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According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association [APA], 2013), in addition to cognitive impairments individuals who have a TBI may experience changes in levels of consciousness, confusion associated with deficits in orientation, new onset or worsening of seizure disorder, visual field deficits, and/or hemiparesis.
A TBI can be categorized as focal (e.g., gunshot wound) or widespread (e.g., diffuse axonal injury sustained in a motor vehicle accident). Severity of a TBI is based on the following: extent and nature of the injury, duration of loss of consciousness, posttraumatic amnesia (PTA; loss of memory for events immediately following injury), and extent of confusion at initial assessment during the acute phase of the individuals’s injury (APA, 2013; Centers for Disease Control and Prevention [CDC], 2015).
The Department of Defense (DOD) labels the levels of severity with four categories (Defense Health Agency, 2019).
(Berg et al., 2003) and social isolation (Hilari & Northcott, 2006; Vickers, 2010) may negatively affect improvement.
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