Functional Status, Chronic Stress, and Cortisol Response After Mild-to-Moderate Traumatic Brain Injury
Abstract
It is well known that individuals experience difficulties with depressive symptoms and functional status after traumatic brain injury. However, it is unclear what the relationship is between these 2 phenomena and whether there is a biological explanation for. In this secondary analysis, we examined whether depressive symptoms explained postinjury functional status and whether chronic stress and salivary cortisol influenced this relationship. Participants included 75 persons within 24 months of their injury dates who were evaluated or treated in specialty clinics. All participants and a family member or significant other completed survey data, and 50 of the participants provided cortisol data. Results indicated that chronic stress, measured using Cohen's Perceived Stress Scale, completely mediated the relationship between depressive symptoms, measured using the Center for Epidemiological Studies Depression Scale, and psychological functioning, measured using the Patient Competency Rating Scale. Furthermore, those who provided cortisol data displayed hypocortisolemia in their 12-hr profile. Results from this analysis suggest that interventions focused on addressing the chronic stress experience may be important in limiting depressive symptoms and improving psychological functioning. Longitudinal study of this phenomenon is required to understand the progression of chronic stress after traumatic brain injury.
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After mild to moderate TBI, chronic stress results in poorer functional outcomes.
“and results in poorer functional outcomes (Bay et al., 2009).”
From Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial. (2020) · cites this paper as Bay et al., 2009
Sustaining a TBI creates a stress response.
“Sustaining a TBI creates a stress response (Bay, Sikorskii, & Gao, 2009)”
From Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial. (2020) · cites this paper as Bay, Sikorskii, & Gao, 2009
Cites
Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress
Tsigos, C., & Chrousos, G. P. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00429-4 · Cited by 2,822 · cited 1× · see citing works
“…secretion is pulsatile and rhythmic in response to day-to-day stress, with higher levels in the early morning and lower levels toward bedtime (Tsigos & Chrousos, 2002), in response to chronic stress, cortisol can show patterns of sustained hypersecretion, hyposecretion, or dysregulation…”
BackgroundMajor Depression Following Traumatic Brain Injury
Jorge, R. E., Robinson, R. G., Moser, D., Tateno, A., Crespo-Facorro, B., & Arndt, S. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.1.42 · Cited by 737 · see citing works
Gaab, J., Rohleder, N., Nater, U. M., & Ehlert, U. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.02.001 · Cited by 525 · see citing works
Design Decisions to Optimize Reliability of Daytime Cortisol Slopes in an Older Population
Kraemer, H. C., Giese-Davis, J., Yutsis, M., O'Hara, R., Neri, E., Gallagher-Thompson, D., Taylor, C. B., & Spiegel, D. (2006) · The American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000201816.26786.5b · Cited by 166 · see citing works
Establishing an Agenda for Translational Research on PTSD
MILLER, M. M., & McEWEN, B. S. (2006) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1364.023 · Cited by 101 · see citing works
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Whiting, D., Deane, F., McLeod, H., Ciarrochi, J., & Simpson, G. (2020) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2019.1583582 · Cited by 71 · see citing works
“After a mild to moderate TBI, chronic stress has been found to be a predictor for the development of depression (Bay, Hagerty, Williams, Kirsch, & Gillespie, 2002) and results in poorer functional outcomes (Bay et al., 2009).”
Background
- Authors
- Bay, E., Sikorskii, A., & Gao, F.
- Affiliations
- Michigan State University (US)
- ORCID
- Sikorskii, Alla
- Venue
- Biological Research For Nursing
- Publisher
- SAGE Publications
- Published
- 2008-11-17
- Volume
- 10
- Issue
- 3
- Pages
- 213-225
- ISSN
- 1099-8004 (ISSN-L)
- 1552-4175
- OpenAlex
- W2091632183
- Cited by
- 43
- References
- 6
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 6 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 4 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 2 · 2013: 3 · 2012: 1
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Research For Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- traumatic brain injury, depressive symptoms, chronic stress, salivary cortisol, adrenal insufficiency, functional status, psychological functioning, mediation, stress biomarkers
- MeSH terms
- Adolescent, Adult, Aged, Brain Injuries, Chronic Disease, Cross-Sectional Studies, Female, Humans, Hydrocortisone, Male, Middle Aged, Severity of Illness Index, Stress, Psychological
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