Trajectories of Affective Balance 1 Year After Traumatic Injury: Associations with Resilience, Social Support, and Mild Traumatic Brain Injury

We examined trajectories of affective balance (AB) among 488 individuals admitted to a metropolitan Level 1 trauma center for serious physical injury. AB was measured prior to hospital discharge, and at three, six, and 12 months post-discharge. Multilevel modeling (MLM) was used to investigate whether initial demographic variables, injury severity, the occurrence of a mild traumatic brain injury (TBI), self-reported resilience and social support predicted AB trajectories. Participants' change in resilience and social support over the 12-month period were also tested as predictors. The results revealed a large amount of between-individual variation in the first year post-injury. Initial resilience, resilience change, initial social support, and social support change predicted AB 1 year later. Changes in resilience and social support predicted the linear growth in AB over time. Demographic and injury-related variables did not significantly predict AB, nor did the diagnosis of a mild TBI. Participants' self-perceived resilience and social support scores changed substantially, for better or worse, over the 12-month period. AB was strongly associated with these changes, even when controlling for initial resilience and social support: Increases in either resilience or social support were significantly associated with increases in AB over time. The final model accounted for 33.2% of the between-individual variance in final scores and 46.9% of the variance in linear growth. These results provide additional evidence of the beneficial effects of existing levels of resilience and social support following traumatic injury, and these characteristics are better predictors of AB than injury severity, basic demographic data, and the presence of a mild head injury. Furthermore, changes that may occur in social support and self-perceived resilience are associated with significant changes in AB, and these factors should be considered in post-discharge plans to facilitate subsequent adjustment.