Introduction to this Issue: Traumatic Brain Injury

Abstract

Every year in the U.S., there are at least 1.7 million traumatic brain injuries (TBIs), occurring either as an isolated injury or along with other injuries (Faul, Zu, Wald, & Coronado, 2010). TBI is a contributing factor to a third of all injury-related deaths in the U.S. About 75% of TBIs that occur each year are concussions or other forms of mild TBI (Centers for Disease Control and Prevention, 2003). In 2000, direct medical costs and indirect costs, such as lost productivity of TBI, totaled an estimated $76.5 billion in the U.S. (Finkelstein, Corso, & Miller, 2006). This is the first time that Behavioral Sciences & the Law (BSL) has addressed TBI within a themed issue. Previous articles have addressed relevant neuropsychological testing, and in 2008 a special issue of BSL was devoted to brain imaging. The current issue includes contributions from psychiatry, psychology, neuropsychology, legal scholars, medical ethicists, and military physicians, all of whom focus on behavioral aspects of TBI within forensic settings. For many TBI survivors, there will be subsequent involvement in adjudication or litigation processes. The emphasis of this special issue is on forensic perspectives important to behavioral health professionals who are often involved in assessing and caring for persons with TBI, as these individuals will commonly be among the healthcare professionals asked to take on the role of forensic expert. The last decade has seen significant controversies develop at the interface between medicine-psychology and the law. The term of art, “neurolaw,” is transforming the practice of TBI litigation and transforming the legal system (Rozen, 2007). In many cases, the law has raced ahead of the science, particularly with regard to using functional neuroimaging to delineate mild TBI (Granacher, 2008a, 2008b; Wortzel, Filley, Anderson, Oster, & Aciniegas, 2008). Few would disagree with the notion that a neurobehavioral analysis of the forensic issues of TBI is incomplete without consideration of the contributions of neuroimaging. Forensic psychiatry has recently added to these contributions, and it is important for behavioral practitioners to understand the role and limitations of structural neuroimaging information within the overall forensic assessment of TBI (Granacher, 2012, 2013). Whereas the structural neuroimaging