Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury

Brain Inj. 2014;28(12):1542-50. doi: 10.3109/02699052.2014.934285. Epub 2014 Jul 16.

Abstract

Primary objective: To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI).

Research design: Longitudinal study.

Methods and procedures: Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity.

Main outcomes and results: Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories.

Conclusions: Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.

Keywords: Coping; distress; post-traumatic stress disorder; resilience; trauma; traumatic brain injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Anxiety / diagnosis*
  • Anxiety / etiology
  • Anxiety / psychology
  • Brain Injuries / complications
  • Brain Injuries / physiopathology
  • Brain Injuries / psychology*
  • Depression / diagnosis*
  • Depression / etiology
  • Depression / psychology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Resilience, Psychological*
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / psychology
  • Substance-Related Disorders / diagnosis*
  • Substance-Related Disorders / etiology
  • Substance-Related Disorders / psychology
  • Time Factors