Research Reports - Preinjury coping, emotional functioning, and quality of life following uncomplicated and complicated mild traumatic brain injury

J Head Trauma Rehabil. 2013 Mar 26

Maestas KL, Sander AM, Clark AN, van Veldhoven LM, Struchen MA, Sherer M, Hannay HJ

OBJECTIVE:: To identify preinjury coping profiles among adults with uncomplicated
mild traumatic brain injury (mTBI) and complicated mTBI and to determine whether
preinjury coping profiles contribute to the prediction of emotional functioning
and quality of life (QOL) 3 months post-mTBI. PARTICIPANTS:: One hundred
eighty-seven persons with medically documented mTBI (uncomplicated mTBI, n = 89;
complicated mTBI, n = 98) were recruited from the emergency center of a level I
trauma center and followed in community 3 months post-mTBI. MEASURES:: The Ways
of Coping Questionnaire was administered within 2 weeks of injury. Cluster
analysis was used to group participants on basis of their preinjury use of
problem-focused and avoidant coping strategies. The Brief Symptom Inventory and
the 36-item Short-Form Health Survey were administered 3 months postinjury.
RESULTS:: Cluster analysis distinguished 3 distinct preinjury coping profiles
that were differentially associated with outcomes. Participants who used avoidant
coping showed the worse emotional functioning and QOL outcomes, although this
cluster also reported high usage of problem-focused strategies. Preinjury coping
profiles explained a significant proportion of the variance in depression,
anxiety, and mental health QOL at 3 months postinjury beyond that accounted for
by demographic characteristics and mTBI severity. CONCLUSIONS:: Cluster analysis
holds practical value in illustrating the pattern of coping strategies used by
person with uncomplicated and complicated mTBI. It appears worthwhile to address
coping in future trials of interventions that are aimed at improving emotional
functioning after mTBI.

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