Satisfaction with Life after Mild Traumatic Brain Injury: A TRACK-TBI Study
Stephanie Agtarap, Laura Campbell‐Sills, Sonia Jain, Xiaoying Sun, Sureyya Dikmen, Harvey S. Levin, Michael McCrea, Pratik Mukherjee, Lindsay D. Nelson, Nancy Temkin, Esther L. Yuh, Joseph T. Giacino, Geoffrey T. Manley, Murray B. Stein, TRACK-TBI Investigators, Opeolu Adeoye, Kim Boase, M. Ross Bullock, John D. Corrigan, Ramon Diaz‐Arrastia, Richard Ellenbogen, Adam R. Ferguson, Raquel C. Gardner, Dana P. Goldman, Shankar P. Gopinath, J. Claude Hemphill, Frederick K. Korley, Natalie Kreitzer, Joan Machamer, Alastair J. Martin, Thomas W. McAllister, Randall E. Merchant, Laura B. Ngwenya, Florence Noël, David O. Okonkwo, Eva Palacios, Daniel P. Perl, Ava M. Puccio, Miri Rabinowitz, Claudia S. Robertson, Jonathan Rosand, Angelle M. Sander, Gabriella Satris, David M. Schnyer, Sabrina R. Taylor, Arthur W. Toga, Alex B. Valadka, Mary J. Vassar, Paul Vespa, Kevin Wang, John K. Yue, Ross Zafonte
Abstract
Identifying the principal determinants of life satisfaction following mild TBI (mTBI) may inform efforts to improve subjective well-being in this population. We examined life satisfaction among participants in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study who presented with mTBI (Glasgow Coma Scale [GCS] score = 13–15; n = 1152). An L1-regularization path algorithm was used to select optimal sets of baseline and concurrent symptom measures for prediction of scores on the Satisfaction with Life Scale (SWLS) at 2 weeks and 3, 6, and 12 months post-injury. Multi-variable linear regression models (all n = 744–894) were then fit to evaluate associations between the empirically selected predictors and SWLS scores at each follow-up visit. Results indicated that emotional post-TBI symptoms (all b = −1.27 to −0.77, all p < 0.05), anhedonia (all b = −1.59 to −1.08, all p < 0.01), and pain interference (all b = −1.38 to −0.89, all p < 0.001) contributed to the prediction of lower SWLS scores at all follow-ups. Insomnia predicted lower SWLS scores at 2 weeks, 3 months, and 6 months (all b = −1.11 to −0.83, all p s < 0.01); and negative affect predicted lower SWLS scores at 2 weeks, 3 months, and 12 months (all b = −1.38 to −0.80, all p < 0.005). Other post-TBI symptom domains and baseline socio-demographic, injury-related, and clinical characteristics did not emerge as robust predictors of SWLS scores during the year after mTBI. Efforts to improve satisfaction with life following mTBI may benefit from a focus on the detection and treatment of affective symptoms, pain, and insomnia. The results reinforce the need for tailoring of evidence-based treatments for these conditions to maximize efficacy in patients with mTBI.