Neurobehavioral symptoms predictive of employment outcome after traumatic brain injury

Kessler Foundation researchers have published their findings linking behavioral symptoms with employment outcomes among adults with moderate to severe traumatic brain injury (TBI). Their findings have implications for strategies aimed at improving employment outcomes in this population. The article, "Impact of frontal neurobehavioral symptoms on employment in individuals with TBI," was epublished ahead of print on July 19 in Rehabilitation Psychology . The authors are Erica Weber, Ph.D., Angela Spirou, MA, Nancy Chiaravalloti, Ph.D., and Jeannie Lengenfelder, Ph.D., of Traumatic Brain Injury Research at Kessler Foundation.

Attaining employment after TBI is challenging. Among those with moderate-to-severe TBI, more than 60% are unemployed. Neural damage to the frontal lobes and white matter tracts often occurs with TBI, resulting in a variety of frontal system neurobehavioral syndromes and an array of overlapping symptoms. Little attention, however, has focused on the influence of these behavioral syndromes on employment.

This study looked at 42 participants (ages 18 to 60) with moderate to severe TBI who were more than one year post injury. Participants were classified as Employed or Unemployed. All underwent neuropsychological evaluation, and were evaluated for depression and fatigue. Information regarding neurobehavioral symptoms (disinhibition, apathy, executive dysfunction), was solicited from the participants using the Frontal Systems Behavior Scale questionnaire; caregivers also provided their assessment of the participants' behaviors pre- and post TBI.

Employed and Unemployed individuals did not differ on tests of neurocognition. There were, however, significant differences between the groups on neurobehavioral tests.

"Our results indicate that frontal neurobehavioral symptoms may be predictive of the ability to achieve and maintain employment after TBI," said Dr. Weber, lead author, and a research scientist at Kessler Foundation. "Developing rehabilitative strategies that address these behaviors could improve employment outcomes," she noted, "and reduce the burden of care on caregivers and society."