Types of brain disorders
Acquired Brain Injury, Traumatic Brain Injury & Brain Disorders
Over the years a brain injury has
been called many things including, head damage, Acquired Brain
Injury and Traumatic Brain Injury.
There are many problems with the wide number of terms used to
describe brain injuries, making it difficult to:
- find relevant information
- form accurate statistics
- apply for funding and research
- create widespread public awareness
- provide consistent support and information services.
Synapse is moving toward using the term 'brain disorder' to
cover all forms of brain injury in order to resolve these
Over 2 million Australians are affected with some form of
Brain Disorder - that's over 1 in 12.
Acquired Brain Injury (ABI) is a complex spectrum disorder
that refers to any type of brain damage or neurological disruption
occurring after birth. The Diagnostic and Statistical Manual of
Mental Disorders 5 (DSM5) has recently moved to the term
'Neurocognitive Disorder' as a descriptor for this condition.
'Neurocognitive Disorder' relates to the same spectrum of
impairments as 'Acquired Brain Injury' with causes including
trauma, vascular disease, Alzheimer's disease and
infection4. The term Neurocognitive Disorder, however,
provides a diagnosis for people experiencing cognitive symptoms
alone, without memory or physical impairments. This means that many
individuals who are not currently receiving recognition or services
(due to the lack of memory or physical impairments) will have this
opportunity for understanding. In view of this shift,
'Neurocognitive Disorder' will be used interchangeably with
'Acquired Brain Injury'.
Due to the complexity of functions the brain undertakes, and the
localization of these functions, organic damage to the brain can
cause a wide range of effects, not limited to cognitive
deficits4. Sight, hearing, and movement can all be
affected by damage to specific areas of the brain. People with
Acquired Brain Injuries therefore, have a higher average number of
co-morbid disabilities than individuals diagnosed with other
disabilities (see Graph 1. below).
Neurocognitive Disorders are also closely correlated with Mental
Health Disorders. A Neurocognitive Disorder is defined by a shift
in abilities and functioning that can often lead to Mental Health
issues. AIHW3 states over 40% of people with an ABI have
a co-morbid Mental Health issue(AIHW). Substance use is also common
within this population, leading to many other complications and
often secondary brain injuries5.
Co-morbid Mental Health and Neurocognitive Disorders can often
lead to social exclusion5. This social exclusion then
regularly leads to homelessness, and can also lead to an increased
risk of entering the criminal justice system5.
Neurocognitive Disorders are over-represented in the prison
population with 65% of people in Australian prisons reporting a
Traumatic Brain Injury in a year in comparison with 32% of people
in the community2. Please note, that the
statistics purporting over 2 million Australians with an ABI does
not include those homeless or in the criminal justice system.
Youth risk-taking behaviour including assault, traffic accidents,
and substance use can also lead to increased incidence of
Neurological Disorders. As you can see from Graph 2. (below), there
is a considerable spike in incidence of ABI for 18-25 years old,
reinforcing the importance of prevention, early-intervention and
harm-minimisation measures to decrease this risk-taking
To reiterate, the term Neurocognitive Disorder will allow for
earlier detection of cognitive issues leading to increased ability
for early intervention. This move will increase the strain on
services that are currently more reactive than proactive. Increased
diagnosis of Neurocognitive Disorders will call for a shift in
service provision, requiring a response from services before
situations deteriorate into crisis.
Further exacerbating the strain on the sector's current
available services is the ageing population. With life expectancy
relatively unaffected, an ABI experienced in earlier life will
continue with someone as they age for the entirety of their life.
The incidence of falls and vascular difficulties increase as people
age. This can magnify existing ABI's as well as lead to new Brain
Injuries in otherwise healthy individuals.
References and further information
- Adjusted from data in World Health Organization.
(2006).Neurological Disorders: Public Health Challenges.
Switzerland: WHO Press.
- Perkes, I., Schofield, P. W., Butler, T., Hollis, S.
J. (2011). Traumatic brain injury rates and sequelae: Acomparison
of prisoners with a matched community sample in Australia.
Brain Injury, 25, 131-141.
- Australian Institute of Health and Welfare. (2007) Disability
in Australia: acquired brain injury. Bulletin no. 55. Cat no. AUS
96. Canberra: AIHW.
- DSM-5: The Future of Psychiatric Diagnosis, http://www.dsm5.org.
- Baldry, E., Dowse, L., Snoyman, P., Clarence, M. & Webster,
I. (2008). A Critical Perspective on Mental Health Disorders and
Cognitive Disability in the Criminal Justice System.
Proceedings of the 2nd Australian & New Zealand
Critical Criminology Conference, 19-20 June 2008.