Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury

Wardlaw, Carla; Hicks, Amelia J.; Sherer, Mark; Ponsford, Jennie Louise

doi:10.3389/fneur.2018.00563

Cited by 48 publications

(34 citation statements)

References 108 publications

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“…These results are also in line with multiple studies addressing the need for a biopsychosocial approach to understanding chronic disability after TBI. [8][9][10][11][12][13][14] Nevertheless, several findings were not consistent with our expectations. Although the regression analyses of disability revealed that the final model significantly explained disability, explaining 49.7% (Nagelkerke R 2 ) of the variance and correctly classifying 78.9% of cases, none of the five independent variables in the model were significant.…”

Section: Fear-avoidance and Disability After Tbi 2643contrasting

confidence: 68%

“…[4][5][6][7][8][9][10][11] Numerous studies have highlighted the potential contribution of psychosocial variables (e.g., personality, coping style, anxiety, and depression) to explain chronic disability. [8][9][10][11][12][13][14][15][16][17][18] The contribution of all these variables suggests the need for a biopsychosocial approach to understandng chronic disability after TBI.…”

Section: Introductionmentioning

confidence: 99%

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Relevance of the Fear-Avoidance Model for Chronic Disability after Traumatic Brain Injury

Wijenberg

Hicks

Downing

et al. 2020

Journal of Neurotrauma

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Section: Fear-avoidance and Disability After Tbi 2643contrasting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Relevance of the Fear-Avoidance Model for Chronic Disability after Traumatic Brain Injury

Wijenberg

Hicks

Downing

et al. 2020

Journal of Neurotrauma

Self Cite

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“…Previous early work showed that stroke outcomes depend on internal buffers, such as overall outlook on life, attitudes regarding the stroke, and ability to cope (39). If it is shown that increased resilience predicts better long-term stroke outcomes, the development of interventions to increase resilience, which is a modifiable construct, may therefore improve cognitive, and emotional outcomes post stroke (18,19,40). Interestingly, neither stress nor resilience was associated with physical outcomes on the Stroke Impact Scale.…”

Section: Discussionmentioning

confidence: 97%

Opposing Associations of Stress and Resilience With Functional Outcomes in Stroke Survivors in the Chronic Phase of Stroke: A Cross-Sectional Study

et al. 2020

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Stroke survivors report significant levels of psychological distress post stroke. To date, most studies conducted have focused on the relationship between psychological stress and functional outcomes in the acute phase of stroke. However, no studies had considered the role of stress over the chronic phase, where stress may continue to exert negative effects on cognitive and psychological processes. Further, the role of potentially modulatory variables, such as psychological resilience, on stroke outcomes has been understudied. The purpose of this study was to consider the relationships between stress and resilience with functional outcomes in long-term survivors of stroke. People (N = 70) who had experienced a stroke between 5 months and 28 years ago were included in the cross-sectional study, along with age-matched controls (N = 70). We measured stress using both the Perceived Stress Scale and biological markers, and resilience using both the Brief Resilience Scale and the Connor-Davidson Resilience Scale. Stroke outcomes were assessed using the Stroke Impact Scale. We found that, compared with age-matched controls, stroke survivors reported greater levels of perceived stress, and lower levels of resilience. In stroke survivors, both perceived stress and resilience were independently associated with stroke outcomes in linear regression models. In particular, these relationships were observed for cognitive outcomes including mood, memory, and communication. The association between stress and stroke outcome did not differ across time post stroke. Given that resilience is a modifiable psychological construct, future research may consider whether strategies directed at enhancing resilience may improve recovery from stroke. Australia and New Zealand Clinical Trials Registry: ACTRN12617000736347.

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“…In fact, many studies of participation after TBI exclude persons with the most severe impairments and lower levels of function for logistical reasons (e.g., inability to complete self-report questionnaires or primary residence in a non-community setting) (7,8). Alternatively, patients with severe TBI and prolonged impairments may be grouped with less severe patient populations (e.g., moderate TBI) (9), thus potentially masking cohort-specific effects (10,11). Prior studies of severe TBI have focused on emergence from a DoC, global function, or recovery of basic cognitive abilities as primary outcome metrics; however, participation in community-based activities is also considered a measure of successful recovery after TBI.…”

Section: Introductionmentioning

confidence: 99%

Participation Following Inpatient Rehabilitation for Traumatic Disorders of Consciousness: A TBI Model Systems Study

et al. 2019

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Severe traumatic brain injury (TBI) may result in a disorder of consciousness (DoC) and lead to substantial long-term disability. While level of independence with activities of daily living, especially for persons who recover consciousness during inpatient rehabilitation, generally improves over time, the degree of change in participation remains unknown. We determined level of participation among persons with TBI between 2005 and 2017 who were admitted to inpatient rehabilitation unable to follow commands and subsequently enrolled in the TBI Model Systems National Database. Participation on the Participation Assessment with Recombined Tools-Objective (PART-O) Productivity, Social Relations, and Out and About subscales was evaluated at 1-5 years post-injury. We used a mixed-effects model to longitudinally compare participation between persons who did and did not regain command-following during inpatient rehabilitation. We further explored the level of participation associated with increasing levels of functional independence (FIM). The analysis included 333 persons (229 recovered command-following during rehabilitation, mean age = 35.46 years, 74.9% male). Participation across groups, at all follow-up time points, on all PART-O subscales, was remarkably low (mean range = 0.021-1.91, maximum possible score = 5). Performance was highest on the Social Relations subscale and lowest on the Productivity subscale. Longitudinal analyses revealed no difference in level of participation or change in participation across time for persons who regained command-following during rehabilitation compared to those who did not. While productivity increased over time, social participation did not and participation outside the home increased more for younger than for older persons. Across Malone et al. Participation After Severe Brain Injury all three PART-O subscales, FIM Motor scores positively predicted participation. FIM Cognitive scores positively predicted level of participation on the Productivity and Social Relations subscales. Exploratory analyses revealed that even persons who achieved independence on the FIM Motor and Cognitive subscales had low levels of participation across domains and follow-up years. In summary, persons with severe TBI who were admitted to inpatient rehabilitation unable to follow commands were found to be unlikely to participate in productive tasks, social endeavors, or activities outside of the home up to 5 years post-injury, even if functional independence was recovered.

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Psychological Resilience Is Associated With Participation Outcomes Following Mild to Severe Traumatic Brain Injury

Cited by 48 publications

References 108 publications

Relevance of the Fear-Avoidance Model for Chronic Disability after Traumatic Brain Injury

Relevance of the Fear-Avoidance Model for Chronic Disability after Traumatic Brain Injury

Opposing Associations of Stress and Resilience With Functional Outcomes in Stroke Survivors in the Chronic Phase of Stroke: A Cross-Sectional Study

Participation Following Inpatient Rehabilitation for Traumatic Disorders of Consciousness: A TBI Model Systems Study

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