@article{ref1,
title="Self-reported driving difficulty in veterans with traumatic brain injury: its central role in psychological well-being",
journal="PM & R : the journal of injury, function, and rehabilitation",
year="2017",
author="Winter, Laraine and Moriarty, Helene J. and Short, Thomas H.",
volume="9",
number="9",
pages="901-909",
abstract="BACKGROUND: The ability to drive is a core function supporting independent living. Traumatic brain injury (TBI) may impair driving capacity in numerous ways. Previous research has documented that individuals with TBI have more driving-related problems than other people and has identified predictors of driving status or capacity, mostly among civilians. But no research has examined the implications of driving limitations for the well-being of individuals with TBI. <br><br>OBJECTIVE: To examine the association between self-reported difficulty in driving with important domains of psychological well-being in veterans with TBI, adjusting for PTSD and years since most recent TBI. <br><br>DESIGN: Cross-sectional. SETTING: Veterans' homes PARTICIPANTS: 61 veterans of the Global Wars on Terror diagnosed with TBI, all outpatient at a VA medical center rehabilitation service METHODS: Home interviews as a baseline assessment for a larger randomized controlled trial MAIN OUTCOME MEASURES: : Community reintegration (extent of social participation), depressive symptomatology, role limitations due to physical health problems and those due to emotional problems. Self-rated competence in driving was the predictor and sociodemographic characteristics, PTSD diagnosis, TBI severity, and time since most recent TBI were covariates. <br><br>RESULTS: Self-rated driving difficulty was associated with decreased community reintegration (β=.280, p =.028), greater depressive symptomatology (β= -. 402, p <.001), and greater role limitations due to physical problems (β= -.312, p =.011) and to emotional problems (β= -.324, p =.006), after adjusting for PTSD and other variables. <br><br>DISCUSSION: The self-reported ability to drive seems to be central to psychological well-being in veterans with TBI, showing clear associations with depression, community reintegration, and health-related role limitations. These associations cannot be attributed to comorbid PTSD. <br><br>CONCLUSION: Rehabilitation specialists should view driving difficulty as a risk factor for poor psychosocial outcomes in veterans with TBI and seek ways to compensate for the veteran's loss of driving if it is no longer advisable.<br><br>Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="1934-1482",
doi="10.1016/j.pmrj.2017.01.007",
url="http://dx.doi.org/10.1016/j.pmrj.2017.01.007"
}