Anxiety trajectories the first 10 years after a traumatic brain injury (TBI): A TBI model systems study

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J90533

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2022 , 103, 11, 2105-2113

Publication Website:

Abstract:

Study examined the presence of distinct anxiety trajectories across the first 10 years after traumatic brain injury (TBI) and identified demographic, preinjury, injury-related, and treatment factors associated with overall anxiety levels and class membership in different anxiety trajectory subgroups. Participants were enrolled in the TBI Model Systems National Database, were assessed for baseline characteristics during inpatient rehabilitation, and were administered the Generalized Anxiety Disorder-7 (GAD-7) at 1, 2, 5, and 10-year follow-ups. Data were analyzed for 2,836 participants with moderate-to-severe TBI who had at least 2 anxiety data collection points. Linear mixed models showed higher GAD-7 scores were associated with Black race, public insurance, pre-injury mental health treatment, 2 additional TBIs with loss of consciousness, violent injury, and more years post-TBI. An interaction between follow-up year and age was also related to GAD-7 scores. A latent class mixed model identified 3 anxiety trajectories: low-stable, high-increasing, and high-decreasing. A substantial minority of participants had anxiety symptoms that either increased (10 percent) or decreased (13 percent) over 10 years but never decreased below mild anxiety. The high-increasing and high-decreasing groups had mild or higher GAD-7 scores up to 10 years. Compared to the low-stable group, the high-decreasing group was more likely to be Black, have public insurance, have had pre-injury mental health treatment, and have had 2 prior TBIs. Awareness of these risk factors may lead to identifying and proactively referring susceptible individuals to mental health services.

Author(s):