Psychological outcomes following moderate-to-severe acquired brain injury: A longitudinal study

Emotional distress is highly prevalent in the years following an acquired brain injury (ABI). Yet, there is a lack of research examining the long-term psychological outcomes and potential influencing factors, among individuals with ABIs. In this study, we trace longitudinal changes in neuropsychological outcomes in 32 individuals with moderate-to-severe ABI who engaged in neurorehabilitation in a post-acute hospital. Outcomes assessed at one- and eight-years post-ABI include emotional distress, coping, subjective experience of injury-related difficulties, and quality of life (QOL). Almost half of all participants reported clinically elevated symptoms of anxiety and depression at eight-years post-ABI (t2). There was minimal variation in neuropsychological outcomes between one- and eight-years post-ABI. Greater use of maladaptive coping responses was associated with greater symptoms of anxiety and depression at t1. As the subjective experiences of injury-related difficulties increased, so too did the symptoms of anxiety and depression at both timepoints. Higher levels of depression were associated with lower psychological and social QOL at t1 and lower levels of psychological, physical, social, and environmental QOL at t2. This study offers a unique insight into the intricate links that exist longitudinally between coping responses, subjective experiences of injury-related difficulties, QOL, and emotional distress following an ABI. It also highlights the need to conceptualize ABI as a chronic health condition that requires long term psychological support.