Depression After Brain Injury-The Causal Link

The Defense Abuses Depression

The Defense will argue that Organic Brain Injury Doesn't Get Worse, it Gets Better

Any Decline is Related to Depression
MMPI Abuse

Unquestionably, the most frustrating and disturbing aspect of representing those with brain injuries, is dealing with the character assassination that the defense is using in virtually every case, to try to misdirect the focus from a truly disabling injury. While outright claims of "feigning and malingering" do occur, the more common, and unfortunately often more effective strategy is to label all deficits as a result of a "somatoform disorder", stemming from a pre-injury depression. There exist serious problems with such a diagnosis, and legally it is flawed. Nonetheless, it is effectively being used to confuse and misdirect juries, with often devastating results.

The primary evidence of depression herein comes from the MMPI or MMPI-2, the standard psychological test that has been administered to determine an individual's psychological profile, for generations. Even with uninjured people, the MMPI is a test of questionable value in real world applications. But its validity as a diagnostic tool with injured persons, is worse than minimal, it is contraindicated.

The MMPI is a test not "normed" against injured people. Someone who is going through the central nervous system stressors of a person adapting to a subtle brain injury, will over endorse items on the MMPI that relate to the very symptoms that he or she is having. Does that mean that emotional vulnerability is the reason for his problems? No.

If the question asks you whether you are experiencing X,Y and Z physical and cognitive problems, and you are in fact experiencing such problems, then endorsement of those items, in no way reflects on your pre-injury emotional state.

As explained by Lloyd I. Cripe, Ph.D., in his chapter on the "Use of the MMPI with Mild Closed Head Injury" contained in The Evaluation and Treatment of Mild Traumatic Brain Injury, Lawrence Erlbaum, 1999, at page 296:

The basic reason that neurologic patients elevate on Scales 1, 2, 3, 7 and 8 is that the inventory is loaded with many items that can be endorsed by a neurologic patient because of their neurologic disorders and the resulting real-world problems rather than necessarily due to psychiatric disorders, "emotional factors," or maladjustment. ....

In essence, a neurologic patient may elevate on these scales because of their neurologic symptoms, and not necessarily because of a psychiatric disorder. They may not be somatizing, depressed or maladjusted in any manner, although the profile can easily be misconstrued as indicating that there are "emotional factors" or a psychiatric disturbance on board.

Next: Defense Abuses Depression, cont.

Why subtlebraininjury.com?

subtlebraininjury.com is a website with a mission to educate with respect to the magnitude of brain injury which does not involve coma - injuries that have been labeled by names which grossly minimize their potential impact upon the life of the injured person. This site is brought to you by the advocates of the Brain Injury Law Group, a community of plaintiff's trial lawyers across the United States united by a common interest in serving the rights of persons with traumatic brain injuries and a common commitment to fully understanding the anatomic, medical and psychological aspects of TBI.

Additional Information

For a full treatment of the topic of brain injury, and recovering adequate compensation for those who have survived such injury, please visit our other pages. tbilaw.com A general treatment of all types of brain injury, including severe brain injury and concussion, with a special focus on the legal aspects of recovering full and adequate compensation for such injuries. tbilaw.com has been at the cornerstone of the web advocacy of the Brain Injury Law Group since it went online in 1996. waiting.com A page designed to assist those with issues regarding coma, especially in the acute phase when the doctors are saying "I just don't know." vestibulardisorder.com Addressing vertigo and dizziness resulting from trauma as well as information and resources for vestibular disorders.

Sensory Brain

Disclaimer:

The materials on this World Wide Web site are provided purely for informational purposes and are not legal advice. These materials are intended, but not promised or guaranteed, to be correct, complete, and current. This web site is not intended to be a source of advertising, solicitation or legal advice. Therefore, the reader should not consider this information an invitation for an attorney-client relationship. Readers should not act or rely upon any information contained in this World Wide Web site and should always seek the advice of competent counsel.
The owner of this web site is a law firm, the Johnson Law Office which organized the Brain Injury Law Group. The Johnson Law Office is licensed to practice in the States of Wisconsin , Illinois and Michigan. The Brain Injury Law Group does not wish to represent anyone desiring representation based upon their viewing any portion of this World Wide Web site that fails to comply with all legal and ethical rules in such individuals state. While not intended to do so, but in a good faith effort to comply with all rules and regulation which may be applicable to it, the Brain Injury Law Group hereby informs readers that this site may be construed as advertising and promotional materials. The Brain Injury Law Group makes no representation that it can obtain the same results as reported in this web site in other legal matters.
The transmission of an e-mail request for information does not create an attorney-client relationship, and you should not send us via e-mail any information or facts relating to your legal problem. If you are a client, remember that e-mail may not be secure. WE BELIEVE THAT THE BY FAR PREFERRED METHOD FOR YOU TO CONTACT US IS BY PHONE AT: 1-800-992-9447.