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Changes in Sexual Functioning From 6 to 12 Months Following Traumatic Brain Injury: A Prospective TBI Model System Multicenter Study

Hanks, Robin A. PhD, ABPP; Sander, Angelle M. PhD; Millis, Scott R. PhD, ABPP; Hammond, Flora M. MD; Maestas, Kacey L. PhD

Section Editor(s): Sander, Angelle M. PhD

The Journal of Head Trauma Rehabilitation: May/June 2013 - Volume 28 - Issue 3 - p 179–185
doi: 10.1097/HTR.0b013e31828b4fae
Original Articles

Objective: To investigate longitudinal changes in sexual functioning during the first year following moderate to severe traumatic brain injury (TBI).

Design: Prospective cohort study.

Setting: Community.

Participants: 182 persons (53 women and 129 men) with moderate to severe TBI who were admitted to 1 of 6 participating TBI Model System centers and followed in the community at 6 and 12 months after injury.

Main Measures: Derogatis Interview for Sexual Functioning—Self-Report (DISF-SR); Global Sexual Satisfaction Index (GSSI).

Results: Mean T-scores on the DISF-SR Arousal subscale demonstrated marginal improvement over time, with a 2.59-point increase (P = .05) from 6 to 12 months after injury. There were no significant differences over this 6-month period on the remaining DISF-SR subscales, including sexual cognition/fantasy, sexual behavior/experience, and orgasm. There was no significant change in satisfaction with sexual functioning on the GSSI from 6 months (72% satisfied) to 12 months (71% satisfied).

Conclusions and Implications: Sexual function and satisfaction appears to be stable in those with moderate to severe TBI from 6 to 12 months after injury, with the exception of minimal improvement in arousal. These findings, to our knowledge, reflect the first evidence regarding prospective changes in sexual functioning in this population. Future research can go far to assist clinicians in treatment planning and managing patient expectations of recovery of sexual functioning after TBI.

Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine/Rehabilitation Institute of Michigan, Detroit, Michigan (Drs Hanks and Millis); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System and Brain Injury Research Center, TIRR Memorial Hermann Dallas, Texas (Drs Sander and Maestas); and Carolinas Rehabilitation, Carolinas HealthCare System, Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Charlotte, North Carolina (Dr Hammond).

Corresponding Author: Robin Hanks, PhD, Wayne State University School of Medicine and the Rehabilitation Institute of Michigan, 261 Mack Ave, Ste 555, Detroit, MI 48201 (

The National Institute on Disability and Rehabilitation Research (NIDRR) TBI Model Systems Module Project on Sexuality After TBI was a collaborative effort between TIRR (principal investigator [PI]: Angelle Sander), Carolinas Rehabilitation (site PI: Flora Hammond), Craig Hospital (site PI: David Ripley), Mayo Clinic (site PI: Anne Moessner), Rehabilitation Institute of Chicago (site PI: Felise Zollman), and Wayne State University/Rehabilitation Institute of Michigan (site PI: Robin Hanks).

This work was supported by grants from the National Institute on Disability and Rehabilitation Research, US Department of Education (grant nos. H133A080044, H133A070042, H133A070043, and H133B031117)

The authors declare no conflicts of Interest.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.