ABSTRACT
It is ironic that improved medical management of the acute aspects of traumatic brain injury (TBI) has increased the number of survivors and, as a result, the number of severely handicapped individuals, many of whom will become burdens to their families, rehabilitation facilities, or social services.1 The social outcome of such injuries is also very significant. More and more studies are suggesting that emotional, behavioral, or other psychosocial changes are more disturbing for relatives, and more difficult for the community to accept, than other forms of physical handicap such as cerebral palsy or quadriplegia.2 The multiple characteristics of behavioral and psychosocial changes following brain trauma include reduced tolerance to stress, increased emotional lability, verbal or physical threatening or aggressive behaviors, a dysfunction of previous social skills, inappropriate behavior, and lack of concern or denial of the feelings of others. Behavioral disorders are far more likely to interfere with integration of the patient into the family and society than are adverse cognitive outcomes following TBI. Abnormal behaviors often lead to interference with rehabilitation attempts.
