Prevalence and Predictors of Personality Change After Severe Brain Injury

Abstract

ObjectivesTo investigate the prevalence of personality change after severe brain injury; to identify predictors of personality change; and to investigate whether personality change is associated with distress in family members. DesignA longitudinal study of personality change. SettingRehabilitation unit. ParticipantsThe study sample was composed of 22 pairs of patients with traumatic brain injury or nontraumatic brain injury (N=22) and their significant others (SOs). InterventionsNot applicable. Main Outcome MeasuresAn SO completed the observer version of the NEO Five Factor Inventory rating the patient at discharge from hospital and 1 year after injury. The SOs were also asked to complete the anxiety and depression scales of the Symptom Checklist-90-Revised, rating their own emotional condition and health-related quality of life (HRQOL) as assessed by the 4 mental scales of the Medical Outcomes Study 36-Item Short-Form Health Survey. ResultsOf the sample, 59.1% experienced personality change after acquired brain injury, and the most dominant changes were observed in the personality traits of neuroticism, extraversion, and conscientiousness. Changes in neuroticism were most often observed in patients with frontal or temporal lesions. Generally, personality changes in patients were not associated with more distress and lower HRQOL in family members; however, change in patient agreeableness was associated with lower HRQOL on the role limitations-emotional scale. ConclusionsPersonality change was observed in most patients with severe brain injury. Change in neuroticism was associated with frontal and temporal lesions. Generally, personality change was not associated with more distress and lower HRQOL in SOs.