A Conceptual Model of Irritability Following Traumatic Brain Injury: A Qualitative, Participatory Research Study.

BACKGROUND

Individuals with a history of traumatic brain injury (TBI) may have chronic problems with irritability, which can negatively affect their lives.

OBJECTIVES

(1) To describe the experience (thoughts and feelings) of irritability from the perspectives of multiple people living with or affected by the problem, and (2) to develop a conceptual model of irritability.

DESIGN

Qualitative, participatory research.

PARTICIPANTS

Forty-four stakeholders (individuals with a history of TBI, family members, community professionals, healthcare providers, and researchers) divided into 5 focus groups.

PROCEDURES: Each group met 10 times to discuss the experience of irritability following TBI. Data were coded using grounded theory to develop themes, metacodes, and theories.

MEASURES: Not applicable.

RESULTS

A conceptual model emerged in which irritability has 5 dimensions: affective (related to moods and feelings); behavioral (especially in areas of self-regulation, impulse control, and time management); cognitive-perceptual (self-talk and ways of seeing the world); relational issues (interpersonal and family dynamics); and environmental (including environmental stimuli, change, disruptions in routine, and cultural expectations).

CONCLUSIONS

This multidimensional model provides a framework for assessment, treatment, and future research aimed at better understanding irritability, as well as the development of assessment tools and treatment interventions.