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Can the TBI Identification Method be used in a prison setting to determine lifetime history of TBI?

Categories: Rehabilitation and Recovery

The Question

Determining if an individual has a history of undocumented TBI is essential in order for appropriate services to be provided. But, how is it possible to evaluate the history of TBI throughout a person’s life?

Past Studies

Past studies developed the OSU TBI Identification Method (OSU TBI-ID). This is a structured interview that helps to evaluate past history of TBI using the following steps.

1. Using a series of questions, the person is asked about all incidents leading to injuries (not just TBI’s) in one’s life.

2. For incidents that could have caused a TBI, the person is asked whether he or she had a loss of consciousness, was confused, or had memory gaps at the time of the injury.

3. Injuries with a loss of consciousness or resulting in confusion/memory gaps are considered TBI’s.

4. For TBI’s, questions are asked about medical care received, whether the person experienced any symptoms immediately after the injury, and if the person is still experiencing symptoms.

One of the past studies showed that information from the OSU TBI-ID can predict a person’s current functioning. Specifically, the following information is useful in predicting current thinking skills and behavior:

  • the number of injuries;
  • the worst injury;
  • how long since the last TBI with a loss of consciousness; and
  • the age of the individual when they had their first TBI.

This previous study also indicated that it was very important to take into account other causes of TBI symptoms, such as:

  • psychiatric disorders;
  • alcohol or other drug use disorders;
  • other brain-related disorders; and
  • learning problems.

The New Study

The new study focused on the use of the OSU TBI-ID with prisoners. Researchers and others have suspected that many prisoners may have a history of TBI. Prisoners with severe psychiatric or neurological disorders were excluded from the study because the results would be difficult to interpret.

The study found that

  1. Similar results are found when the interview is given on two different occasions, providing additional information about the reliability of the OSU TBI-ID.
  2. Many of the prisoners had a history of TBI, as well as problems with alcohol or drug use, mental health issues, and learning difficulties.
  3. When non-TBI factors were taken into account, it was found that:
  • the number of more severe TBI’s predicted working memory problems;
  • the number of TBI’s with loss of consciousness predicted problems with controlling behavior;
  • other aspects of TBI history also predicted problems with thinking and behavior.

Overall, the results of this study were consistent with the previous study.

Who May Be Affected By These Findings

Hopefully, this new method will more easily identify individuals with undocumented TBIs so that services could be provided for them.

Caveats

This study was done with prisoners who volunteered and were available for the study. They do not represent all prisoners.

Bottom Line

This study provides some additional evidence that the OSU TBI-ID is useful in identifying people with an undocumented TBI.

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Find This Study

Bogner, J and Corrigan, J.D. Reliability and predictive validity of the Ohio State University TBI Identification Method with prisoners. Journal of Head Trauma Rehabilitation July/August 2009 – Volume 24 – Issue 4 – p 279-291

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