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

J Neurotrauma. 2013 Apr 15;30(8):642-52

McCauley SR, Wilde EA, Miller ER, Frisby ML, Garza HM, Varghese R, Levin HS, Robertson CS, McCarthy JJ

Abstract There is significant heterogeneity in outcomes following mild traumatic
brain injury (mTBI). While several host factors (age, gender, and preinjury
psychiatric history) 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<0.007). 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 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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