Research Reports - Gender differences in awareness and outcomes during acute traumatic brain injury recovery

J Womens Health (Larchmt). 2014 Jul;23(7):573-80

Niemeier JP(1), Perrin PB, Holcomb MG, Rolston CD, Artman LK, Lu J, Nersessova KS

Abstract Background: Recent literature on traumatic brain injury (TBI), though
mixed when reporting outcomes, seems collectively to suggest possible gender
advantage for women in postinjury recovery, especially in executive functions.
Hormonal neuroprotection, through female reproductive hormones, is often proposed
as an underlying factor in these results. We explored potential gender
differences in an aspect of executive functions, self-awareness (SA), which is
often impaired after TBI, limits patient effort in critical rehabilitation, and
increases caregiver burden. Methods: Within a prospective survey,
repeated-measures design, 121 patients with moderate or severe TBI undergoing
acute rehabilitation in a Level 1 trauma center, a family member or caregiver
informant, and a treating clinician were asked to complete the Patient Competency
Rating Scale (PCRS) and the Frontal Systems Behavior Scale (FrSBe) at admission
and discharge. Results: Although overall, women and men with TBI showed generally
similar levels of SA, women had significantly better awareness of their
injury-related deficits at acute rehabilitation discharge, even when controlling
for age, education, and injury severity. Conclusions: Mixed findings in this
study mirror the pattern of results that dominate the published literature on
gender and TBI. Gender differences in executive dysfunction may not be as large
or robust as some researchers argue. In addition, complex interplays of
socialization, gender-role expectations, naturally occurring male and female
ability differences, and differences in access to postinjury rehabilitation are
understudied potential moderators.

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