Related Experiment Video
Updated: May 2, 2026
Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Transitions in Independent Living, Productivity, and Social Relationships Among Individuals Sustaining Traumatic
Angelle M Sander1, Shannon B Juengst, Abdulaziz Bako
1Author Affiliations: Brain Injury Research Center, TIRR Memorial Herman, Houston, Texas (Drs Jesson, Sander, and Juengst); Department of Physical Medicine & Rehabilitation, UT Health Houston, Houston, Texas (Dr Juengst); Center for Health Outcomes and Informatics Research in Rehabilitation, TIRR Memorial Herman, Houston, Texas (Dr Bako); Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia (Dr Haarbauer-Krupa); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Communication Sciences and Disorders, Northeastern University, Boston, Massachusetts (Dr O'Neil-Pirozzi); Jefferson Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Venkatesan); Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (Dr Venkatesan); Department of Rehabilitation Counseling and Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia (Dr Talley); and Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas (Dr Wright).
Objective:
To characterize transitions in independent living, productivity, and social relationships over the first 5 years postinjury among adolescents sustaining complicated mild to severe traumatic brain injury (TBI) between ages 16 and 18.
Setting:
Community following discharge from inpatient rehabilitation. Participants: 584 individuals ages 16 to 18 in the traumatic brain injury model systems (TBIMS) national database who completed follow-up at 1, 2, and/or 5 years postinjury.
Design:
Multicenter longitudinal observational study.
Main Measures:
Independent living, employment/school/homemaking, having a close friend/confidant, and involvement in a romantic relationship.
Results:
Hidden Markov models were used to identify trajectories of participation, with the optimal number of hidden states (groups) selected using the Bayesian information criterion (BIC). Three states/groups were the best fit for the data and were labeled as: At Risk, On Track , and Partially Transitioned . About 57.5% of participants started as Partially Transitioned , 30% started as At Risk , and 12.5% were On Track . Most in the On Track group had a close friend/confidant and were involved in a romantic relationship. Most in the Partially Transitioned group had a close friend/confidant but were not involved in a romantic relationship. Around 16.7% of individuals in the Partially Transitioned group and only 6.5% of the At Risk group transitioned to On Track , and 98.5% of those in the On Track group remained in the same status. Factors associated with transition to the On Track group included female sex and problem alcohol/substance use. However, further analysis showed that the significant effect of problem alcohol/substance use became nonsignificant after accounting for within-person correlation. Conclusions : Many who sustain a TBI in late adolescence transition to independent living and employment/school/homemaking activity over the first 5 years postinjury; however, a subset remain At Risk or Partially Transitioned in major life roles. Rehabilitation services, beyond the acute period, are needed to ensure maximal independence, social relationships, and community participation.
