Patterns of Post-traumatic Stress Symptoms in Mild Traumatic Brain Injury and Their Relationship with Outcomes: A Latent Profile Analysis
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Taylor and Francis Group
Abstract
INTRODUCTION: Post-traumatic stress symptoms (PTSS) are known to contribute to postconcussion symptoms and functional status following mild traumatic brain injury (mTBI). Identifying symptom cluster profiles provide an opportunity to better understand PTSS and their influence on these outcomes. In this study, latent profiles of PTSS following mTBI were identified, and their association with mTBI outcomes was examined. The predictive role of demographic and injury related variables on profile membership was also explored. METHOD: Adults (N = 252) completed self report measures of PTSS and mTBI outcomes (post-concussion symptoms and functional status) within three months of mTBI. These measures were re-administered six months later (N = 187). Latent profile analysis (LPA) was used to ascertain the latent class structure of PTSS, and regression analysis to examine predictors of profiles. ANCOVA, with general psychological distress as a covariate, revealed the relationship between profiles and mTBI outcomes. RESULTS: LPA identified a four-profile model to best describe PTSS at baseline. This included a resilient (49.6%), moderate (30.6%), moderate with high intrusion/avoidance (14.3%) and a highly symptomatic profile (5.6%). A secondary school education or less and/or unemployment before mTBI was significantly more likely in the highly symptomatic profile, as well as sustaining an mTBI due to an assault or motor vehicle accident. PTSS latent class membership was significantly associated with mTBI outcomes even when controlling for general psychological distress. The resilient group had significantly better outcomes at baseline and six-month follow-up. However, no significant differences in mTBI outcomes emerged between the moderate, moderate with high intrusion/avoidance and the highly symptomatic profiles. CONCLUSION: The current study provides novel information on the symptom profiles of PTSS in mTBI, predictors of profile membership and their relationship with mTBI outcomes. Although future research using this approach is needed, the current study offers a more in-depth understanding of PTSS in mTBI to inform clinical care.Description
Keywords
latent profile analysis, Mild traumatic brain injury, outcomes, post-traumatic stress, Mild traumatic brain injury, latent profile analysis, outcomes, post-traumatic stress, 5203 Clinical and Health Psychology, 52 Psychology, Physical Injury - Accidents and Adverse Effects, Traumatic Head and Spine Injury, Traumatic Brain Injury (TBI), Brain Disorders, 3 Good Health and Well Being, 1109 Neurosciences, 1701 Psychology, 1702 Cognitive Sciences, Experimental Psychology, 5202 Biological psychology, 5203 Clinical and health psychology, 5204 Cognitive and computational psychology
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Journal of Clinical and Experimental Neuropsychology, ISSN: 1380-3395 (Print); 1744-411X (Online), Taylor and Francis Group, 45(3), 230-241. doi: 10.1080/13803395.2023.2227401
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© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.