{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:49:58Z","timestamp":1790156998595,"version":"4.0.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>\n                    The current prospective, multi-center, longitudinal cohort study examined how veterans\/service members (V\/SM) changed in their irritability, anger, and aggression (IAA) scores from admission to discharge in post-acute rehabilitation settings. The goals were to identify trajectory subgroups, and explore if there were different predictors of the subgroups. V\/SM (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009346) from five Veterans Affairs TBI Model Systems Polytrauma Rehabilitation Centers participated. The sample was mostly men (92%) and identified as white (69%), black (13%), and other races (18%). Median age was 28 years, and 78% had sustained a severe TBI. Staff rated IAA at admission and discharge using the Mayo-Portland Adaptability Inventory-4 item#15. Four IAA trajectory subgroups were identified: (1) no IAA at admission or discharge (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200989, 25.72%), (2) resolved IAA (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200961, 17.63%), (3) delayed onset IAA (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200931, 8.96%), and (4) persistent IAA (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009165, 47.69%). Greater post-traumatic stress disorder (PTSD) symptoms were the only consistent predictor of belonging to all the subgroups who had IAA compared with the no IAA subgroup. We conclude that IAA had different trajectories after a TBI. The majority of V\/SM had persistent impairment from IAA, a quarter of the sample had no impairment from IAA, and fewer participants had resolving or worsening IAA. Findings emphasize the importance of educating providers and family of the different ways and times that IAA can manifest after TBI. Timely diagnosis and treatment of PTSD symptoms during and after rehabilitation are critical treatment targets.\n                  <\/jats:p>","DOI":"10.1089\/neu.2020.7451","type":"journal-article","created":{"date-parts":[[2021,1,20]],"date-time":"2021-01-20T07:12:08Z","timestamp":1611126728000},"page":"1827-1833","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Evolution of Irritability, Anger, and Aggression after Traumatic Brain Injury: Identifying and Predicting Subgroups"],"prefix":"10.1177","volume":"38","author":[{"given":"Shannon R.","family":"Miles","sequence":"first","affiliation":[{"name":"Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, Florida, USA."},{"name":"Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora M.","family":"Hammond","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Neumann","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Silva","sequence":"additional","affiliation":[{"name":"Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, Florida, USA."},{"name":"Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA."},{"name":"Department of Internal Medicine Pulmonary and Sleep Medicine Division, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA."},{"name":"Department of Psychology, University of South Florida, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Tang","sequence":"additional","affiliation":[{"name":"Tampa VA Research and Education Foundation, Inc., Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Kajankova","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Human Performance, Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Dillahunt-Aspillaga","sequence":"additional","affiliation":[{"name":"Rehabilitation and Mental Health Counseling Program, College of Behavioral and Community Sciences, University of South Florida, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risa","family":"Nakase-Richardson","sequence":"additional","affiliation":[{"name":"Mental Health and Behavioral Sciences, James A. Haley Veterans' Hospital, Tampa, Florida, USA."},{"name":"Department of Internal Medicine Pulmonary and Sleep Medicine Division, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA."},{"name":"TBI Center of Excellence, James A. Haley Veterans' Hospital, Tampa, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Surveillance Report of Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths\u2014United States, 2014","author":"Centers for Disease Control and Prevention (2019)","unstructured":"Centers for Disease Control and Prevention (2019). Surveillance Report of Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths\u2014United States, 2014. 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