Violence With a History of Brain Injury

The link between brain injury and violence is strong. The possibility is even stronger if post traumatic stress disorder (PTSD) has also been a factor.

Studies indicate that there is a correlation between brain injuries and violence. It is suspected that personality changes brought about as a result of a head injury may predispose a sufferer to violent behaviour. The cognitive and behavioral effects of a traumatic brain injury, particularly if it is a frontal lobe injury can cause aggression and/or violent behaviour. According to a recent study, a brain injury can also cause problems in reasoning, impulsiveness and aggression.

The U.S. soldier who is suspected of recently leaving his base in Afghanistan at night and killing sixteen civilians, mainly women and children, in their homes had suffered a traumatic brain injury in 2010. The brain injury occurred while involved in a vehicle roll-over accident while on tour in Iraq. He was treated and returned to duty in December, 2011. Studies show that recovery from brain injuries is not quick. Take a look at Sydney Crosby, the hockey player, and the tough road he has had to travel to recovery.

The additional problem is that many of these soldiers are not only returned to duty while still suffering from their brain injury but many have undiagnosed brain injuries. As well, it is likely that many are suffering from post traumatic stress disorder (PTSD) too.

PTSD is marked by sleep problems, irritability, difficulty concentrating, jumpiness and is often associated with anger, hostility and aggression. Flash backs can trigger an aggressive act meant to ward off a threat. Those with PTSD are more likely to perceive or imagine a threat. Also those suffering from post traumatic disorder may lack empathy, be depressed, aggressive and be unable to grasp the seriousness of a violent act.

An estimated 200,000 soldiers have been diagnosed with a traumatic brain injury since the Iraq and Afghanistan wars began with many more undiagnosed. Because brain injuries impair their judgment, a traumatic brain injury will increase the risk that a sufferer will behave violently.

The frontal lobe portion of the brain influences impulse control, understanding right from wrong and being able to anticipate the consequences of one's actions. The frontal lobe is particularly vulnerable to injury so is the most often affected. It is estimated that nearly forty percent of all TBI sufferers have exhibited violent behaviour compared to only eleven percent of those who have not had a TBI.

A study done of Iraq war veterans who had suffered traumatic brain injuries indicated that they experienced significantly more mental health problems in the years following their injuries, particularly those associated with PTSD. These problems also often lead to drugs, substance abuse and severe depression.

The soldier suspected in the recent massacre was on his fourth combat deployment. Many soldiers have three, four and five combat tours up to a year each in length. And at the height of the Iraq fighting, these tours often lasted as long as fifteen months.

This has to take a huge toll on any soldier even one without a brain injury or PTSD. Studies indicate that a high rate of Iraq or Afghanistan veterans either commit suicide or attempt suicide. Also domestic violence has surged by over thirty percent among military families. This is an unbelievably high human cost of war on many levels - of the needless killing of innocent people such as the sixteen recently killed, on the soldier himself, on his family and on the health care system.

Brain Injuries and Suicide

According to research, many of those who have suffered a traumatic brain injury are at a higher risk for suicide than those in the general population. What are the risk factors and how can they be prevented?

Where brain injuries and suicide are concerned, the following are some of the risk factors: depression, anxiety, post traumatic stress disorder, lower levels of psychosocial functioning, aggressive behavior, and those with poor decision making skills. Other risk factors are panic attacks, issues with anger, memory loss and impaired thinking, substance abuse, a tendency to withdraw from society and impulsive behavior.

Mental health disorders are a major factor contributing to suicides as well as having such pre-injury problems as a seizure disorder, (either pre or post injury), bipolar disease, personality disorder, psychosis,history of psychiatric illness or a history of suicide in other family members.

Other issues relating to the risk of suicide is a feeling of hopelessness, those who have a perception of loss, isolation, poor family relationships, feeling lonely, suffering from lack of initiative, experiencing extreme fatigue, having few friends, no significant other, an inability to get a job, cognitive issues, feelings of low self-worth, feelings of unhappiness and those who are likely to engage in high risk behaviors.

The largest percentage of brain injury sufferers at risk for attempted suicide or suicide are males in the 25 - 35 year age range. Suicides and attempted suicides are particularly high amongst soldiers in the military. The rate has increased despite programs for suicide prevention and intervention particularly since the wars in Iraq and Afghanistan.

In order to help a friend or family member decrease the risk of suicide, what can we do? It is necessary to identify any psychiatric or psychological issues. If any are suspected, contact a Mental Health Association with your concerns. Other issues leading to a high risk situation are economic problems, inability to adjust to their disability, pre-injury problems such as a dysfunctional and chaotic family background and a lower economic status.

It is also important to be aware of any non-verbal behaviors or cues, to maintain contact with the person and be aware of their whereabouts, encourage communication, avoid arguments, help to establish a safety net, let others know of the risk potential, encourage counseling, try to identify triggers that may initiate suicidal thoughts, recognize their moods and to provide alternatives to high risk behaviors.

Most head injury sufferers are definitely not predisposed to suicide. However, if the patient is at high risk, it is important to be aware of this so that measures can be taken to ensure his/her safety.