Collaborative Research Explores Emotional Dysfunction After Traumatic Brain Injury

To female researchers reviewing data on a computer monitor.

After traumatic brain injury (TBI), it is common for individuals to experience difficulties regulating their emotions and behaviors, leading to anger and aggression that may negatively impact their relationships and societal participation. Currently, evidence-based treatments addressing these emotional challenges are lacking. A collaborative study funded by The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) is exploring this topic to better understand why events in everyday life result in feelings of anger and aggression in people with chronic TBI. Led by Flora Hammond, MD, and Dawn Neumann, PhD, at Indiana University, the Reactions Events Appraisals and Context in TBI (REACT) Study spans five Traumatic Brain Injury Model Systems Sites (Indiana University School of Medicine, Moss Rehabilitation Research Institute (MRRI), TIRR Memorial, Spaulding Rehabilitation, and Craig Hospital).

At MRRI, Amanda Rabinowitz, PhD, serves as the site principal investigator for the REACT Study. Dr. Rabinowitz brings to this project extensive experience using mobile technology for assessment and treatment of people with TBI, as well as expertise in ecological momentary assessment (EMA). EMA involves real-time data collection which can be more accurate than relying on recall of past events. Dr. Rabinowitz has completed various studies using EMA and is currently working on a separate ongoing project characterizing the temporal dynamics of chronic post-concussion symptoms.1-4

In the REACT Study, researchers will sample the thoughts, feelings, and experiences of people with TBI during their daily lives using an accessible mobile application. Participants will report on their experiences of frustrating events, and their emotional and behavioral responses over a two-week period. The study will also examine potential connections between these emotional reactions and factors including the circumstances, patient characteristics, how they assess real-life situations, and their methods of emotional management.

Gaining insight into why people with TBI experience anger and aggression will help scientists and clinicians improve care in a number of ways — by developing better educational approaches for patients and their families, refining screening methods to identify patients at risk, and informing targeted treatments to improve outcomes. “By leveraging valuable collaborations through the TBI Model Systems, this project will bring us closer to developing effective evidence-based interventions to help people with TBI better manage their emotions in real-world situations,” Dr. Rabinowitz remarked.


1) Rabinowitz, A. R., & Fisher, A. J. (2020). Person-specific methods for characterizing the course and temporal dynamics of concussion symptomatology: a pilot study. Scientific reports, 10(1), 1-9.