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Trajectories of Emotional Symptoms Among Survivors After Severe Traumatic Brain Injury

Fan, Jun (2013) Trajectories of Emotional Symptoms Among Survivors After Severe Traumatic Brain Injury. Master's Thesis, University of Pittsburgh. (Unpublished)

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The purpose of the study is to characterize emotional symptom patterns in survivors after severe Traumatic Brain Injury and also determine risk factors associated with these distinct patterns. The data used in this study were available from the University of Pittsburgh Brain Trauma Research Center (BTRC). Subjects who survived from their severe Traumatic Brain Injury were recruited and we use the subset of the collected data including the acute phase of the demographics and injury severity and the longitudinal emotional symptom data collected at 3, 6, 12 and 24 months after injury. By using a person-centered, semi-parametric group-based modeling approach, symptom phenotype data were evaluated to identify and characterize group trajectory classifications for each emotional symptom outcome as well as their co-occurrence across time. Additionally, logistic regression and/or multinomial regression models were used to evaluate the associations between trajectories of depression, anxiety and satisfaction of life and covariates such as demographics and clinical variables.
Two trajectories of depression were identified: low stable and high increasing trajectories. Three trajectories of anxiety were identified: low stable, high peak and high decreasing symptom groups. Two trajectories of satisfaction with life were identified: low decreasing and high increasing. Dual trajectory models were also conducted. The results show a strong relationship between the trajectories for depression and anxiety, anxiety and satisfaction with life, depression and satisfaction with life.
Finally multi-trajectory model were fitted. Three multi-trajectories were identified. Multi-trajectory of high depression and high anxiety and low satisfaction with life was predicted by very severe initial injury severity (OR=4.12, P=0.06) in univariate model and predicted by marital status (married, OR=0.08, P=0.06) in multivariate model. Therefore we concluded that by a person-centered, semi-parametric group-based modeling approach, we identified distinct patterns of change in depression, anxiety and satisfaction with life after severe TBI. Our results also indicated that depressive symptoms, anxiety symptoms and satisfaction with life are related. The survivors after severe TBI in high depressive trajectories were more likely also to develop high level of anxiety symptom with lower satisfaction with life. Initial injury severity and marital status have association with emotional disorder after severe traumatic brain injury. The finding of this study may help public health develop efficient preventive strategies or targeted interventions on emotional disorder for the population after severe TBI.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Fan, Junjuf15@pitt.eduJUF15
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairRen, Dianxudir8@mail.pitt.eduDIR8
Committee MemberTang, Gongtang@nsabp.pitt.eduGOT1
Committee MemberBandos, Andriyanb61@pitt.eduANB61
Committee MemberConley, Yvette P.yconley@pitt.eduYCONLEY
Date: 27 June 2013
Date Type: Publication
Defense Date: 27 March 2013
Approval Date: 27 June 2013
Submission Date: 21 November 2012
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 124
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Biostatistics
Degree: MS - Master of Science
Thesis Type: Master's Thesis
Refereed: Yes
Date Deposited: 27 Jun 2013 18:53
Last Modified: 01 May 2018 05:15


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