Behavioral Changes and Depression, Disability, and Life Satisfaction in Two Cohorts of Adults With TBI

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Objective

To explore the association between behavior – Frontal Systems Behavioral Scale (FrSBe) – and depression, disability, and life satisfaction in two cohorts of adults with traumatic brain injury (TBI).

Design

Cohort study and a cross-sectional study

Setting

Community

Participants

Fifty-five adults with severe TBI; Sixty-five adults with complicated mild to severe TBI.

Interventions

None.

Main Outcome Measure(s)

Behavior was assessed with the FrSBe’s Apathy, Disinhibition, and Executive Function subscales. Depression status was determined using the Patient Health Questionnaire-9. Disability was measured in the first cohort with the Functional Independence Measure and in the second cohort with the Mayo Portland Adaptability Inventory. Life satisfaction was measured in the first cohort by Percent Back to Normal and in the second cohort by the Participation Assessment with Recombined Tools – Satisfaction.

Results

Cohort 1: Apathy, disinhibition, and executive dysfunction were all significantly associated with depression (t=-4.97 to -2.37, p<.001-.022) and life satisfaction (r=-.681 to -.332, p<.001-.016), and apathy and executive dysfunction were significantly associated with disability (r=-.571 to -360, p<.001-.007). Cohort 2: Apathy, disinhibition, and executive dysfunction were significantly associated with disability (r=.440-.730, p<.001-.035), regardless of time since injury, and with life

Conclusions

For all individuals who sustain a TBI, regardless of initial severity, behavioral changes may negatively influence depression, disability, and life satisfaction, beginning in the first year post-injury and continuing well beyond five years post-injury.Therefore, behavior may represent a viable target – both early after injury and for individuals living in the community – for rehabilitation interventions to improve various long-term outcomes after TBI.

Key Words

Depression, Brain Injury, Impulsive Behavior, Apathy, Executive Function

Disclosure(s)

None Disclosed.

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