Hart Leads Clinic to Enhance Care for Military Survivors of Traumatic Brain Injury

The Department of Health Psychology in the School of Health Professions has a long-standing clinical focus in adult neuropsychology. Faculty clinicians provide diagnostic neuropsychology assessments including general cognitive and personality functioning to uninsured and underserved patients.

Dr. Eric Hart, associate chair and associate clinical professor of health psychology, currently oversees the adult neuropsychology clinical operation, and has worked to strengthen interdisciplinary collaboration with Fort Leonard Wood to offer neuropsychological assessment to active duty military personnel that have incurred traumatic brain injury.

Traumatic brain injury, which is brain dysfunction caused by an outside force, usually a violent blow to the head or from shearing and stretching of tissue causing displacement of the brain due to movement, as well as Post-traumatic Stress Disorder (PTSD) are signature injuries affiliated with the members of the military. The team hopes to learn more about co-occurring psychiatric conditions that could have impact on day-to-day social skills of military men and women.

“Research supports that early identification of a mild brain injury can drastically influence the course of recovery for a survivor,” said Dr. Hart. “By offering some level of psychoeducation early on, health professionals can begin the lengthy discussion about what the injury is, what it is not, and identify what limitations to daily functions may exist.”

When the brain is injured, there are cognitive, emotional, behavioral and physical changes that are experienced. A few of those include: struggling to remember new information, not having the same vigilance or mental energy to attend to daily activities like problem solving, and an impact on the ability to multitask.

The clinic serves soldiers suffering from a mild or even more severe traumatic brain injury during basic training; those injured after multiple deployments, but returning to service; and injured soldiers who are nearing retirement or retired.

These injuries are certainly not a new trend. However, the ability to assess and determine what causes injury or trauma and how it is affecting brain integrity is a growing area of study. Clinical researchers are looking at what repeated exposure to Improvised Explosive Devices (IEDs), or roadside bombs, and other explosions, are having over time to the brain function of those in combat.

It is highly recommended that a survivor of a traumatic brain injury receive care from multiple providers to determine what functionalities are impacted and what symptoms have developed. This team of providers can include any combination of an occupational therapist, physical therapist, speech therapist, nurse, case manager, general psychologist, rehabilitation psychologist, or neuropsychologist.

Hart advises that this interdisciplinary system of care providers should also be communicating with each other for optimal care and to address some possible consequences of the injury.

Although there is a recent increase in the momentum of research and public awareness of military brain injuries and sports concussions, several misconceptions of neuropsychological assessments remain. A common misconception is that providers can rely on conventional neuroimaging alone to understand the brain functionality of those who have incurred traumatic brain injury.

Conventional neuroimaging components such as computerized tomography (CT) scans and magnetic resonance imaging (MRI) scans can only indicate an actual picture of the brain. There could be functional markers of brain dysfunction which cannot be identified through these images alone.

A neuropsychological assessment is a non-invasive evaluation of the brain’s function that tells what brain is capable of doing.

Coupled together, both techniques enable neuropsychologists to observe the various aspects of brain function to determine what someone’s strengths and weaknesses are, as well as provide recommendations for treatment.

“Our neuropsychological clinic will continue to offer state of the art neuropsychological assessments and make recommendations to help survivors enhance their quality of life and return to their work-related duties,” said Hart. “Also, we will continue enhancing our research relationships among other disciplines.”