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Demographic and cognitive predictors of long-term psychosocial outcome following traumatic brain injury

Published online by Cambridge University Press:  17 May 2006

RODGER LL. WOOD
Affiliation:
Department of Psychology, School of Human Sciences, University of Wales Swansea, Swansea, United Kingdom
NEIL A. RUTTERFORD
Affiliation:
Department of Psychology, School of Human Sciences, University of Wales Swansea, Swansea, United Kingdom

Abstract

Demographic factors and cognitive impairment have been found previously to have associations with outcome after brain injury. Kendall and Terry (1996) suggest that preinjury psychosocial functioning, neurological factors, and cognitive impairment have a direct relationship with multidimensional psychosocial adjustment, but that cognitive impairment also has an indirect relationship by means of the mediation of appraisal and coping variables. The aim of this study was to explore these theoretical relationships at very late stages of recovery after brain injury. A total of 131 participants who were more than 10 years after injury (mean = 15.31 yr) completed a neuropsychological assessment, plus outcome measures that included employment status, community integration, life satisfaction, quality of life (QoL), and emotion. Results indicated that injury severity was predictive of life satisfaction; gender and relationship status predicted community integration; and age at injury predicted employment status. Impairment in working memory directly predicted all outcomes except QoL and anxiety. An indirect relationship was also evident between working memory, life satisfaction, and depression. Results partially support Kendall and Terry's model but the variables that significantly influence outcome seem to be determined by the outcome dimensions selected. (JINS, 2006, 12, 350–358.)

Type
Research Article
Copyright
© 2006 The International Neuropsychological Society

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References

REFERENCES

Baddeley, A., Emslie, H., & Nimmo Smith, I. (1992). The speed and capacity of language-processing test. Bury St. Edmunds, England: Thames Valley Test Company.
Baron, R.M. & Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 11731182.CrossRefGoogle Scholar
Bartlett, M.S. (1954). A note on the multiplying factors for various chi square approximations. Journal of the Royal Statistical Society, 16, 296298.Google Scholar
Boake, C., Millis, S.R., High, W.M.J., Delmonico, R.L., Kreutzer, J.S., Rosenthal, M., Sherer, M., & Ivanhoe, C. (2001). Using early neuropsychological testing to predict long-term productivity outcome from traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 82, 761768.CrossRefGoogle Scholar
Brooks, D.N., Campsie, L., Symington, C., Beattie, A., & McKinlay, W. (1986). The five-year outcome of severe blunt head injury: A relative's view. Journal of Neurology Neurosurgery and Psychiatry, 49, 764770.CrossRefGoogle Scholar
Burgess, P.W. & Shallice, T. (1997). The Hayling and Brixton Tests. Bury St. Edmunds, England: Thames Valley Test Company Limited.
Carver, C.S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92100.CrossRefGoogle Scholar
Colantonio, A., Ratcliff, G., Chase, S., Kelsey, S., Escobar, M., & Vernich, L. (2004). Long term outcomes after moderate to severe traumatic brain injury. Disability and Rehabilitation, 26, 253261.CrossRefGoogle Scholar
Corrigan, J.D. & Deming, R. (1995). Psychometric characteristics of the community integration questionnaire: Replication and extension. Journal of Head Trauma Rehabilitation, 10, 4153.CrossRefGoogle Scholar
Corrigan, J.D., Smith-Knapp, K., & Granger, C.V. (1998). Outcomes in the first 5 years after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 79, 298305.CrossRefGoogle Scholar
Dawson, D.R., Levine, B., Schwartz, M., & Stuss, D.T. (2000). Quality of life following traumatic brain injury: A prospective study. Brain and Cognition, 44, 3539.Google Scholar
Deb, S., Lyons, I., & Koutzoukis, C. (1999). Neurobehavioural symptoms one year after a head injury. British Journal of Psychiatry, 174, 360365.CrossRefGoogle Scholar
Diener, E., Emmons, R.A., Larsen, R.J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 7175.CrossRefGoogle Scholar
Dijkers, M. (1997). Measuring the long-term outcomes of traumatic brain injury: A review of the community integration questionnaire. Journal of Head Trauma Rehabilitation, 12, 7491.CrossRefGoogle Scholar
Groswasser, Z., Melamed, S., Agranov, E., & Keren, O. (1999). Return to work as an integrative outcome measure following traumatic brain injury. Neuropsychological Rehabilitation, 9, 493504.CrossRefGoogle Scholar
Heinemann, A.W. & Whiteneck, G.G. (1995). Relationships among impairment, disability, handicap, and life satisfaction in persons with traumatic brain injury. Journal of Head Trauma Rehabilitation, 10, 5463.CrossRefGoogle Scholar
Hoofien, D., Gilboa, A., Vakil, E., & Donovick, P.J. (2001). Traumatic brain injury (TBI) 10–20 years later: A comprehensive outcome study of psychiatric symptomology, cognitive abilities and psychosocial functioning. Brain Injury, 15, 189209.Google Scholar
Jennett, B., Snoek, J., Bond, M.R., & Brooks, N. (1981). Disability after severe head injury: Observations on the use of the Glasgow Outcome Scale. Journal of Neurology Neurosurgery and Psychiatry, 44, 285293.CrossRefGoogle Scholar
Johnstone, B., Hexum, C.L., & Ashkanazi, G. (1995). Extent of cognitive decline in traumatic brain injury based on estimates of premorbid intelligence. Brain Injury, 9, 377384.CrossRefGoogle Scholar
Kaiser, H. (1970). A second generation little jiffy. Psychometrika, 35, 401415.CrossRefGoogle Scholar
Kaiser, H. (1974). An index of factorial simplicity. Psychometrika, 39, 3136.CrossRefGoogle Scholar
Kendall, E. & Terry, D.J. (1996). Psychosocial adjustment following closed head injury: A model for understanding individual differences and predicting outcome. Neuropsychological Rehabilitation, 6, 101132.CrossRefGoogle Scholar
Klonoff, P.S., Costa, L.D., & Snow, W.G. (1986). Predictors and indicators of quality of life in patients with closed head injury. Journal of Clinical and Experimental Neuropsychology, 8, 469485.CrossRefGoogle Scholar
Levin, H.S., Gary, H.E., Eisenberg, H.M., Ruff, R.M., Barth, J.T., Kreutzer, J., High, W.M., Portman, S., Foulkes, M.A., Jane, J.A., Marmarou, A., & Marshall, L.C. (1990). Neurobehavioural outcome 1-year after severe head injury—experience of the traumatic coma data-bank. Journal of Neurosurgery, 73, 699709.CrossRefGoogle Scholar
Lewin, W., Marshall, T.F., & Roberts, A.H. (1979). Long-term outcome after severe head injury. British Medical Journal, 2, 15331538.CrossRefGoogle Scholar
McAuley, E., Duncan, T.E., & Russell, D.W. (1992). Measuring causal attributions: The revised Causal Dimension Scale (CDSII). Personality and Social Psychology Bulletin, 18, 566573.CrossRefGoogle Scholar
McMillan, T.M., Jongen, E.L.M.M., & Greenwood, R.J. (1996). Assessment of post-traumatic amnesia after severe closed head injury: Retrospective or prospective? Journal of Neurology Neurosurgery and Psychiatry, 60, 422427.Google Scholar
Moorey, S., Greer, S., Watson, M., Gorman, C., Rowden, L., Tunmore, L., Tunmore, R., Robertson, B., & Bliss, J. (1991). The factor structure and factor stability of the hospital anxiety and depression scale in patients with cancer. British Journal of Psychiatry, 158, 255259.CrossRefGoogle Scholar
Novack, T.A., Bush, B.A., Meythaler, J.M., & Canupp, K. (2001). Outcome after traumatic brain injury: Pathway analysis of contributions from premorbid, injury severity, and recovery variables. Archives of Physical Medicine and Rehabilitation, 82, 300305.CrossRefGoogle Scholar
Rapoport, M.J., McCullagh, S., Shammi, P., & Feinstein, A. (2005). Cognitive impairment associated with major depression following mild and moderate traumatic brain injury. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 6165.CrossRefGoogle Scholar
Reitan, R.M. & Wolfson, D. (1985). The Halstead-Reitan Neuropsychological Test Battery. Tucson: Neuropsychology Press.
Ross, S.R., Millis, S.R., & Rosenthal, M. (1997). Neuropsychological prediction of psychosocial outcome after traumatic brain injury. Applied Neuropsychology, 4, 165170.CrossRefGoogle Scholar
Ruff, R.M., Marshall, L.F., Crouch, J., Klauber, M.R., Levin, H.S., Barth, J., Kreutzer, J., Blunt, B.A., Foulkes, M.A., Eisenberg, H.M., Jane, J.A., & Mamarou, A. (1993). Predictors of outcome following severe head trauma—follow-up data from the traumatic coma data-bank. Brain Injury, 7, 101111.CrossRefGoogle Scholar
Rutterford, N.A. & Wood, R.Ll. (2006, this issue). Evaluating a theory of stress and adjustment when predicting long term psychosocial outcome after brain injury. Journal of the International Neuropsychological Society, 12, 359367.Google Scholar
Schwarzer, R. (1993). Measurement of perceived self-efficacy: Psychometirc scales for cross-cultural research. Berlin: Freie Universitat.
Seibert, P.S., Reedy, D.P., Hash, J., Webb, A., Stridh-igo, P., Basom, J., & Zimmerman, C.G. (2002). Brain injury: Quality of life's greatest challenge. Brain Injury, 16, 837848.CrossRefGoogle Scholar
Sherer, M., Sander, A.M., Nick, T.G., High, W.M., Jr., Malec, J.F., & Rosenthal, M. (2002a). Early cognitive status and productivity outcome after traumatic brain injury: Findings from the TBI model systems. Archives of Physical Medicine and Rehabilitation, 83, 183192.Google Scholar
Sherer, M., Novack, T.A., Sander, A.M., Struchen, M.A., Alderson, A., & Thompson, R.N. (2002b). Neuropsychological assessment and employment outcome after traumatic brain injury: A review. The Clinical Neuropsychologist, 16, 157178.Google Scholar
Tabachnick, B. & Fidell, L.S. (2001). Using multivariate statistics. Boston: Allyn and Bacon.
Thomsen, I.V. (1984). Late outcome of very severe blunt head trauma: A 10–15 year second follow-up. Journal of Neurology, Neurosurgery and Psychiatry, 47, 260268.CrossRefGoogle Scholar
Wagner, A.K., Hammond, F.N., Sasser, H.C., & Wiercisiewski, D. (2002). Return to productive activity after traumatic brain injury: Relationship with measures of disability, handicap and community integration. Archives of Physical Medicine and Rehabilitation, 83, 107114.CrossRefGoogle Scholar
Wechsler, D. (1997a). Wechsler Adult Intelligence Scale—Third Edition. San Antonio, TX: The Psychological Corporation.
Wechsler, D. (1997b). Wechsler Memory Scale—Third Edition. San Antonio, TX: The Psychological Corporation.
Willer, B., Linn, R.T., & Allen, K. (1993a). Community integration and barriers to integration for individuals with brain injury. In M.A.J. Finlayson & S. Garner (Eds.), Brain injury rehabilitation: Clinical considerations (pp. 355375). Baltimore: Williams and Wilkins.
Willer, B., Rosenthal, M., Kreutzer, J.S., Gordon, W.A., & Rempel, R. (1993b). Assessment of community integration following rehabilitation for traumatic brain injury. Journal of Head Trauma Rehabilitation, 8, 7587.Google Scholar
Willer, B., Ottenbacher, K.J., & Coad, M.L. (1994). The community integration questionnaire: A comparative examination. American Journal of Physical Medicine and Rehabilitation, 73, 103111.CrossRefGoogle Scholar
Wood, R.Ll. & Rutterford, N.A. (2006). Psychosocial adjustment 17 years after severe brain injury. Journal of Neurology Neurosurgery and Psychiatry, 77, 7173.CrossRefGoogle Scholar
Wood, R.Ll. & Rutterford, N.A. (in press a). The effect of litigation on long term cognitive and social outcome after severe brain injury. Archives of Clinical Neuropsychology.
Wood, R.Ll. & Rutterford, N.A. (in press b). The long term impact of head trauma on intellectual abilities: A 16 year outcome study. Journal of Neurology, Neurosurgery and Psychiatry.
Wood-Dauphinee, S.L., Opzoomer, M.A., Williams, J.I., Marchand, B., & Spitzer, W.O. (1988). Assessment of global function: The reintegration to normal living index. Archives of Physical Medicine and Rehabilitation, 69, 583590.Google Scholar
Zigmond, A.S. & Snaith, R.P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361370.CrossRefGoogle Scholar