Research Reports - Preinjury resilience and mood as predictors of early outcome following mild traumatic brain injury

J Neurotrauma. 2012 Oct 9

McCauley SR, Wilde EA, Miller ER, Frisby ML, Garza HM, Varghese R, Levin H, Robertson CS, McCarthy J.

There is significant heterogeneity in outcomes following mild traumatic brain
injury (mTBI). While several host factors (age, gender, preinjury psychiatric
history, etc.) have been investigated, the influence of preinjury psychological
resilience and mood status in conjunction with mild TBI remains relatively
unexplored. Euthymic mood and high resilience are potentially protective against
anxiety and postconcussion symptoms, but their relative contributions are
currently unknown. This prospective study obtained preinjury estimates of
resilience and mood measures in addition to measures of anxiety (Acute Stress
Disorder Scale and PTSD-Checklist-Civilian form) and postconcussion symptom
severity (Rivermead Post Concussion Symptoms Questionnaire) < 24 hours
(Baseline), 1 week, and 1 month postinjury in patients with either mTBI (n=46) or
a comparison group with orthopedic injuries not involving the head (OI, n=29).
The groups did not differ on preinjury resilience or mood status at Baseline, but
differed significantly on measures of anxiety and postconcussion symptom severity
at each subsequent study occasion. Multivariate linear regression analyses were
conducted to determine if preinjury resilience and mood were significant
contributors to anxiety and postconcussion symptoms during the first month
postinjury after accounting for other known host factors (e.g., age at injury,
gender, and education). Injury group and preinjury mood status were significant
predictors for all three dependent variables at each study occasion (all p <
.007). Preinjury resilience showed a positive trend only for acute stress
severity at baseline, but demonstrated significant prediction of all three
dependent measures at one week and one month postinjury. These results suggest
that preinjury depressed mood and low resilience are significant contributors to
the severity of postinjury anxiety and postconcussion symptoms, even after
accounting for effects of other specific host factors.

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