Trajectories of Life Satisfaction After Traumatic Brain Injury: Influence of Life Roles, Age, Cognitive Disability, and Depressive Symptoms

• Published in: Rehabilitation psychology 2015-11, Vol.60 (4), p.353-364
• Main Authors: Juengst, Shannon B, Adams, Leah M, Bogner, Jennifer A, Arenth, Patricia M, O'Neil-Pirozzi, Therese M, Dreer, Laura E, Hart, Tessa, Bergquist, Thomas F, Bombardier, Charles H, Dijkers, Marcel P, Wagner, Amy K
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Differences; Age Factors; Brain Injuries - diagnosis; Brain Injuries - psychology; Brain Injuries - rehabilitation; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Cognition Disorders - rehabilitation; Cognitive Ability; Culture; Depressive Disorder - diagnosis; Depressive Disorder - psychology; Depressive Disorder - rehabilitation; Disabilities; Disability Evaluation; Female; Human; Humans; Life Satisfaction; Longitudinal Studies; Major Depression; Male; Middle Aged; Models, Psychological; Personal Satisfaction; Prospective Studies; Quality of Life - psychology; Role; Roles; Statistics as Topic; Symptoms; Traumatic Brain Injury; Young Adult
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000056

Objectives: (a) Identify life satisfaction trajectories after moderate to severe traumatic brain injury (TBI); (b) establish a predictive model for these trajectories across the first 5 years postinjury; and (c) describe differences in these life satisfaction trajectory groups, focusing on age, depressive symptoms, disability, and participation in specific life roles. Research Method: Analysis of the longitudinal TBI Model Systems National Database was performed on data collected prospectively at 1-, 2-, and 5-years post-TBI. Participants (n = 3,012) had a moderate to severe TBI and were 16 years old and older. Results: Four life satisfaction trajectories were identified across the first 5 years postinjury, including: stable satisfaction, initial satisfaction declining, initial dissatisfaction improving, and stable dissatisfaction. Age, depressive symptoms, cognitive disability, and life role participation as a worker, leisure participant, and/ or religious participant at 1-year postinjury significantly predicted trajectory group membership. Life role participation and depressive symptoms were strong predictors of life satisfaction trajectories across the first 5 years post-TBI. Conclusions: The previously documented loss of life roles and prevalence of depression after a moderate to severe TBI make this a vulnerable population for whom low or declining life satisfaction is a particularly high risk. Examining individual life role participation may help to identify relevant foci for community-based rehabilitation interventions or supports.