Mental Side Effects of TBI: The Question of Addictive Personality

Written by Arleigha Cook ’16

In considering the many emotional side-effects of Traumatic Brain Injury (TBI) that can lead to diagnoses such as depression, anxiety, bipolar, etc., one of the central questions I found myself asking is that of whether or not an “addictive personality” exists.

The question of addictive personalities became a topic of discussion in my abnormal psychology class a few days ago.  As the topic was further discussed, turned over, and considered, I began to relate it to TBI.  I thought about how certain survivors—especially former athletes—will say that they feel “more impulsive” or that they “just don’t think” about what they are doing at times.  It became more and more apparent to me that there is probably a considerable connection between addictive personality tendencies and TBI.

There are biological, psychological, and sociocultural factors that determine whether or not one is likely to have addictive personality tendencies.  These three perspectives represent the biopsychosocial model, a theory that posits mental illness (including depression, anxiety, anorexia, and others) is derived from the interaction of biological, psychological, and sociocultural factors.  This post will discuss these three perspectives in detail and how they relate TBI to addictive personality tendencies, with particular emphasis placed on former athletes who have sustained a TBI.

Biological Perspective

Biology is a more influential factor in personality tendencies than previously supposed.  Research shows that temperament is largely heritable (see the 2005 study “Behavioral Genetics and Child Temperament” conducted at Boston University), and by definition it includes traits that dictate how “impulsive,” “sensation-seeking,” and “neurotic” a person is.  In other words, these traits run in families—and sometimes they do not show until they are triggered by a certain event or other psychological or sociocultural factors.  In a TBI patient’s case, the trigger is usually the brain injury itself.  Thus, survivors may already be predisposed to increased impulsivity, the seeking out of certain sensations as a result of said increased impulsivity, and emotional instability.  These traits may only show post-injury, and many TBI survivors I know have told me that they feel like a different person since the onset of these “new” personality traits.  This certainly speaks to the complexity of our genetic makeup and the extent to which a concussion or other TBI can alter genetic expression.

I relate collegiate and professional athletes to these biological causal factors because athletes already seem to be more impulsive, sensation-seeking, and (sometimes) emotionally unstable than other people.  Further postulation led me to consider that one or more of these biological traits may be the reason that a particular athlete plays a sport in the first place.  A young man may be so sensation-seeking that he is driven to partake in an activity where he can get hit, hit people back, sprint, leap, jump, you name it.  Then, a few years later, you learn that this young man receives a full ride to Florida State University because he’s so “aggressive” that he has no problem winning games for his team.  It can be said that athletes who go on to participate in higher levels of a sport are usually the ones who already make risky decisions on the field (specifically soccer and football).  And it’s no stretch to say that making risky decisions on the field—and subsequently finding success—can translate to a proneness to making similar decisions off the field.  If this theory holds true, athletes are particularly vulnerable to the consequences of impulsivity after sustaining a TBI.

Psychological Perspective

It is true that psychological factors or vulnerabilities can increase one’s proclivity for developing an addictive personality.  These include dependent personality characteristics, such as immaturity and praise seeking; depressive personality style, such as consistently “seeing the negative”; and low frustration tolerance.  For high-level athletes, failure is usually not an option.  A commendable performance is required at all times, and those athletes who go on to sustain a TBI struggle with  their low frustration and failure tolerance (because, as we all know, TBI survivors don’t always find success—and we almost never find the kind of “success” for which professional athletes strive).  Many times, an athlete’s emotional state depends on his or her success.  Expectedly, “success” acquires varying definitions for varying athletes and can take the form of perfectionism.  To those who view anything less than perfect as failure, recovery from TBI can be excruciating.

Praise is another conversation.  An athlete is used to receiving praise from coaches, peers, other players, trainers, etc.  With the incurrence of TBI comes a significant decrease or a sharp cut off from praise for former athletic prowess.  Once that source of confidence is gone, a former athlete may choose to seek acceptance or praise from others in different forms.  This often leads to actions such as drinking or gambling, which can be highly addictive.  Also, the loss that former athletes experience is traumatic in itself without the brain injury and can easily create or trigger a depressive personality style, leading them to compare the present to their “former lives.”  Thus, the co-occurrence of these psychological phenomena can become dangerous should they go unmonitored.

Sociocultural Perspective

Family characteristics and rituals are often influential factors on behavior and cognition.  Parental modeling and socioeconomic status (SES) are two sociocultural factors to which I would like to draw particular attention.  Growing up, children often learn coping strategies from their parents.  If, for example, a child’s parent drinks to cope with stress or to feel more at ease, then the child may be more likely to participate in that behavior because it was displayed by a parent or caregiver as a viable coping mechanism.  A lower SES can have an adverse effect on families as well.  It is an added stressor that has the potential to create an unsupportive family environment if the parents are constantly working instead of monitoring the children.  A TBI survivor may or may not be affected by these circumstances, but they can become powerful influences in a person’s recovery and likelihood of developing what some people call an “addictive personality.”


In the end, it is thought that there isn’t actually an addictive personality.  There are, however, specific biological, psychological, and sociocultural factors (as gathered from the biopsychosocial model) that can combine to create addictive tendencies.  My professor’s short answer to the question of whether or not there exists an addictive personality was “yes and no.”  And this is why athletes who sustain TBI are, I believe, particularly prone to developing or fostering previously-existing addictive tendencies.  Then, with a triggering event (likely the onset of TBI), the struggle with addiction begins.  Some people struggle with going “cold turkey” on their addiction to the sport, and others end up developing other addictions, but that’s a topic for another day.