title: Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury.
abstract: OBJECTIVE
  To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI).
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity.
  
  
  RESULTS
  Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories.
  
  
  CONCLUSIONS
  Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time.
authors.affiliation: Department of Research, Sunnaas Rehabilitation Hospital , Nesoddtangen , Norway .
authors.forename: S
authors.initials: S
authors.lastname: Sigurdardottir
authors.forename: N
authors.initials: N
authors.lastname: Andelic
authors.forename: C
authors.initials: C
authors.lastname: Roe
authors.forename: A K
authors.initials: AK
authors.lastname: Schanke
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D055500:Resilience, Psychological; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D013997:Time Factors
keywords: Coping; distress; post-traumatic stress disorder; resilience; trauma; traumatic brain injury