Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury

Abstract

Primary objective: To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI).

Research design: Longitudinal study.

Methods and procedures: Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity.

Main outcomes and results: Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories.

Conclusions: Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.

• Coping
• distress
• post-traumatic stress disorder
• resilience
• trauma
• traumatic brain injury

Acknowledgements

The authors are grateful to all the persons for their participation. Thanks to Morten Hestnes and Nils Oddvar Skaga from the Oslo University Hospital’s Trauma Registry, for the extraction of trauma scores. S. Sigurdardottir received grant support from the South-Eastern Norway Regional Health Authority (Ref: 2005-217).