Mild traumatic brain injury (mTBI), also known as concussion, is caused by a physiological disruption in the brain function and can result in impairment of a myriad amount of functions. These injuries can be incurred by a blow to the head commonly found in violent acts, motor vehicle or bicycle accidents, or in sports; falls such as those from high distances; and in blasts mostly from military combat. The severity of the injury ranges from mild, to moderate, to severe, with most occurrences being mild. mTBI presents cognitive dysfunction when memory and reaction time is compromised but other behavioral functions can be affected as well such as social isolation or lack of motivation. Commonly overlooked is the psychological aspect that can be affected by mTBI such as personality changes, loss of inhibition, and even mental illness such as depressive and anxiety disorders. Current assessment and diagnosing procedures vary widely among mental and medical practices while the symptoms presented can appear in various fashions. There are ongoing psychological effects of mTBI even after cognition is reestablished. Because of the variations in assessing and diagnosing mTBI, the psychological impairments can be misunderstood and misdiagnosed which causes an unknown prevalence, prognosis, and treatment for the injury.
Undoubtedly, the varying nature of defining a mTBI can create diagnosing problematic among mental health professionals and medical providers. Diagnostic measures of brain injuries typically fall within the neurocognitive domains of complex attention, executive function, learning and memory, language, perceptual-motor, and social cognition. The Diagnostic and Statistical Manual of Mental Disorders (2013), also known as the DSM-5, categorizes TBI as a neurocognitive disorder ranging in severity. Severity ratings are dependent on the length of time of loss of consciousness, posttraumatic amnesia, and disorientation and confusion at initial assessment. With an impact to the head or quick movement or displacement of the brain (such as blast injuries), there must be one or more of the following: a loss of consciousness, posttraumatic amnesia, disorientation and confusion, and/or neurological signs such as found in neuroimaging, new onset of seizures or worsening of current seizure disorder, visual disturbances, anosmia, or hemiparesis (p. 624). Diagnosis codes vary depending on the presence of behavioral disturbances and skull fractures. This diagnosing method only takes into account the recent occurrence of a TBI and lacks the long lasting effects that continue.
Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. (2013). Washington, D.C.: American Psychiatric Association.