Journal of Head Trauma Rehabilitation最新文献

{"title":"Effects of Home Neighborhood Tree Canopy Coverage on Mental Health Outcomes: A Traumatic Brain Injury Model Systems Investigation.","authors":"Shannon B Juengst, Raj G Kumar, Alexandra Holland, Achituv Cohen, Trisalyn A Nelson, John D Corrigan, Angelle M Sander, Paul B Perrin, Umesh M Venkatesan, Amanda Rabinowitz, Simon Driver, Kristin Wilmoth, Candace Tefertiller","doi":"10.1097/HTR.0000000000001031","DOIUrl":"10.1097/HTR.0000000000001031","url":null,"abstract":"<p><strong>Objective: </strong>Explore the relationship between tree canopy coverage (TCC) in one's home neighborhood and mental health outcomes, and how these relationships differ by home neighborhood factors, among persons with traumatic brain injury (TBI) in the United States.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Enrolled in the TBI Model Systems National Database with completed follow-up interview after January 1, 2017.</p><p><strong>Design: </strong>Secondary analysis of cross-sectional data.</p><p><strong>Main measures: </strong>Neighborhood (census tract) Percent TCC, depressive (Patient Health Questionnaire-9) and anxiety (General Anxiety Disorder-7) symptoms (scores ≥10 on each measure), personal/demographic (age, sex, education, homebound status), and neighborhood factors (type, socioeconomic disadvantage).</p><p><strong>Results: </strong>Separate negative binomial regression models were constructed for the 2 mental health outcomes (depression and anxiety symptoms). Covariates in final models were age, sex, neighborhood type, Functional Independence Measure (FIM) total (concurrent), driving status, homebound status, and neighborhood-level socioeconomic disadvantage. The interaction between Percent TCC and neighborhood type (but not homebound status) was significant for depression and anxiety symptoms. The nature of the significant interaction was such that, for both mental health outcomes, those living in rural neighborhoods with higher Percent TCC were more likely to have moderate to severe mental health symptoms. However, this effect was attenuated after adding neighborhood level socioeconomic disadvantage, suggesting that part of the effect may be due to socioeconomic characteristics of rural versus other neighborhoods.</p><p><strong>Conclusions: </strong>After adjusting for SDoH, the direct effect of TCC on mental health after TBI was small and opposite the direction hypothesized (higher TCC associated with poorer mental health), particularly for those living in rural neighborhoods potentially more likely to experience socioeconomic disadvantage. Our findings highlight the importance of evaluating interactions between different aspects of the social (eg, SDoH), natural (eg, greenspace), and built (eg, neighborhood type) environment to provide a comprehensive understanding of factors affecting health after TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"107-116"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the Association Between Traumatic Brain Injury and Discontinuation of Medications for Opioid Use Disorder in a Commercially Insured Adult Population.","authors":"Jake R Morgan, Sharon Reif, Maureen T Stewart, Marc R Larochelle, Rachel Sayko Adams","doi":"10.1097/HTR.0000000000000964","DOIUrl":"10.1097/HTR.0000000000000964","url":null,"abstract":"<p><strong>Objective: </strong>Extending prior research that has found that people with traumatic brain injury (TBI) experience worse substance use treatment outcomes, we examined whether history of TBI was associated with discontinuation of medication to treat opioid use disorder (MOUD), an indicator of receiving evidence-based treatment.</p><p><strong>Setting: </strong>We used MarketScan claims data to capture inpatient, outpatient, and retail pharmacy utilization from large employers in all 50 states from 2016 to 2019.</p><p><strong>Participants: </strong>We identified adults aged 18 to 64 initiating non-methadone MOUD (ie, buprenorphine, injectable naltrexone, and oral naltrexone) in 2016-2019. The exposure was whether an individual had a TBI diagnosis in the 2 years before initiating MOUD. During this period, there were 709 individuals with TBI who were then matched with 709 individuals without TBI.</p><p><strong>Design: </strong>We created a retrospective cohort of matched individuals with and without TBI and used quasi-experimental methods to identify the association between TBI status and MOUD use. We estimated propensity scores by TBI status and created a 1:1 matched cohort of people with and without TBI who initiated MOUD. We used a Cox proportional hazards model to identify the association between TBI and MOUD discontinuation.</p><p><strong>Main measure: </strong>The outcome was discontinuation of MOUD (ie, a gap of 14 days or more of MOUD).</p><p><strong>Results: </strong>Among those initiating MOUD, the majority were under 26 years of age, male, and living in an urban setting. Nearly 60% of individuals discontinued medication by 6 months. Adults with TBI had an elevated risk of MOUD discontinuation (hazard ratio [HR] 1.13; 95% confidence interval [CI], 1.01-1.27) compared to those without TBI. Additionally, initiating oral naltrexone was associated with a higher risk of discontinuation (HR 1.63; 95% CI, 1.40-1.90).</p><p><strong>Conclusion: </strong>We found evidence of reduced MOUD retention among people with TBI. Differences in MOUD retention may reflect health care inequities, as there are no medical contraindications to using MOUD for people with TBI or other disabilities.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E111-E120"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contextual Determinants of Health Disparities in Utilization of Community-Based Rehabilitation Services Among Medicare Fee-for-Service Beneficiaries With Traumatic Brain Injury.","authors":"Chinedu Onwudebe, Caitlin R Aguirre, Ioannis Malagaris, Yong-Fang Kuo, Monique R Pappadis","doi":"10.1097/HTR.0000000000001026","DOIUrl":"10.1097/HTR.0000000000001026","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between contextual social determinants of health (SDoH) and receipt of first outpatient or home health (HH) rehabilitation visit after hospital discharge among older adults with traumatic brain injury (TBI) in Texas.</p><p><strong>Setting: </strong>Community following hospital discharge.</p><p><strong>Participants: </strong>19 117 patients aged 66 and older hospitalized for a TBI from January 1, 2014, and discharged up to December 31, 2018, who returned home within 90 days from discharge.</p><p><strong>Design: </strong>Retrospective cohort study using 100% Texas Medicare claims data.</p><p><strong>Main measures: </strong>Contextual-level SDoH (eg, neighborhood ethno-racial identity make-up, socioeconomic position, and residential context) from the 2022 American Community Survey (zip-code level) and the 2023 County Health Rankings; HH and Outpatient Rehabilitation Services (eg, physical therapy, occupational therapy, speech/language therapy, and behavioral health [eg, psychology, neuropsychology, social work]). Fine-Gray competing risk models were conducted.</p><p><strong>Results: </strong>Patients living in areas with higher median household incomes (Hazard ratio, HR = 0.92; 95% Confidence Interval, 95% CI: 0.87-0.97) and higher unemployment rate (HR = 0.98; 95% CI: 0.97-0.99) had decreased likelihood of having a HH visit upon return to community; those with higher uninsured rates (HR = 0.78; 95% CI: 0.70-0.87) and in rural areas (HR = 0.83; 95% CI: 0.76-0.92) had decreased likelihood of having an outpatient visit. In contrast, Food Environment Index (HR = 1.08; 95% CI: 1.05-1.11) increased the likelihood of having a HH visit while a higher percentage with severe housing problems (HR = 1.34; 95% CI: 1.22-1.46) increased the likelihood of an outpatient visit. When treating either outpatient or HH visits as a competing event, contextual-level SDoH was associated with a decreased likelihood of an outpatient visit but an increased likelihood of a HH visit.</p><p><strong>Conclusions: </strong>Disparities exist in access to rehabilitation following community discharge, based on contextual-level SDoH, indicating the need to improve access to rehabilitation services for persons with TBI living in communities with greater social needs.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"40 2","pages":"76-85"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The TBI Model Systems Neighborhood Socioeconomic Disadvantage Index (TBIMS-NSDI): Development and Comparison to Individual Socioeconomic Characteristics.","authors":"Raj G Kumar, Andrew Delgado, John D Corrigan, C B Eagye, Gale G Whiteneck, Shannon B Juengst, Librada Callender, Jennifer A Bogner, Shanti M Pinto, Amanda R Rabinowitz, Paul B Perrin, Umesh M Venkatesan, Amanda L Botticello, Anthony H Lequerica, Shameeke Taylor, Ross D Zafonte, Kristen Dams-O'Connor","doi":"10.1097/HTR.0000000000000968","DOIUrl":"10.1097/HTR.0000000000000968","url":null,"abstract":"<p><strong>Objective: </strong>To create a census-based composite neighborhood socioeconomic deprivation index (NSDI) from geocoded residential addresses and to quantify how NSDI aligns with individual-level socioeconomic factors among people with traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>People enrolled in the TBI Model Systems National Database (TBIMS NDB).</p><p><strong>Design: </strong>Secondary analysis of a longitudinal cohort study.</p><p><strong>Main measures: </strong>The TBIMS-NSDI was calculated at the census tract level for the United States population based on a principal components analysis of eight census tract-level variables from the American Community Survey. Individual socioeconomic characteristics from the TBIMS NDB were personal household income, education (years), and unemployment status. Neighborhood:Individual NSDI residuals represent the difference between predicted neighborhood disadvantage based on individual socioeconomic characteristics versus observed neighborhood disadvantage based on the TBIMS-NSDI .</p><p><strong>Results: </strong>A single principal component was found to encompass the eight socioeconomic neighborhood-level variables. It was normally distributed across follow-up years 2, 5, and 10 post-injury in the TBIMS NDB. In all years, the TBIMS-NDSI was significantly associated with individual-level measures of household income and education but not unemployment status. Males, persons of Black and Hispanic background, Medicaid recipients, persons with TBI caused by violence, and those living in urban areas, as well as in the Northeast or Southern regions of the United States, were more likely to have greater neighborhood disadvantage than predicted based on their individual socioeconomic characteristics.</p><p><strong>Conclusions: </strong>The TBIMS-NSDI provides a neighborhood-level indicator of socioeconomic disadvantage, an important social determinant of outcomes from TBI. The Neighborhood:Individual NSDI residual adds another dimension to the TBIMS-NSDI by summarizing how a person's socioeconomic status aligns with their neighborhood socioeconomics. Future studies should evaluate how both measures affect TBI recovery and life quality. Research studying neighborhood socioeconomic disadvantage may improve our understanding of how systemic adversity influences outcomes after TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"86-96"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decisional Needs of Veterans With Mild Traumatic Brain Injury Initiating Treatment for Insomnia Disorder and Obstructive Sleep Apnea.","authors":"Adam R Kinney, Lisa A Brenner, Morgan Nance, Joseph Mignogna, Audrey D Cobb, Jeri E Forster, Christi S Ulmer, Risa Nakase-Richardson, Nazanin H Bahraini","doi":"10.1097/HTR.0000000000000978","DOIUrl":"10.1097/HTR.0000000000000978","url":null,"abstract":"<p><strong>Objective: </strong>We sought to elicit key informant (KI) perspectives regarding decisional needs of Veterans with mild traumatic brain injury (mTBI) who are initiating insomnia disorder and obstructive sleep apnea (OSA) treatment within the Veterans Health Administration (VHA) Polytrauma/TBI System of Care (PSC). Specifically, we sought to understand: (1) information regarding treatment options that Veterans with mTBI require in order to make an informed decision; and (2) values used to guide decision-making (ie, personally meaningful aspects of the decision used to compare treatment options).</p><p><strong>Setting: </strong>Nationwide VHA PSC sites.</p><p><strong>Participants: </strong>Clinicians included VHA providers and policymakers involved in the management of mTBI and/or sleep disorders in the VHA PSC ( n = 29). Veterans included those with a clinician-confirmed mTBI who received care for insomnia disorder and/or OSA within the past year ( n = 20).</p><p><strong>Design: </strong>Semi-structured interviews with the 49 KIs were recorded and transcribed verbatim. Themes were identified using a descriptive and interpretive approach to qualitative analysis.</p><p><strong>Main measures: </strong>Not applicable.</p><p><strong>Results: </strong>Informational needs identified by both KI groups included information regarding outcomes and downsides of treatment, accessible delivery, treatment candidates, description of diagnosis, and level of commitment. Values used to guide decision-making for both insomnia disorder and OSA treatment included benefits, downsides, and availability of treatments. Values used to decide on insomnia treatments alone included time commitment, intrinsic management of sleep, beliefs regarding mental health treatment, and time course of benefit. Values used to decide on OSA treatment alone included intrusiveness of the treatment, appearance, and impact on bed partners.</p><p><strong>Conclusions: </strong>The current study revealed the decisional needs of Veterans with mTBI who are initiating sleep disorder treatment. Findings can inform the development of decision aids and other efforts aimed at promoting patient-centered management of comorbid mTBI and sleep disorders, thereby improving care quality and clinical outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E144-E153"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Integration Challenges of Men and Women After Traumatic Brain Injury: A Reflexive Thematic Analysis of Lived Experiences Through a Gender Lens.","authors":"Lulu Lian, Rachael Coupland, Thaisa Tylinski Sant'Ana, Angela Colantonio, Tatyana Mollayeva","doi":"10.1097/HTR.0000000000000994","DOIUrl":"10.1097/HTR.0000000000000994","url":null,"abstract":"<p><strong>Objective: </strong>To investigate community integration (CI) challenges following traumatic brain injury (TBI) through a gender lens.</p><p><strong>Setting: </strong>Rehabilitation research-teaching hospital.</p><p><strong>Participants: </strong>Adult participants (22 men and 20 women) with a primary diagnosis of mild or moderate-severe TBI, in the acute or chronic stages after injury, were recruited using purposive sampling.</p><p><strong>Design: </strong>Qualitative study. Data were collected through semistructured interviews, and thematic analysis was used to identify themes of CI challenges.</p><p><strong>Results: </strong>Three overarching themes emerged: (1) lack of a \" graduated home plan \": difficulty enacting gendered roles and responsibilities at home, (2) \" Something that I cannot handle \": mismatch between occupational demands and abilities, and (3) \" Slipping away \": disrupted connections with self and others. Men consistently voiced struggles with and inability to fulfill household tasks, whereas women detailed ways of adapting domestic responsibilities because of postinjury limitations. Productivity challenges resonated with a substantial number of participants, and a gendered pattern was observed: More women reported an inability, whereas more men reported a limited ability to meet occupational demands. Both genders conveyed disruptions in recreational and leisure activities, although women predominantly discussed challenges relating to social activities and men a tendency to avoid social situations because of anticipated stigma and/or shame. Across all themes, a pervasive sense of diminished community contributions and disrupted identities was observed.</p><p><strong>Conclusion: </strong>The incongruence between preinjury roles and responsibilities and postinjury abilities resulted in difficulties across multiple CI domains for the study participants and did not go unnoticed by them. It is important for health care professionals to assist patients in addressing gendered challenges at home, work, and in the social circle for a smoother transition back into the community.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E163-E174"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental Factors and Traumatic Brain Injury.","authors":"Raj G Kumar, Shannon B Juengst","doi":"10.1097/HTR.0000000000001035","DOIUrl":"10.1097/HTR.0000000000001035","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":"40 2","pages":"53-56"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood Deprivation and Recovery Following Traumatic Brain Injury Among Older Adults.","authors":"Jennifer S Albrecht, Jennifer Kirk, Kathleen A Ryan, Jason R Falvey","doi":"10.1097/HTR.0000000000001007","DOIUrl":"10.1097/HTR.0000000000001007","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the extent to which neighborhood impacts recovery following traumatic brain injury (TBI) among older adults could spur targeting of rehabilitation and other services to those living in more disadvantaged areas. The objective of the present study was to determine the extent to which neighborhood disadvantage influences recovery following TBI among older adults.</p><p><p>Setting and Participants: Community-dwelling Medicare beneficiaries aged ≥65 years hospitalized with TBI 2010-2018.</p><p><strong>Design and main measures: </strong>In this retrospective cohort study, the Area Deprivation Index (ADI) was used to assess neighborhood deprivation by linking it to 9-digit beneficiary zip codes. We used national-level rankings to divide the cohort into the top 10% (highest neighborhood disadvantage), middle 11-90%, and bottom 10% (lowest neighborhood disadvantage). Recovery was operationalized as days at home, calculated by subtracting days spent in a care environment or deceased from monthly follow-up over the year post-TBI.</p><p><strong>Results: </strong>Among 13,747 Medicare beneficiaries with TBI, 1713 (12.7%) were in the lowest decile of ADI rankings and 1030 (7.6%) were in the highest decile of ADI rankings. Following covariate adjustment, beneficiaries in neighborhoods with greatest disadvantage [rate ratio (RtR) 0.96; 95% confidence interval (CI) 0.94, 0.98] and beneficiaries in middle ADI percentiles (RtR 0.98; 95% CI 0.97, 0.99) had fewer days at home per month compared to beneficiaries in neighborhoods with lowest disadvantage.</p><p><strong>Conclusion: </strong>This study provides evidence that neighborhood is associated with recovery from TBI among older adults and highlights days at home as a recovery metric that is responsive to differences in neighborhood disadvantage.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"57-64"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Variation in Hospital Density and Social Deprivation Across Small Geographic Areas Play a Role in Perceived Barriers to Care Among People With Traumatic Brain Injury?","authors":"Anthony H Lequerica, Amanda L Botticello","doi":"10.1097/HTR.0000000000001027","DOIUrl":"10.1097/HTR.0000000000001027","url":null,"abstract":"<p><strong>Objective: </strong>To examine the role of area-level variables (hospital density and social deprivation) in the experience of health care access and quality among individuals with traumatic brain injury.</p><p><strong>Setting: </strong>Online questionnaire of community dwelling individuals Participants: 300 individuals with a history of traumatic brain injury with loss of consciousness.</p><p><strong>Design: </strong>Cross-sectional observational survey.</p><p><strong>Main measures: </strong>Barriers to Care Questionnaire, Social Deprivation Index, Hospital Density.</p><p><strong>Results: </strong>In an unadjusted regression model, less social deprivation and higher hospital density were associated with better perceived health care access and quality. After adjusting for personal factors of race, ethnicity, age, injury severity, food insecurity, and housing insecurity, the effect of social deprivation was fully attenuated whereas the effect of hospital density on health care access and quality remained significant. A model containing only the personal factors demonstrated reduced health care access and quality among individuals identifying as Hispanic. However, this effect was non-significant with the inclusion of the area-level contextual factors in a fully adjusted model.</p><p><strong>Conclusions: </strong>Higher area-level hospital density is associated with a reduction in perceived barriers to care among individuals with TBI. In addition, contextual, area-level data accounted for the reduced health care access and quality among Hispanic participants. Area-level data can provide explanatory value in the study of health disparities for people with TBI from underrepresented racial and ethnic groups.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"117-124"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alexithymia Prevalence, Characterization, and Associations With Emotional Functioning and Life Satisfaction: A Traumatic Brain Injury Model System Study.","authors":"Dawn Neumann, Flora M Hammond, Angelle M Sander, Jennifer Bogner, Tamara Bushnik, Jacob A Finn, Joyce S Chung, Daniel W Klyce, Mitch Sevigny, Jessica M Ketchum","doi":"10.1097/HTR.0000000000000967","DOIUrl":"10.1097/HTR.0000000000000967","url":null,"abstract":"<p><strong>Objectives: </strong>Alexithymia an emotional processing deficit that interferes with a person's ability to recognize, express, and differentiate emotional states. Study objectives were to (1) determine rates of elevated alexithymia among people with moderate-to-severe traumatic brain injury (TBI) 1-year post-injury, (2) identify demographic and injury-related variables associated with high versus low-average levels of alexithymia, and (3) examine associations among alexithymia with other aspects of emotional functioning and life satisfaction.</p><p><strong>Setting: </strong>Data were collected during follow-up interviews across four TBI Model System (TBIMS) centers.</p><p><strong>Participants: </strong>The sample consisted of 196 participants with moderate-to-severe TBI enrolled in the TBIMS. They were predominately male (77%), White (69%), and had no history of pre-injury mental health treatment (66.3%).</p><p><strong>Design: </strong>Cross-sectional survey data were obtained at study enrollment and 1-year post-injury.</p><p><strong>Main measures: </strong>Toronto Alexithymia Scale-20 (TAS-20) as well as measures of anger, aggression, hostility, emotional dysregulation, post-traumatic stress, anxiety, depression, resilience and life satisfaction. Sociodemographic information, behavioral health history and injury-related variables were also included.</p><p><strong>Results: </strong>High levels of alexithymia (TAS-20 score > 1.5 standard deviation above the normative mean) were observed for 14.3%. Compared to individuals with low/average levels of alexithymia, the high alexithymia group tended to have lower levels of education. At 1-year follow-up, high TAS-20 scores were strongly associated with emotional dysregulation and post-traumatic stress; moderately associated with anger, hostility, depression, anxiety, lower resilience and lower satisfaction with life; and weakly associated with aggression.</p><p><strong>Conclusion: </strong>These findings provide further evidence that alexithymia is associated with poor emotional functioning and life satisfaction after TBI. Longitudinal studies are needed to determine if alexithymia is a risk factor that precipitates and predicts worse emotional outcomes in the TBI population. This line of work is important for informing treatment targets that could prevent or reduce of psychological distress after TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":"E175-E184"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}