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Longitudinal Examination of Resilience After Traumatic Brain Injury: A Traumatic Brain Injury Model Systems Study
Authors:Jennifer H Marwitz  Adam P Sima  Jeffrey S Kreutzer  Laura E Dreer  Thomas F Bergquist  Ross Zafonte  Douglas Johnson-Greene  Elizabeth R Felix
Institution:1. Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA;2. Department of Biostatistics, Virginia Commonwealth University, Richmond, VA;3. Department of Neurological Surgery, Virginia Commonwealth University, Richmond, VA;4. Department of Psychiatry, Virginia Commonwealth University, Richmond, VA;5. Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL;6. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL;g. Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN;h. Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN;i. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Massachusetts General Hospital, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA;j. Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, FL
Abstract:

Objectives

To evaluate (1) the trajectory of resilience during the first year after a moderate-severe traumatic brain injury (TBI); (2) factors associated with resilience at 3, 6, and 12 months postinjury; and (3) changing relationships over time between resilience and other factors.

Design

Longitudinal analysis of an observational cohort.

Setting

Five inpatient rehabilitation centers.

Participants

Patients with TBI (N=195) enrolled in the resilience module of the TBI Model Systems study with data collected at 3-, 6-, and 12-month follow-up.

Interventions

Not applicable.

Main Outcome Measure

Connor-Davidson Resilience Scale.

Results

Initially, resilience levels appeared to be stable during the first year postinjury. Individual growth curve models were used to examine resilience over time in relation to demographic, psychosocial, and injury characteristics. After adjusting for these characteristics, resilience actually declined over time. Higher levels of resilience were related to nonminority status, absence of preinjury substance abuse, lower anxiety and disability level, and greater life satisfaction.

Conclusions

Resilience is a construct that is relevant to understanding brain injury outcomes and has potential value in planning clinical interventions.
Keywords:Brain injuries  Psychological  Rehabilitation  Resilience  psychological  CD-RISC  Connor-Davidson Resilience Scale  DRS  Disability Rating Scale  GED  General Equivalency Diploma  HS  high school  mTBI  mild traumatic brain injury  PART-O  Participation Assessment with Recombined Tools–Objective  SWLS  Satisfaction With Life Scale  TBI  traumatic brain injury  TBIMS  Traumatic Brain Injury Model System
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