Date of Award

10-19-2015

Publication Type

Doctoral Thesis

Degree Name

Ph.D.

Department

Psychology

Keywords

Brain injury, Depression, NeuroPsychology, Rehabilitation

Supervisor

Abeare, Christopher

Rights

info:eu-repo/semantics/openAccess

Abstract

Cognitive, neurological, and psychosocial predictors of depression after TBI were investigated in an Early and a Late Recovery group. The Early Recovery group consisted of 80 participants who were 1.3 years removed from their TBI, while the Late Recovery Group consisted of 107 participants who were 10.1 years removed from their TBI. Participants were enrolled in the Southeastern Michigan Traumatic Brain Injury System (SEMTBIS). Depression was measured using the Brief Symptom Inventory Depression subscale. The cognitive domains that were assessed included attention, executive functioning, and memory. Injury severity was used as a measure of neurological damage while psychosocial variables of interest included emotion-focused coping, problem-focused coping, perceived social support, and alcohol use. Five models were run using multiple linear regression and the best fitting models were selected using the Bayesian Information Criterion. For the Early Recovery group, the model that included only psychosocial variables was the best fit. Specifically, the use of emotion-focused coping and lack of perceived social support was associated with higher levels of depression. Conversely, the use of problem-focused coping was associated with lower levels of depression. For the Late Recovery group, a model that included cognitive functioning and psychosocial variables was the best fit. Specifically, the use of emotion-focused coping, lack of perceived social support, and better attention ability were associated with higher levels of depression. The findings suggest that psychosocial variables may be related to depression during early recovery. With time however, the role of cognitive functioning, namely better attention, may become an important factor in predicting depression. Also, the influence of problem-focused coping on depression may diminish with time. Conversely, emotion-focused coping and perceived social support may become more important in predicting depression as time since injury increases. Generally, the results imply that treatment protocols that focus on improving coping and social skills throughout the recovery process may improve outcome. Similarly, cognitive screening several years after TBI may be useful in identifying persons who may be susceptible to the development of depression. Lastly, possible changes in the effectiveness of problem-focused coping over time may provide evidence in favour of creating interventions that are more relevant to specific stages of recovery.

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