title: Predictors of positive growth after traumatic brain injury: a longitudinal study.
abstract: OBJECTIVE
  To investigate long-term positive psychological growth in individuals with traumatic brain injury (TBI) and to relate growth to injury characteristics and early outcomes.
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Long-term follow-up of a group of TBI survivors recruited between 1991-1995. In 2004, 240 of the 563 original participants were invited to take part in a follow-up study. At follow-up, survivors completed the Positive Changes in Outlook Questionnaire (CiOP) along with a structured interview/questionnaire which permitted a Glasgow Outcome Scale (GOSE) score to be assigned.
  
  
  RESULTS
  One hundred and sixty-five TBI survivors completed both questionnaire and CiOP. One hundred and three (62%) participants had suffered severe TBI, 24 (15%) moderate and 38 (23%) mild. Mean length of follow-up was 11.5 years post-injury (range 9-25 years). On the GOSE at follow-up, 43 (26%) had severe disability; 72 (44%) moderate disability; and 50 (30%) good recovery. Scores on the CiOP indicated positive psychological growth in over half of the sample, as evidenced by agreement with items such as 'I don't take life for granted anymore' and 'I value my relationships much more now'. CiOP total scores did not correlate with any injury or early outcome variables. However, at long-term follow-up there was a negative correlation between positive growth and anxiety and depression.
  
  
  CONCLUSIONS
  Survivors of mild, moderate and severe TBI showed evidence of long-term positive changes in outlook.
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, UK. c.a.hawley@warwick.ac.uk
authors.forename: Carol A
authors.initials: CA
authors.lastname: Hawley
authors.forename: Stephen
authors.initials: S
authors.lastname: Joseph
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D003863:Depression / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011379:Prognosis; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013995:Time