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Development of Depressive Symptoms During Early Community Reintegration After Traumatic Brain Injury

Published online by Cambridge University Press:  17 November 2010

Tamara Ownsworth ,
Jennifer Fleming ,
Terry Haines ,
Petrea Cornwell ,
Melissa Kendall ,
Emily Nalder  and
Cassandra Gordon
Tamara Ownsworth*
Affiliation:
School of Psychology and Griffith Institute for Health and Medical Research, Griffith University, Mt Gravatt, Australia
Jennifer Fleming
Affiliation:
The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Australia Occupational Therapy Department, Princess Alexandra Hospital, Queensland, Australia
Terry Haines
Affiliation:
School of Physiotherapy, Monash University, Victoria, Australia Allied Health Clinical Research Unit, Southern Health, Victoria, Australia
Petrea Cornwell
Affiliation:
School of Psychology and Griffith Institute for Health and Medical Research, Griffith University, Mt Gravatt, Australia Metro North Health Service District, Queensland Health, Australia
Melissa Kendall
Affiliation:
Acquired Brain Injury Outreach Service, Princess Alexandra Hospital, Buranda, Australia
Emily Nalder
Affiliation:
The University of Queensland, School of Health and Rehabilitation Sciences, St Lucia, Australia Occupational Therapy Department, Princess Alexandra Hospital, Queensland, Australia
Cassandra Gordon
Affiliation:
School of Psychology and Griffith Institute for Health and Medical Research, Griffith University, Mt Gravatt, Australia
*
Correspondence and reprint requests to: Tamara Ownsworth, School of Psychology, Griffith University, Mt Gravatt, 4122 Australia. E-mail: [email protected]
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Abstract

The early onset of depression following traumatic brain injury (TBI) is associated with poorer psychosocial outcomes; however, the direction of this relationship is unclear. This study investigated the relationship between progress in resuming preinjury lifestyle (transition events), change in perceived functioning and level of depressive symptoms at discharge and 3-months postdischarge. As part of a prospective longitudinal study of brain injury outcomes, 96 consecutively discharged patients with TBI completed measures of transition events (Sentinel Events Questionnaire) and perceived functioning (Mayo-Portland Adaptability Inventory-4 Ability and Adjustment indices) at discharge and 3-months follow-up. Level of depressive symptoms was assessed at discharge and 3-months follow-up using the Depression Anxiety Stress Scale 21. After controlling for age and discharge depressive symptoms, change in perceived functioning was found to mediate the relationship between total transition events and depressive symptoms at 3-months postdischarge (β reduced from .21 to .14), with a significant indirect effect observed. The present findings indicate that lack of progress in resuming preinjury lifestyle contributes to postdischarge depressive symptoms through an influence on perceived functioning, thus providing an improved conceptualization of reactive depression in the context of brain injury. (JINS, 2011, 17, 000–000)

Keywords

Traumatic brain injuryDepressive symptomsCommunity reintegrationPerceived functioningTransition events
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 17 , Issue 1 , January 2011 , pp. 112 - 119
Copyright
Copyright © The International Neuropsychological Society 2010

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References

Baron, R.M., Kenny, D.A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. doi:10.1037/0022-3514.51.6.1173CrossRefGoogle ScholarPubMed
Bombardier, C.H., Bell, K.R., Temkin, N.R., Fann, J.R., Hoffman, J., Dikmen, S. (2009). The efficacy of a scheduled telephone intervention for ameliorating depressive symptoms during the first year after traumatic brain injury. Journal of Head Trauma Rehabilitation, 24, 230–238. doi:10.1097/HTR.0b013e3181ad65f0CrossRefGoogle ScholarPubMed
Corrigan, J.D., Selassie, A.W., Orman, J.A. (2010). The epidemiology of traumatic brain injury. Journal of Head Trauma Rehabilitation, 25, 72–80. doi:10.1097/HTR.0b013e3181ccc8b4CrossRefGoogle ScholarPubMed
Felmingham, K., Baguley, I., Crooks, J. (2001). A comparison of acute and postdischarge predictors of employment 2 years after traumatic brain injury. Archives of Physical and Medical Rehabilitation, 82, 435–439. doi:10.1053/apmr.2001.21985CrossRefGoogle ScholarPubMed
Godfrey, H.P.D., Partridge, F.M., Knight, R.G., Bishara, S. (1993). Course of insight disorder and emotional dysfunction following closed head injury: A controlled cross-sectional follow-up study. Journal of Clinical and Experimental Neuropsychology, 15, 503–515.CrossRefGoogle ScholarPubMed
Gomez-Hernandez, R., Max, J.E., Kosier, T., Paradiso, S., Robinson, R.G. (1997). Social impairment and depression after traumatic brain injury. Archives of Physical Medicine Rehabilitation, 78, 1321–1326. doi:10.1016/S0003-9993(97)90304-XCrossRefGoogle ScholarPubMed
Gracey, F., Evans, J.J., Malley, D. (2009). Capturing process and outcome in complex rehabilitation interventions: A “Y-shaped” model. Neuropsychological Rehabilitation, 19, 867–890. doi:10.1080/09602010903027763CrossRefGoogle Scholar
Jorge, R.E., Robinson, R.G., Moser, D., Tateno, A., Crespo-Facorro, B., Arndt, S. (2004). Major depression following traumatic brain injury, Archives of General Psychiatry, 61, 42–50. Retrieved from www.archgenpsychiatry.comGoogle Scholar
Kendall, E., Terry, D. (2009). Understanding the adjustment following traumatic brain injury: Is the goodness of fit coping hypothesis useful? Social Science and Medicine, 67, 1217–1224. doi:10.1016/j.socscimed.2008.05.033CrossRefGoogle Scholar
Kolb, B., Whishaw, I.Q. (2003). Fundamentals of human neuropsychology (5th ed.). New York: Worth Publishers.Google Scholar
Kreutzer, J.S., Seel, R.T., Gourley, E. (2001). The prevalence and symptom rates of depression after traumatic brain injury: A comprehensive examination. Brain Injury, 15, 563–576.CrossRefGoogle ScholarPubMed
Lovibond, S., Lovibond, P. (1995). Manual for the depression anxiety and stress scales (3rd ed.). Sydney: Psychology Foundation.Google Scholar
MacKinnon, D.P., Warsi, G., Dwyer, J.H. (1995). A simulation study of mediated effect measures. Multivariate Behavioural Research, 30, 41–62. doi:10.1207/s15327906mbr3001_3CrossRefGoogle ScholarPubMed
Malec, J. (2005). The Mayo-Portland Adaptability Inventory. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/combi/mpaiGoogle Scholar
Malec, J.F., Testa, J.A., Rush, B.K., Brown, A.W., Moessner, A.M. (2007). Self-assessment of impairment, impaired self-awareness, and depression after traumatic brain injury. Journal of Head Trauma Rehabilitation, 22, 156–166. doi:10.1097/01.HTR.0000271116.12028.afCrossRefGoogle ScholarPubMed
Nalder, E., Fleming, J., Cornwell, P., Foster, M., Worrall, L., Ownsworth, T., Chenoweth, L. (2010). What constitutes transition success? An investigation into factors influencing the perceptions of individuals with a TBI regarding the transition from hospital to home. Paper presented at the 8th World Congress on Brain Injury, Washington, DC.Google Scholar
Ownsworth, T., Fleming, J. (2005). The relative importance of metacognitive skills, emotional status and executive functioning in psychosocial adjustment following acquired brain injury. Journal of Head Trauma Rehabilitation, 20, 315–332.CrossRefGoogle ScholarPubMed
Ownsworth, T.L., Fleming, J., Nalder, E., Cornwell, P., Haines, T., Kendall, M., Chenoweth, L. (2009). Occurrence of sentinel events and emotional adjustment during the hospital to home transition following acquired brain injury. Paper presented at the International Neuropsychological Society and Finnish Neuropsychological Society Joint Mid-Year Meeting, Helsinki, Finland. Abstract published in the Journal of the International Neuropsychological Society, 15(S2), 102.Google Scholar
Ownsworth, T.L., Little, T., Turner, B., Hawkes, A., Shum, D. (2008). Assessing emotional status following acquired brain injury: The clinical potential of the Depression, Anxiety and Stress Scales. Brain Injury, 22, 858–869. doi:10.1080/02699050802446697CrossRefGoogle ScholarPubMed
Ownsworth, T., Oei, T.P.S. (1998). Depression after traumatic brain injury: Conceptualisation and treatment considerations. Brain Injury, 12, 735–751. doi:10.1080/026990598122133Google Scholar
Riley, G.A., Brennan, A.J., Powell, T. (2004). Threat appraisal and avoidance after traumatic brain injury: Why and how often are activities avoided? Brain Injury, 18, 871–888.Google Scholar
Robertson, I.H., Murre, J.M.J. (1999). Rehabilitation of brain damage: Brain plasticity and principles of guided recovery. Psychological Bulletin, 125, 544–575. doi:10.1037/0033-2909.125.5.544CrossRefGoogle ScholarPubMed
Ruff, R., Marshall, L., Crouch, M., Klauber, M., Levin, S., Barth, J., Marmarou, A. … (1993). Predictors of outcome following severe head trauma: Follow-up data from the Traumatic Coma Data Bank. Brain Injury, 7, 101–111. doi:10.3109/02699059309008164CrossRefGoogle ScholarPubMed
Rutterford, N.A., Wood, R.L. (2006). Evaluating a theory of stress and adjustment when predicting long-term psychosocial outcome after brain injury. Journal of the International Neuropsychological Society, 12, 359–367.Google Scholar
Seel, R.T., Kreutzer, J.S., Rosenthal, M., Hammond, F.M., Corrigan, J.D., Black, K. (2003). Depression after traumatic brain injury: A national institute on disability and rehabilitation research model systems multicenter investigation. Archives of Physical Medicine and Rehabilitation, 84, 177–184.CrossRefGoogle Scholar
Tate, R.L., Broe, G.A. (1999). Psychosocial adjustment after traumatic brain injury: What are the important variables? Psychological Medicine, 29, 713–725. doi:10.1017/S0033291799008466Google Scholar
Turner, B., Ownsworth, T.L., Cornwell, P., Fleming, J. (2009). Re-engagement in meaningful occupations during the transition from hospital to home for individuals with acquired brain injury and their family caregivers. American Journal of Occupational Therapy, 63, 609–620. doi:10.5014/ajot.63.5.609CrossRefGoogle Scholar
Williams, W.H., Evans, J.J. (2003). Brain injury and emotions: An overview to a special issue on biopsychosocial approaches in neurorehabilitation. Neuropsychological Rehabilitation, 13, 1–11. doi:10.1016/S0960-9822(02)01374-XGoogle ScholarPubMed