Citation

Agtarap SD, Campbell-Sills L, Jain S, Sun X, Dikmen S, Levin H, McCrea M, Mukherjee P, Nelson LD, Temkin N, Yuh EL, Giacino JT, Manley GT, Investigators TTT. J. Neurotrauma 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7055

PMID

33107371

Abstract

Identifying the principal determinants of life satisfaction following mild TBI (mTBI) may inform efforts to improve subjective well-being in this population. We examined life satisfaction among participants in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study who presented with mTBI (Glasgow Coma Scale=13-15; N=1,152). An L1-regularization path algorithm was used to select optimal sets of baseline and concurrent symptom measures for prediction of scores on the Satisfaction with Life Scale (SWLS) at 2 weeks and 3, 6, and 12 months post-injury. Multivariable linear regression models (ns=744-894) were then fit to evaluate associations between the empirically-selected predictors and SWLS scores at each follow-up visit.

RESULTS indicated that emotional post-TBI symptoms (b's= -1.27 to -0.77, ps<.05), anhedonia (b's = -1.59 to -1.08, ps<.01), and pain interference (b's= -1.38 to -0.89, ps<.001) contributed to the prediction of lower SWLS scores at all follow-ups. Insomnia predicted lower SWLS scores at 2 weeks, 3 months, and 6 months (b's= -1.11 to -0.83, ps<.01); and negative affect predicted lower SWLS scores at 2 weeks, 3 months, and 12 months (b's= -1.38 to -0.80, ps<.005). Other post-TBI symptom domains and baseline socio-demographic, injury-related, and clinical characteristics did not emerge as robust predictors of SWLS scores during the year after mTBI. Efforts to improve satisfaction with life following mTBI may benefit from a focus on the detection and treatment of affective symptoms, pain, and insomnia. The results reinforce the need for tailoring of evidence-based treatments for these conditions to maximize efficacy in patients with mTBI.

Language: en

Keywords

TRAUMATIC BRAIN INJURY; OUTCOME MEASURES; PROSPECTIVE STUDY