Model System:


Reference Type:

Journal article

Accession No.:



Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

, 101, 11, 1973-1979

Publication Website:


Study examined heterogeneity in the temporal patterns of depression and participation over the first 2 years after traumatic brain injury (TBI). Data were analyzed for 2,307 people with TBI enrolled in the TBI Model Systems database, who had follow-up conducted primarily by telephone at 1 year and 2 years post injury. Outcome measures included the Patient Health Questionnaire-9 (PHQ-9) and Participation Assessment With Recombined Tools-Objective (PART-O). Latent class modeling was used to examine heterogeneity in the longitudinal relationship between PHQ-9 and PART-O. The identified 6 classes were most distinct in terms of (1) level of PHQ-9 score and (2) association between the year 1 PART-O score and year 2 PHQ-9 score. For most participants, PART-O at year 1 predicted PHQ-9 at year 2 more than the reverse. However, there was a subgroup of participants that demonstrated the reverse pattern, PHQ-9 predicting later PART-O, who were on average, older and in the “other” employment category. Results suggest that links between participation and depression are stronger for some people living with TBI than for others and that variation in the temporal sequencing of these 2 constructs is associated with demographic characteristics. These findings illustrate the value in accounting for population heterogeneity when evaluating temporal among outcome domains.


Rabinowitz, Amanda R. |Chervoneva, Inna |Hart, Tessa |O’Neil-Pirozzi, Therese M.|Juengst, Shannon B. |Hoffman, Jeanne M.|

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