Psychosocial Outcomes After Traumatic Brain Injury: Life Satisfaction, Community Integration, and Distress

Objective: To examine the relationship between life satisfaction, community integration, and emotional distress in adults with traumatic brain injury (TBI). Method: This was an archival study of a longitudinal data set on the outcome and recovery process of persons with TBI. Participants were 253 consecutive adults with mild complicated, moderate, and severe TBI who were enrolled in a large, longitudinal study of persons with TBI. Main measures included the Satisfaction with Life Scale, the Positive Affective and Negative Affective Schedule, the Craig Hospital Assessment and Reporting Technique Short-Form, the Community Integration Measure, and the Brief Symptom Inventory-18. Results: The three-factor model adequately fit the data, and a higher-order model did not necessarily improve model fit but revealed significant relationships with first-order constructs and one second-order construct. Conclusions: Life satisfaction, community integration, and emotional distress were found to be related yet unique concepts in persons with TBI. Life satisfaction was positively related to community involvement and inversely related to emotional distress. Community integration was inversely related to emotional distress. In addition, these concepts are related to a higher-order concept of psychosocial status, a global representation of subjective and objective functioning. These findings demonstrate the interrelated and dynamic nature of psychosocial well-being after brain injury and highlight the need for integrative and holistic treatment plans.