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Chapter 4. Neuropsychiatric Assessment

Kimberly A. Arlinghaus, M.D.; Nicholas J. Pastorek, Ph.D.; David P. Graham, M.D., M.S.
DOI: 10.1176/appi.books.9781585624201.672629

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Excerpt

A traumatic brain injury (TBI) is a significant event that may result in dramatic alterations in an individual's cognition, behavior, and emotions. The neuropsychiatric manifestations of such an injury depend on several factors: 1) preexisting variables such as the patient's personality and temperament before the injury, family psychiatric history, and previous psychiatric, medical, and neurological history; 2) the patient's psychosocial, economic, and vocational status at the time of injury; 3) the type, location, and severity of the brain injury; 4) the emotional and psychological responses of the individual to the TBI-mediated disturbances in cognition and behavior; 5) the impact of such changes on personal and professional roles and relationships, especially those involving the family; and 6) the interplay between TBI-related impairments and community barriers and supports. The multiple variables that result in neurobehavioral disturbances subsequent to TBI require a comprehensive and integrated approach to data collection, diagnostic formulation, and treatment planning.

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Table 4–1. Sample questions for traumatic brain injury (TBI) assessment
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Table 4–2. Classification of traumatic brain injury (TBI)
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Table 4–3. Mayo Traumatic Brain Injury (TBI) Severity Classification System
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Table 4–4. Traumatic brain injury symptom checklist
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Table 4–5. Sources of collateral history
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Table 4–6. Rancho Los Amigos Cognitive Scale
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Table 4–7. Traumatic brain injury (TBI)–related DSM-IV-TR disorders
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Table 4–8. Neurological examination after traumatic brain injury: key areas of assessment
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Table 4–9. Common endocrine disturbances after traumatic brain injury
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Table 4–10. Preinjury factors that can influence recovery
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Table 4–11. Symptoms reported by family members of patients with severe brain injury
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Table 4–12. "Bedside" evaluation of frontal lobe function
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Table 4–13. Mayo Portland Adaptability Inventory–4 (MPAI-4) indexes and item content
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Table 4–14. Items in the Sydney Psychosocial Reintegration Scale
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Table 4–15. Comprehensive assessment of traumatic brain injury

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