Group-Based Trajectory Analysis of Emotional Symptoms Among Survivors After Severe Traumatic Brain Injury.
Group-Based Trajectory Analysis of Emotional Symptoms Among Survivors After Severe Traumatic Brain Injury.
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严重创伤性脑损伤后幸存者情绪症状的分组轨迹分析。
DOI：
10.1097/htr.0000000000000294
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Conley,Yvette
中科院分区：
文献类型：
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作者：
Ren,Dianxu;Fan,Jun;Puccio,AvaM;Okonkwo,DavidO;Beers,SueR;Conley,Yvette
目的：抑郁和焦虑是重型颅脑损伤后常见的情绪结果。生活满意度是主观幸福感总体结构中的一个主要因素。然而，随着时间的推移，关于严重脑外伤后情绪结果和生活满意度之间的相互关系的文献有限。本研究的目的是描述重型颅脑损伤后24个月抑郁症状、焦虑和生活满意度的不同变化模式，并评估不同轨迹组之间的相互关系以及相关的学科特征。方法：这项前瞻性研究使用了从匹兹堡大学脑创伤研究中心收集的来自重型颅脑损伤幸存者(N=129)的纵向数据。除了与人口统计学和损伤相关的数据外，还收集了损伤后3、6、12和24个月的抑郁症状、焦虑和生活满意度。一个基于群体的轨迹模型被用来确定抑郁症状、焦虑和生活满意度的不同纵向模式。用χ-2检验不同轨迹组之间的相互关系。结果：基于群体的轨迹模型识别出3种结果的两种不同模式：持续低抑郁症状组(70.4%比29.6%)、持续低焦虑组(69.1%比30.9%)和低下降高生活满意度组(56.3%比43.7%)。在抑郁症状和焦虑的轨迹组成员之间观察到强烈的成对关联(P<；抑郁症状和生活满意度(P<；0001)、焦虑和生活满意度(P<；001)。重度创伤增加的受试者更有可能属于高度稳定的抑郁症状组，而年龄、性别、种族、教育程度、婚姻状况与明显的抑郁症状、焦虑和生活满意度轨迹组之间没有显著的关联。结论：基于组的轨迹模型揭示了重型颅脑损伤幸存者中尚未完全探索的情绪症状的模式。抑郁症状、焦虑和生活满意度似乎分别有不同的轨迹模式。情绪症状之间存在很强的相互关系。这些发现增加了我们对严重脑外伤后随着时间的推移所经历的心理社会后果的理解。
Objectives:Depressive symptoms and anxiety are fairly common emotional outcomes after severe traumatic brain injury (TBI). Life satisfaction is a main factor in the general construct of subjective well-being. However, there is limited literature available on the interrelationship between emotional outcomes and life satisfaction post–severe TBI over time. The purpose of this study was to characterize distinct patterns of change in depressive symptoms, anxiety, and life satisfaction over 24 months after severe TBI and evaluate the interrelationship of different trajectory groups among them as well as associated subject characteristics.Methods:This prospective study used longitudinal data collected from the University of Pittsburgh Brain Trauma Research Center from survivors of severe TBI (N= 129). In addition to demographic and injury-related data, depressive symptoms, anxiety, and life satisfaction were collected at 3, 6, 12, and 24 months postinjury. A group-based trajectory model was performed to identify distinct longitudinal patterns of depressive symptoms, anxiety, and life satisfaction. The interrelationships of distinct trajectory groups were examined using χ 2 tests. A multivariate logistic regression model was used to examine the predictors of different emotional symptom trajectories.Results:The group-based trajectory model identified 2 distinct patterns of each of 3 outcomes: constantly low and constantly high depressive symptoms group (70.4% vs 29.6%), constantly low and constantly high anxiety group (69.1% vs 30.9%), and low-decreasing and high-stable life satisfaction groups (56.3% vs 43.7%). A strong pairwise association was observed between trajectory group membership for depressive symptoms and anxiety (P<. 0001), depressive symptoms and life satisfaction (P<. 0001), and anxiety and life satisfaction (P<. 001). Subjects with increased severe injury were more likely to belong to the high-stable depressive symptoms group, while there were no significant associations between age, gender, race, education, marriage status and distinct depressive symptoms, anxiety, and life satisfaction trajectory groups.Conclusions:A group-based trajectory model revealed patterns of emotional symptoms that have not been fully explored among survivors of severe TBI. There appear to be distinct trajectory patterns for depressive symptoms, anxiety, and life satisfaction, respectively. There was strong interrelationship among emotional symptoms. The findings add to our understanding of psychosocial outcomes experienced over time after severe TBI.