Model System:


Reference Type:

Journal article

Accession No.:



Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

, 103, 1, 69-74

Publication Website:


Study investigated the relationships among suicidal ideation (SI), depressive symptoms, and functional independence over the first 10 years after traumatic brain injury (TBI). Data were collected through the TBI Model Systems network at acute rehabilitation hospitalization, as well as at 1, 2, 5, and 10 years after injury. A total of 9,539 participants who provided a response to the question on SI (i.e., Patient Health Questionnaire-9 item 9) at any of the follow-up assessments during the first 10 years post injury were included in the current analyses. A cross-lagged panel structural equation model, which is meant to indirectly infer causality through longitudinal correlational data, suggested that SI, depressive symptoms, and functional independence each significantly predicted themselves over time. Within the model, bivariate correlations among variables were all significant within each time point. Between years 1 and 2 and between years 2 and 5, depressive symptoms had a larger effect on SI than SI had on depressive symptoms. Between years 5 and 10, there was reciprocal causality between the two variables. Functional independence more strongly predicted depressive symptoms than the reverse between years 1 and 2 as well as years 2 and 5, but its unique effects on SI over time were extremely marginal or absent after controlling for depressive symptoms.


Perrin, Paul B. |Klyce, Daniel W. |Fisher, Lauren B. |Juengst, Shannon B. |Hammond, Flora M. |Gary, Kelli W. |Niemeier, Janet P. |Bergquist, Thomas F. |Bombardier, Charles H. |Rabinowitz, Amanda R. |Zafonte, Ross D. |Wagner, Amy K.|

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