Abstract:
Intentional violence is a growing cause of TBI. Although there is evidence that violent etiology results in poorer outcomes, whether observed outcomes differences are due to violence or are basically attributable to covarying factors such as severity of injury or pre-injury race, socio-economic status, or pre-injury handicap levels is unclear. The fundamental objective of this study is to increase knowledge of the implications of violence, particularly how it is associated with pre-existing and continuing psychosocial factors. Four hypotheses will be investigated: 1) Violent etiology will be associated with poorer functional outcomes (physical functioning, cognitive functioning, community integration); 2) Violent etiology will be associated with more psychological and behavioral problems (depression, post-traumatic stress disorder, maladaptive social behavior, lower life satisfaction, lower activities-related quality of life);
3) Violent etiology will be associated with greater reported problems with access to care and with greater total cost; and 4)Short- and long-term outcomes will be negatively affected by certain characteristics of the person and his/her social environment that are associated with violent etiology and that existed pre-injury and continue to exist post-discharge (maladaptive behavior such as aggression, criminal activity, substance abuse, and psychiatric symptoms, problems at school, lack of friends, low economic status). We expect that race will be related to violent etiology and poorer outcomes, but only because these factors are demographically associated with factors listed above.