Resilience and well-being after traumatic brain injury

Abstract

Purpose: This study examined the extent to which resilience is associated with well-being outcomes after traumatic brain injury, and whether those relationships are independent of global personality traits, such as affectivity.

Materials and methods: Sixty-seven adults with complicated-mild to severe traumatic brain injury participated. Measures included the Connor-Davidson Resilience Scale, Modified Cumulative Illness Rating Scale, Disability Rating Scale, SF-12 Health Survey, Satisfaction with Life Scale, and Community Integration Measure.

Results: Objective physical health and disability showed modest relation to resilience, indicating that adverse health conditions and disability decreased with increasing resilience. The three measures of subjective well-being showed modest-to-strong positive relation to resilience. These correlations between resilience and well-being generally remained significant after accounting for negative and positive affectivity. Results also suggest that the influence of resilience on well-being has a threshold effect: a greater influence on outcome among people with low or inadequate resilience than among people with average or high resilience.

Conclusion: The experience of brain injury does not diminish the positive influence resilience may have on long-term well-being. Resilience may function as a buffer to trauma even in the challenging context of cognitive insult. Routine assessment of resilience might be beneficial to the rehabilitation team.

Implications for rehabilitation

• Resilience is positively associated with subjective and objective well-being among adults with moderate-to-severe traumatic brain injury, and it appears to function among adults with traumatic brain injury similarly to adults without cognitive disabilities.

• Resilience overlaps with overarching trait personality constructs such as affectivity; yet, it has unique characteristics and unique value in understanding well-being.

• The adverse effects of low resilience show stronger influence on well-being than do the positive effects of high resilience.

• Routine assessment of resilience might be beneficial to the rehabilitation team in understanding patients and their families, especially in discharge planning, where beliefs about personal capabilities to rebound from adversity shape likely future behavior.

Keywords:

• Traumatic brain injury
• resilience
• outcomes
• psychosocial
• positive psychology

Acknowledgments

The authors thank the participants in this study, as well as Carole Koviak and Robert Kotasek for their contributions to participant recruitment and data collection.

Disclosure statement

The authors have no financial or other conflicts of interest to disclose.

Additional information

Funding

This work was supported by the National Institute on Disability, Independent Living and Rehabilitation Research [grant number H133G080064].