Self-assessment of impairment, impaired self-awareness, and depression after traumatic brain injury

James F. Malec, Julie A. Testa, Beth K. Rush, Allen W. Brown, Anne M. Moessner

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

OBJECTIVE: To identify patient features associated with early and late depression after traumatic brain injury (TBI). PARTICIPANTS: 3 clinical trauma groups (mild TBI, moderate-severe TBI, orthopedic injury) and their significant others. MEASURES: Preinjury: age, education, substance abuse, and psychiatric history; Injury severity: classification using Glasgow Coma Scale and cranial CT scan, posttraumatic amnesia; Early impairment: Neurobehavioral Functioning Inventory (NFI), Impaired Self-Awareness (ISA); Social and family support: Multidimensional Scale of Perceived Social Support, Family Assessment Device; Depression: NFI Depression Scale. METHOD: Regression analyses of predictor variables on early and late measures of depression. RESULTS: Depression rates did not differ among the 3 trauma groups. Preinjury level of education, previous psychiatric history, and perceived level of social support explained a small portion of the variance in depressive symptoms. Patients' self-assessment of their impairment at discharge was most strongly correlated with both early and late depression. ISA was associated with reduced self-report of depressive symptoms. However, when those with ISA were excluded from the analysis, self-assessment of impairment remained strongly associated with depression. CONCLUSIONS: Patients' self-assessment of impairment is strongly associated with early and late depression. Presence and severity of TBI does not appear to play a direct role in depression but does appear related to ISA, which serves as a barrier to the development of depression. Focusing on impairment appears to be a cardinal feature of depression in both patients with TBI and an orthopedic trauma group.

Original languageEnglish (US)
Pages (from-to)156-166
Number of pages11
JournalJournal of Head Trauma Rehabilitation
Volume22
Issue number3
DOIs
StatePublished - May 2007
Externally publishedYes

Fingerprint

Depression
Wounds and Injuries
Social Support
Equipment and Supplies
Traumatic Brain Injury
Self-Assessment
Orthopedics
Psychiatry
Brain Concussion
Education
Glasgow Coma Scale
Amnesia
Self Report
Substance-Related Disorders
Regression Analysis

Keywords

  • Brain injury
  • Depression
  • Impaired self-awareness
  • Rehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Clinical Neurology
  • Health Professions(all)

Cite this

Self-assessment of impairment, impaired self-awareness, and depression after traumatic brain injury. / Malec, James F.; Testa, Julie A.; Rush, Beth K.; Brown, Allen W.; Moessner, Anne M.

In: Journal of Head Trauma Rehabilitation, Vol. 22, No. 3, 05.2007, p. 156-166.

Research output: Contribution to journalArticle

Malec, James F. ; Testa, Julie A. ; Rush, Beth K. ; Brown, Allen W. ; Moessner, Anne M. / Self-assessment of impairment, impaired self-awareness, and depression after traumatic brain injury. In: Journal of Head Trauma Rehabilitation. 2007 ; Vol. 22, No. 3. pp. 156-166.
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