Original research
Resilience Following Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study

https://doi.org/10.1016/j.apmr.2015.12.003Get rights and content

Abstract

Objective

To examine resilience at 3 months after traumatic brain injury (TBI).

Design

Cross-sectional analysis of an ongoing observational cohort.

Setting

Five inpatient rehabilitation centers, with 3-month follow-up conducted primarily by telephone.

Participants

Persons with TBI (N=160) enrolled in the resilience module of the TBI Model System study with 3-month follow-up completed.

Interventions

Not applicable.

Main Outcome Measure

Connor-Davidson Resilience Scale.

Results

Resilience scores were lower than those of the general population. A multivariable regression model, adjusting for other predictors, showed that higher education, absence of preinjury substance abuse, and less anxiety at follow-up were significantly related to greater resilience.

Conclusions

Analysis suggests that lack of resilience may be an issue for some individuals after moderate to severe TBI. Identifying persons most likely at risk for low resilience may be useful in planning clinical interventions.

Section snippets

Participants

Participants were a subset of enrollees in the TBIMS National Database, a longitudinal, multicenter study of TBI funded by the National Institute on Disability, Independent Living, and Rehabilitation Research.29 Inclusion criteria required an age >18 years, care in a TBIMS-affiliated trauma center within 72 hours of injury, receipt of inpatient TBIMS rehabilitation, and English speaking.

Eligible participants were recruited from 5 TBIMS centers. This study is cross-sectional and part of a larger

Results

Participants had a mean ± SD CD-RISC score of 76.8±17.3. Overall, the sample's score was significantly (P=.004) lower than the scores derived from the general population (mean ± SD, 80.4±12.8; n=577).21 The most highly endorsed resilience items for the present sample were related to pride in accomplishments, supportive relationships, and persistence. Items with the lowest endorsement were related to feeling in control, maintaining focus, and feeling strengthened by stress.

Overall, the sample

Discussion

This multicenter study documented the extent of resilience at 3 months postinjury in adults living in the community after moderate-severe TBI. These individuals, who had been acutely hospitalized and then received inpatient rehabilitation, had lower levels of resilience than persons in the general population.21 The present findings are consistent with those in the current literature showing lower levels of resilience after pediatric and adult TBI.24, 26 A number of variables demonstrated a

Conclusions

Early postinjury resilience levels for individuals with moderate to severe TBI were lower than those in the general population. Postacute emotional distress and disability, less education, and higher levels of preinjury substance abuse are clearly related to lower resilience. Individuals with these characteristics may be a priority for clinical intervention. Future studies should be aimed at longitudinal assessment of the relationship between resilience and these important variables of

Supplier

  • a.

    SAS version 9.4; SAS Institute Inc.

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  • Cited by (0)

    Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant nos. 90DP0030, 90DP0033, 90DP0034, H133A120096, H133A120099). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this manuscript do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

    Disclosures: none.

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