Neuroanatomical Correlates of Positive Psychology Among People with Traumatic Brain Injury: A Biopsychosocial Model

Abstract

Objectives: To investigate the complex relationships among strengths of character, structurally-imaged estimates of white matter damage in frontal brain regions, psychological resiliency, and outcomes including satisfaction with life and community integration among people with TBI. Of particular interest is the extent to which Peterson and Seligman’s Character Strengths model of recovery from physical illness and trauma[1] holds true for people recovering from TBI during the acute transition phase of adjustment to disability. Psychosocial, cognitive, and physical characteristics that may influence these relationships will also be explored.

Sample and setting: The sample will consist of 80 participants who will receive Magnetic Resonance Imaging (e.g., Diffusion Tensor Imaging - DTI), cognitive and psychosocial evaluation at 6 months to 2 years post injury.

Main Outcome Measures: The primary outcomes of interest are satisfaction with life (as measured by the Satisfaction with Life Scale) and community integration (as measured by the Community Integration Measure). Character strengths will be evaluated via two self-report scales: The Values in Action – Inventory of Strengths[1], and the Connor-Davidson Resiliency Scale[2]. Estimates of structural brain damage will be gathered via diffusion tensor imaging (DTI) in three main areas of the prefrontal cortex: the dorsolateral, orbitofrontal, and ventromedial cortices. Ancillary measures will be included in the design in order to elucidate the relationships between positive psychology constructs and important mediators/moderators of recovery from TBI: neuropsychological status, perceived social support, problem-solving coping style, positive and negative affectivity, and comorbid physical illness.

Design and Procedures: Self-report psychological measures, neuropsychological data, and other ancillary measures will be collected from 80 consecutively enrolled participants who are 6 months to 2 years post injury.

Expected Results: It is expected that white matter damage in the ventromedial area—as opposed to the orbitofrontal and dorsolateral prefrontal cortices—will show inverse associations with self-reported resiliency; stronger associations are expected for predominantly left ventromedial lesions. It is further expected that these relationships will be influenced by perceived social support, cognitive reserve, problem-solving coping style, and comorbid physical disease. Consistent with the Peterson and Seligman model of Character Strengths[1] in recovery from physical illness and trauma, it is expected that certain self-reported strengths of character (bravery, kindness, humor, and spirituality) will show stronger positive associations with life satisfaction and community integration

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