@article{ref1,
title="Fatigue as a cause, not a consequence of depression and daytime sleepiness: A cross-lagged analysis",
journal="Journal of head trauma rehabilitation",
year="2014",
author="Schönberger, Michael and Herrberg, Marlene and Ponsford, Jennie",
volume="29",
number="5",
pages="427-431",
abstract="OBJECTIVES:: To examine the temporal relation between fatigue, depression, and daytime sleepiness after traumatic brain injury. Fatigue is a frequent and disabling consequence of traumatic brain injury (TBI). However, it is unclear whether fatigue is a primary consequence of the structural brain injury or a secondary consequence of injury-related sequelae such as depression and daytime sleepiness. PARTICIPANTS:: Eighty-eight adults with complicated mild-severe TBI (69% male). MAIN MEASURES:: Fatigue Severity Scale; depression subscale of the Hospital Anxiety and Depression Scale; Epworth Sleepiness scale at baseline and 6-month follow-up. RESULTS:: A cross-lagged path analysis computed within a structural equation modeling framework revealed that fatigue was predictive of depression (β = .20, P < .05) and sleepiness (β = .25, P < .05). However, depression and sleepiness did not predict fatigue (P > .05). CONCLUSIONS:: The results support the view of fatigue after TBI as &quot;primary fatigue&quot;--that is, a consequence of the structural brain injury rather than a secondary consequence of depression or daytime sleepiness. A rehabilitation approach that assists individuals with brain injury in learning to cope with their neuropsychological and physical limitations in everyday life might attenuate their experience with fatigue.<p /> <p>Language: en</p>",
language="en",
issn="0885-9701",
doi="10.1097/HTR.0b013e31829ddd08",
url="http://dx.doi.org/10.1097/HTR.0b013e31829ddd08"
}