Hostname: page-component-7bb8b95d7b-2h6rp Total loading time: 0 Render date: 2024-09-18T02:24:32.921Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological functioning predicts psychosocial adjustment after postacute rehabilitation for traumatic brain injury

Published online by Cambridge University Press:  06 October 2022

Jeremy A. Feiger Open the ORCID record for Jeremy A. Feiger [Opens in a new window] ,
Jeffry Snell  and
Kathy S. Chiou Open the ORCID record for Kathy S. Chiou [Opens in a new window]
Jeremy A. Feiger*
Affiliation:
Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
Jeffry Snell
Affiliation:
QLI, Omaha, NE, USA
Kathy S. Chiou
Affiliation:
Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
*
Corresponding author: Jeremy A. Feiger, Email: Jfeiger@huskers.unl.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To examine neuropsychological functioning as a predictor of psychosocial adjustment difficulties at discharge from a postacute residential rehabilitation facility for traumatic brain injury (TBI) and depression as a potential mediator.

Methods:

A retrospective record review was conducted of 172 adults who received rehabilitation services for TBI. Individuals completed a full battery of neuropsychological tests, depression assessment, and functional assessments at admission. Functional assessments were also obtained at discharge.

Results:

A two-phase structural equation model analysis was performed. The first phase specified a good fitting model of a cognitive functioning (CF) latent construct with four indicators of cognitive domains measuring verbal fluency, cognitive flexibility, verbal learning, and working memory. Worse CF was associated with greater psychosocial adjustment impairment at discharge, but not related to depression. Psychosocial adjustment impairment at admission was positively associated with depression when controlling for CF, however depression did not predict psychosocial adjustment at discharge. Thus, depression was not found to be a significant mediator of psychosocial adjustment impairment at discharge.

Conclusions:

Results provide support for neuropsychological functioning at the start of postacute rehabilitation for TBI as an important predictor of psychosocial functioning difficulties that remain upon discharge and highlights the need to examine mechanisms beyond depression.

Keywords

Brain InjuriesTraumatic/rehabilitation*depressionneuropsychologycognitive dysfunction/rehabilitation*retrospective studiesprognosis
Type
Brief Communication
Information
Journal of the International Neuropsychological Society , Volume 29 , Issue 4 , May 2023 , pp. 410 - 414
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albrecht, J. S., Barbour, L., Abariga, S. A., Rao, V., & Perfetto, E. M. (2019). Risk of depression after traumatic brain injury in a large national sample. Journal of Neurotrauma, 36(2), 300–307. https://doi.org/10.1089/neu.2017.5608 CrossRefGoogle Scholar
Andelic, N., Arango-Lasprilla, J. C., Perrin, P. B., Sigurdardottir, S., Lu, J., Landa, L. O., Landa, L. O., Forslund, M. V., & Roe, C. (2016). Modeling of community integration trajectories in the first five years after traumatic brain injury. Journal of Neurotrauma, 33(1), 95–100. https://doi.org/10.1089/neu.2014.3844 CrossRefGoogle ScholarPubMed
Army, U. S. (1944). Army individual test battery. Manual of directions and scoring. War Department, Adjunct General’s Office.Google Scholar
Beadle, E. J., Ownsworth, T., Fleming, J., & Shum, D. H. K. (2020). The nature of occupational gaps and relationship with mood, psychosocial functioning and self-discrepancy after severe traumatic brain injury. Disability and Rehabilitation, 42(10), 1414–1422. https://doi.org/10.1080/09638288.2018.1527954 CrossRefGoogle ScholarPubMed
Beck, A. T., Steer, R. A. & Brown, G. K. (1996). Manual for the Beck depression inventory-II. Psychological Corporation.Google Scholar
Beck, A. T., Steer, R. A. & Brown, G. K. (2000). Manual for the Beck depression inventory-fastScreen for medical patients. Psychological Corporation.Google Scholar
Benton, A. L., de Hamsher, K. S., & Sivan, A. B. (1994). Multilingual Aphasia examination. AJA Associates.Google Scholar
Brandt, J., & Benedict, R. H. B. (2001). Hopkins verbal learning test-revised professional manual. Psychological Assessment Resources.Google Scholar
Gracey, F., Evans, J. J., & Malley, D. (2009). Capturing process and outcome in complex rehabilitation interventions: A “Y-shaped” model. Neuropsychological Rehabilitation, 19(6), 867–890. https://doi.org/10.1080/09602010903027763 CrossRefGoogle Scholar
Joosub, N., Cassimjee, N., & Cramer, A. (2017). The relationship between neuropsychological performance and depression in patients with traumatic brain injury. South African Journal of Psychology, 47(2), 171–183. https://doi.org/10.1177/0081246316654327 CrossRefGoogle Scholar
Lewis, F. D., & Horn, G. J. (2017). Depression following traumatic brain injury: Impact on post-hospital residential rehabilitation outcomes. NeuroRehabilitation, 40(3, 401–410. https://doi.org/10.3233/NRE-161427 CrossRefGoogle ScholarPubMed
Malec, J. (2005). The Mayo–Portland adaptability inventory. Retrieved from http://www.tbims.org/combi/mpai Google Scholar
Muthén, L.K., & Muthén, B.O. (1998–2017). Mplus user’s guide (8th ed.). Muthén & Muthén.Google Scholar
Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing moderated mediation hypotheses: Theory, methods, and prescriptions. Multivariate Behavioral Research, 42(1), 185–227. https://doi.org/10.1080/00273170701341316 CrossRefGoogle ScholarPubMed
Rapoport, M. J., McCullagh, S., Shammi, P., & Feinstein, A. (2005). Cognitive impairment associated with major depression following mild and moderate traumatic brain injury. The Journal of Neuropsychiatry and Clinical Neurosciences, 17(1), 61–65. https://doi.org/10.1176/jnp.17.1.61 CrossRefGoogle ScholarPubMed
Schönberger, M., Ponsford, J., McKay, A., Wong, D., Spitz, G., Harrington, H., & Mealings, M. (2014). Development and predictors of psychological adjustment during the course of community-based rehabilitation of traumatic brain injury: A preliminary study. Neuropsychological Rehabilitation, 24(2), 202–219. https://doi.org/10.1080/09602011.2013.878252 CrossRefGoogle ScholarPubMed
Singh, R., Mason, S., Lecky, F., & Dawson, J. (2018). Prevalence of depression after TBI in a prospective cohort: The SHEFBIT study. Brain Injury, 32(1), 84–90. https://doi.org/10.1080/02699052.2017.1376756 CrossRefGoogle Scholar
Spitz, G., Schönberger, M., & Ponsford, J. (2013). The relations among cognitive impairment, coping style, and emotional adjustment following traumatic brain injury. Journal of Head Trauma Rehabilitation, 28(2), 116–125. https://doi.org/10.1097/HTR.0b013e3182452f4f CrossRefGoogle ScholarPubMed
Wechsler, D. (2008). WAIS-IV: Administration and scoring manual. The Psychological Corporation.Google Scholar
Williams, M. W., Rapport, L. J., Millis, S. R., & Hanks, R. A. (2014). Psychosocial outcomes after traumatic brain injury: Life satisfaction, community integration, and distress. Rehabilitation Psychology, 59(3), 298–305. https://doi.org/10.1037/a0037164 CrossRefGoogle ScholarPubMed