Differences in Coping Strategies Between Women and Men Based on Experience of Frequent Pain/Headaches in Chronic Traumatic Brain Injury

Abstract

<h3>Research Objectives</h3> To identify gender differences in coping strategies by experience of pain/headaches in chronic traumatic brain injury (TBI). <h3>Design</h3> Cross-sectional study. <h3>Setting</h3> Community. <h3>Participants</h3> n=133 adults with chronic mild-severe TBI (M=7.5 years post-injury). <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Behavioral Assessment Screening Tool (BAST) coping items: two adaptive (asking someone I trust for help, going for a walk/exercising) and four avoidant (bought things I didn't need, took my emotions out on other people, unable to make decisions, went to sleep) rated on a 1=never to 5=very often ordinal scale. <h3>Results</h3> Two-thirds of women (52/78), 45% of men (23/54), and one individual (100%) identifying as transgender reported experiencing frequent pain/headaches. Almost all participants (n=130, 97.7%) felt stressed over the past two weeks. When stressed, men without pain (n=31) exercised/walked (M=3.14, SD=1.6) more often than men with pain (M=2.39, SD=1.03, p=.024) and women without pain (M=2.46, SD=1.25, p=.037). Women with pain engaged more frequently in maladaptive coping strategies (M=2.58-3.17) than women without pain (M=2.08-2.71). Women with pain bought things they did not need more often than all others (p's=.019- < .001) and went to sleep significantly more often than men with pain (p=.029) and women without pain (p=.003). <h3>Conclusions</h3> Individuals with chronic TBI frequently report feeling stressed, and many - particularly women - report experiencing frequent pain/headaches. Women experiencing pain/headaches after TBI engage in maladaptive coping more often than women without pain/headaches or men regardless of pain experience. However, they also walk/exercise to manage stress more than women without pain or men with pain, suggesting that women experiencing pain/headaches after chronic TBI may use more coping strategies - including both adaptive and maladaptive strategies - overall to manage their stress. Providers should emphasize the benefits of physical activity and social support after TBI. <h3>Author(s) Disclosures</h3> This work was supported by funding from the National Institutes for Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH/NICHD). Grant #: R03HD09445 (PI: Juengst).