Journal:Psychiatric Clinics of North America
Year, Volume, Issue, Page(s):14, 37, 1, 31-53
Article provides clinicians with practical guidance on the evaluation and management of emotional and behavioral dyscontrol following traumatic brain injury (TBI). Methods of assessing emotional and behavioral dyscontrol are described briefly, and the importance of considering the differential diagnoses for these clinical phenomena is highlighted. Emotional dyscontrol is a common consequence of moderate or severe TBI and includes pathologic laughing and crying (also known as pseudobulbar affect or emotional incontinence), affective lability, and irritability. These problems are common in the early period following mild TBI, after which they resolve in most people. Among the most challenging forms of posttraumatic behavioral dyscontrol are disinhibition and aggression. These problems tend to be more common, chronic, disruptive, and challenging to manage among persons with moderate and severe TBI. Emotional and behavioral dyscontrol frequently co-occur with other posttraumatic neuropsychiatric disturbances, the treatment of which may concurrently reduce the frequency and severity of dyscontrol symptoms. When emotional and/or behavioral dyscontrol require symptom-specific treatments, a combination of non-pharmacologic (i.e., psychological, behavioral, environmental) and pharmacologic approaches is usually required. Properly administered, these interventions may provide persons with TBI and their families with substantial relief from these problems and their effects on daily functioning and quality of life.