Lisa A Brenner1, Nazanin Bahraini2, Beeta Y Homaifar2, Lindsey L Monteith3, Herbert Nagamoto4, Brooke Dorsey-Holliman5, Jeri E Forster6. 1. Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Neurology, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO. Electronic address: lisa.brenner@va.gov. 2. Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO. 3. Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO. 4. Department of Psychiatry, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO; Veterans Health Administration, Eastern Colorado Health Care System, Denver, CO. 5. Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO. 6. Rocky Moutain Mental Illness Research, Education, and Clinical Center (MIRECC), Denver, CO; Department of Physical Medicine and Rehabilitation, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO.
Abstract
OBJECTIVE: To examine the relationship between executive dysfunction, as a multidimensional construct (ie, decision-making, impulsivity, aggression, concept formation), and suicide attempt (SA) history in a high-risk sample of veterans with moderate to severe traumatic brain injury (TBI). DESIGN: Observational, 2×2 factorial design. To estimate group differences, linear regression was used to model the primary and secondary outcomes of interest as a function of history of SA, TBI, and the interaction between the 2 variables. Additionally, to determine the pattern of performance over the course of the Iowa Gambling Test (IGT), scores were modeled across the 5 IGT blocks by using a varying-coefficient model. SETTING: Veterans Health Administration. PARTICIPANTS: Veterans (N=133; no SA/no TBI, n=48; no SA/yes TBI, n=51; yes SA/no TBI, n=12; yes SA/yes TBI, n=22) completed the study measures. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: IGT, Immediate and Delayed Memory Test, State-Trait Anger Expression Inventory-2, Wisconsin Card Sorting Test. RESULTS: All groups demonstrated learning over the course of the IGT, except for veterans with a history of both SA and TBI. No group differences were identified on other measures of executive functioning. CONCLUSIONS: These findings highlight the potential, unique decision-making challenges faced by veterans with a history of TBI and SA. Specialized interventions focused on overall distress reduction and means restriction may be required to prevent future self-directed violence.
OBJECTIVE: To examine the relationship between executive dysfunction, as a multidimensional construct (ie, decision-making, impulsivity, aggression, concept formation), and suicide attempt (SA) history in a high-risk sample of veterans with moderate to severe traumatic brain injury (TBI). DESIGN: Observational, 2×2 factorial design. To estimate group differences, linear regression was used to model the primary and secondary outcomes of interest as a function of history of SA, TBI, and the interaction between the 2 variables. Additionally, to determine the pattern of performance over the course of the Iowa Gambling Test (IGT), scores were modeled across the 5 IGT blocks by using a varying-coefficient model. SETTING: Veterans Health Administration. PARTICIPANTS: Veterans (N=133; no SA/no TBI, n=48; no SA/yes TBI, n=51; yes SA/no TBI, n=12; yes SA/yes TBI, n=22) completed the study measures. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: IGT, Immediate and Delayed Memory Test, State-Trait Anger Expression Inventory-2, Wisconsin Card Sorting Test. RESULTS: All groups demonstrated learning over the course of the IGT, except for veterans with a history of both SA and TBI. No group differences were identified on other measures of executive functioning. CONCLUSIONS: These findings highlight the potential, unique decision-making challenges faced by veterans with a history of TBI and SA. Specialized interventions focused on overall distress reduction and means restriction may be required to prevent future self-directed violence.
Authors: Laura D Crocker; Amber V Keller; Sarah M Jurick; Jessica Bomyea; Chelsea C Hays; Elizabeth W Twamley; Amy J Jak Journal: J Int Neuropsychol Soc Date: 2018-11-16 Impact factor: 2.892
Authors: Richard T Liu; Zoë M Trout; Evelyn M Hernandez; Shayna M Cheek; Nimesha Gerlus Journal: Neurosci Biobehav Rev Date: 2017-09-18 Impact factor: 8.989
Authors: Alejandro Interian; Catherine E Myers; Megan S Chesin; Anna Kline; Lauren St Hill; Arlene R King; Rachael Miller; Miriam Latorre; Michael A Gara; Barbara H Stanley; John G Keilp Journal: Psychiatry Res Date: 2019-10-18 Impact factor: 3.222
Authors: T D Gould; P Georgiou; L A Brenner; L Brundin; A Can; P Courtet; Z R Donaldson; Y Dwivedi; S Guillaume; I I Gottesman; S Kanekar; C A Lowry; P F Renshaw; D Rujescu; E G Smith; G Turecki; P Zanos; C A Zarate; P A Zunszain; T T Postolache Journal: Transl Psychiatry Date: 2017-04-11 Impact factor: 6.222