explosions of anger. The episodes can range in severity and have various causes.When a brain functions normally, it allows us to curb socially unacceptable urges. TBIs can damage the internal control system that regulates behaviour and actions. The more severe the brain injury is, the greater the likelihood of frequent explosive outbursts.

Environment is another factor that affects behaviour. Noisy, crowded environments can increase a TBI victim’s discomfort and anxiety. Because they lack the ability to control their responses, under these circumstances, an explosive reaction can occur.

Some TBIs damage the cognitive abilities, which leads to a decline in an individual’s capacity to observe, comprehend and respond to their surroundings. Not being able to remember the socially appropriate responses to certain situations is frustrating and also likely to trigger an outburst.

Personality has to be taken into consideration as well. If the person had a hair-trigger temper prior to the TBI, this tendency is likely to be exacerbated. Children who previously struggled with keeping their behaviours in line will be even more challenged by their injury.

The below strategies can be used by caregivers and parents to limit the frequency and intensity of the outbursts:

  • Provide structure with a consistent daily routine
  • Incorporate visible cues like calendars and clocks into their environment
  •  Reinforce their knowledge of time, date, and scheduling
  •  Allow time for rest breaks and down time
  •  Decrease exposure to environments that are too stressful or stimulating
  •  Give the person choices about activities and preferences
  •  Use concise language and short sentences
  •  Discuss past events and familiar topics of interest
  •  Explain what will be happening ahead of time to increase awareness

Demonstrating patience with TBI-related outbursts can shorten episodes.

Seeking compensation for TBIs from at-fault defendants should include claims for counselling for the victims to assist them with developing better control over their negative behavioural responses.

Source: Brain Injury Alliance of Kentucky, “Explosive Behavior,” accessed June 26, 2015

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