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Rehabilitation Approaches to the Management of Aggressive Behaviour Disorders after Acquired Brain Injury

Published online by Cambridge University Press:  14 May 2013

Nick Alderman ,
Caroline Knight  and
Jennifer Brooks
Nick Alderman*
Affiliation:
Brain Injury Services, Partnerships in Care, Grafton Manor, Grafton Regis, UK Brain Injury Research Group, College of Human and Health Science, Swansea University, Swansea, Wales
Caroline Knight
Affiliation:
National Brain Injury Centre, St Andrew's Healthcare, Billing Road, Northampton, UK Kings College London, St Andrew's Academic Centre, Northampton, UK
Jennifer Brooks
Affiliation:
National Brain Injury Centre, St Andrew's Healthcare, Billing Road, Northampton, UK
*
Address for correspondence: Professor Nick Alderman, Brain Injury Services, Partnerships in Care, Grafton Manor, Grafton Regis, Northampton NN12 7SS, UK. E-mail: [email protected]
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Abstract

Symptoms of neurobehavioural disability acquired through brain injury, especially aggression, are associated with severe social handicap. Differences in terminology have resulted in varying estimates, but aggressive behaviour disorder appears to be characteristic of survivors at some point in their recovery journey. This paper provides a brief review regarding the prevalence, development and causes of aggression associated with acquired brain injury (ABI), and what can be done to help manage them. The advantages of using standardised measures conceptualised for ABI in the assessment and formulation of aggressive behaviour disorders are especially highlighted. A range of treatment methods and the evidence base relating to these are described. The contribution of pharmacological therapies, cognitive behavioural therapy and behavioural interventions are explored. It is argued that the strongest evidence base is associated with behaviour therapy, especially when carried out in the context of neurobehavioural rehabilitation, and two case studies are described to illustrate the clinical advantages of interventions derived from operant theory. Comparative lack of ABI experts trained in the management of post-acute behaviour disorders remains a limiting factor.

Keywords

acquired brain injuryneurobehavioural disabilityaggressiontreatmentrehabilitation
Type
State of the Art Reviews
Information
Brain Impairment , Volume 14 , Issue 1: State of the art reviews in mental health after traumatic brain injury , May 2013 , pp. 5 - 20
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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