Traumatic Brain Injury (TBI) — A message to the public

Phineas Gage’s Traumatic Brain Injury:

In 1848, Phineas Gage, a 25-year-old railroad construction foreman, survived a horrific accident. While using a 43-inch-long, 13-pound iron tamping rod to pack explosive powder into a hole in the rock, the powder unexpectedly detonated. The iron rod propelled through his left cheek and skull, entering near the lower jaw hinge, passing behind his left eye socket, penetrating the base of his skull, and traversing the left frontal lobe upwards. It then exited through the top frontal portion of his skull and landed about 25-30 yards behind him. 

Remarkably, Gage was thrown onto his back, had some brief convulsions, but within minutes, he could stand, speak, and walk. Despite the severity of the injury, Gage made an improbable recovery and lived for 12 more years. 

The injury to his frontal lobe resulted in profound shifts in his personality and conduct, rendering him almost unrecognizable to those who knew him before. Prior to the incident, Gage exhibited traits of being composed, playful, amiable, and capable, serving as a dependable employee in the railroad industry. However, following the accident, he underwent a stark transformation, displaying hostility, irritability, vulgarity, irrationality, and a marked decline in social discernment. His outbursts of unchecked anger proved detrimental to his employment stability. While it’s plausible that any individual enduring such trauma might undergo some personality alterations, the magnitude and drastic nature of Gage’s changes were primarily ascribed to the physical trauma inflicted on his brain (Bartol & Bartol, 2020).

Traumatic Brain Injury (TBI) vs. Aggression:

TBI can impair the brain regions and circuits that regulate emotions, impulses, and social cognition, leading to increased aggression in some individuals. The risk and severity of aggression after TBI depend on several factors, such as the location and extent of brain damage, the presence of other psychiatric or neurological disorders, the level of cognitive functioning, the quality of social support, and the availability of rehabilitation services (Bartol & Bartol, 2020).

Traumatic Brain Injury (TBI) vs. Related Antisocial Behavior:

An article published on Medicina (Kaunas) reviews studies that show a positive correlation between TBI and aggressive behavior, especially in the acute and post-acute phases after the injury. Multiple biological and psychosocial factors, such as depression, substance abuse, age at the time of injury, and social support, can influence aggression (Maresca et al, 2020).

Activities that may cause brain Injuries:

Traumatic brain injuries are also linked with certain sports, notably football, soccer, and boxing. These injuries have the potential to cause brain damage, which in turn may trigger shifts in personality and aggressive tendencies (Bartol & Bartol, 2020).

% in Incarcerated Population: 

Approximately 60% of the prison population in the United States is thought to have indications of Traumatic Brain Injury (TBI) in their history, in contrast to only 8.5% in the general populace. Certain studies indicate that up to 82% of individuals in the criminal justice system fulfill the criteria for having experienced a TBI at some stage in their lives (Bartol & Bartol, 2020).

Treatment and Prevention: 

There are treatments for aggression after TBI: a combination of pharmacological and psychological interventions, such as antidepressants, anticonvulsants, mood stabilizers, cognitive-behavioral therapy, anger management, and social skills training.

Also, prevention of TBI and aggression requires public health measures, such as wearing helmets, reducing alcohol and drug use, enforcing traffic laws, and promoting nonviolent conflict resolution.

Author’s thoughts: 

Many people, especially those who have suffered head injuries, have encountered difficulties in controlling their behavior. Harm can result from clashes between one person’s aggression and another’s. I advise individuals with typically functioning brains to pause and step back to avoid being provoked by someone else’s aggression.

Reference:

Bartol, C. R., & Bartol, A. M. (2020). Criminal Behavior: A Psychological Approach (12th ed.). Pearson Education (US).

Maresca G., Lo Buono V., Anselmo A., Cardile D., Formica C., Latella D., Quartarone A., & Corallo F. (2023). Traumatic Brain Injury and Related Antisocial Behavioral Outcomes: A Systematic Review. Medicina (Kaunas). 59(8):1377. doi: 10.3390/medicina59081377.

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