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Citation
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Ignacio D, Degeneffe C, Serpas DG, Clay K, Liu Y, Berges V, Shinoda K. Arch. Clin. Neuropsychol. 2023; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Traumatic Brain Injury (TBI) is a silent public health epidemic that begins as a medical condition ("neurometabolic cascade") that may develop into significant psychiatric symptoms that negatively impact community reintegration for survivors following injury ("neuropsychosocial cascade"). However, survivors may not seek medical attention for a variety of reasons (e.g., anosognosia, fear of retaliation, no insurance). Therefore, medical incidence does not necessarily reflect the community prevalence of TBI.
METHOD: The California Department of Rehabilitation, the Department of Public Health, and the State Survey Panel collected data from a randomized and representative sample of Californians (N = 1057) using three probability-based techniques, such that every Californian registered with the United States postal service had a non-zero chance of being selected. Respondents were evaluated using psychometrically established methods for screening history and symptoms of TBI.
RESULTS: California rates of community prevalence ranged between 15% (estimated 4.2 million Californians) and 42%, depending on the definition of TBI used, highlighting significant disparities in operationalization. These rates were compared to the annual medical rates (< 1%) derived from the California Department of Public Health (2016-2020).
CONCLUSIONS: This study revealed significantly higher rates of depression, anxiety, and neurocognitive disorders over three decades, on average, relative to the general California population: illustrating a disease process. Neuropsychiatric disparities were associated with dysfunctional community reintegration (e.g., home insecurity, justice system involvements, employment instability).
Language: en |