title: Impact of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI.
abstract: OBJECTIVE
  This study investigates the contribution of pre-injury family functioning and resources on self-reported post-concussive symptoms and functional outcomes in persons with mild TBI (mTBI).
  
  
  METHODS
  Participants with uncomplicated or complicated mTBIs were recruited from consecutive admissions to the emergency department of a level 1 trauma centre. Patients completed baseline assessments within 2 weeks of injury and an outcomes assessment at 3 months post-injury.
  
  
  METHODS
  One hundred and sixty-six adults with mTBI were included. Baseline measures of pre-injury history, family functioning and resources were obtained. Functional status assessments and self-reported measures of health, common TBI symptoms and psychological problems were administered at 3-months post-injury.
  
  
  RESULTS
  Data reduction of outcome measures using principle components analysis revealed two factors: self-reported post-concussive symptoms and current functional/participation status, explaining 60.53% of the variance. Family resources (β = -0.239, t(150) = -2.84, p = 0.005) and age (β = -0.170, t(150) = -2.19, p = 0.030), but not family functioning, were significant predictors of self-reported post-concussive symptoms at follow-up, R2= 0.051, F(5, 150) = 4.09, p = 0.002. Neither family resources nor functioning predicted current functional/participation status.
  
  
  CONCLUSIONS
  Fewer family resources and younger age were associated with increased self-reported post-concussive symptoms. Fewer resources may be a potential risk factor to heightened perception of post-concussive symptoms. Providing low-cost counselling or resource facilitation services may improve outcomes for those with limited resources after mTBI.
authors.affiliation: a Department of Psychology and Neuropsychology , TIRR Memorial Hermann , Houston , TX , USA.|b Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA.
authors.forename: Jessica Lynn
authors.initials: JL
authors.lastname: Temple
authors.affiliation: a Department of Psychology and Neuropsychology , TIRR Memorial Hermann , Houston , TX , USA.|b Department of Physical Medicine and Rehabilitation , Baylor College of Medicine , Houston , TX , USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Struchen
authors.affiliation: c Division of Rehabilitation Sciences , The University of Texas Medical Branch at Galveston , Galveston , TX , USA.|d Brain Injury Research Center, TIRR Memorial Hermann , Houston , TX , USA.
authors.forename: Monique R
authors.initials: MR
authors.lastname: Pappadis
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology; D001924:Brain Concussion / Q000150:complications* / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology; D004185:Disability Evaluation; D005195:Family Relations; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care; D038223:Post-Concussion Syndrome / Q000209:etiology* / Q000523:psychology*; D025341:Principal Component Analysis; D011594:Psychometrics; D012189:Retrospective Studies; D057566:Self Report; D013781:Texas; D055815:Young Adult
keywords: Mild TBI; family functioning; family resources; functional status; postconcussive symptoms