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Factors Associated With Sexuality Following Traumatic Brain Injury

Ponsford, Jennie L. PhD; Downing, Marina G. PhD; Stolwyk, Rene DPsych

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

Journal of Head Trauma Rehabilitation: May/June 2013 - Volume 28 - Issue 3 - p 195–201
doi: 10.1097/HTR.0b013e31828b4f7b
Original Articles

Background: Previous research has demonstrated that sexuality is compromised following traumatic brain injury (TBI).

Objectives: The aim of this study was to determine the association between sexuality following TBI and demographic, injury-related, and postinjury variables (age, gender, time since injury, posttraumatic amnesia duration, independence in activities of daily activities (ADL), antidepressant use, depression, and self-esteem).

Methods: Participants included 986 individuals with predominantly moderate to severe TBI, who completed the Brain Injury Questionnaire of Sexuality (BIQS), the Hospital Anxiety and Depression Scale, and the Rosenberg Self-Esteem Scale and an ADL assessment on 1 or more occasions, providing a total of 1673 assessments across 1, 2, 3, 5, 10, and 20 years postinjury.

Results: Being depressed, older in age, at shorter time postinjury, and less independent in ADL significantly predicted poorer overall BIQS scores as well as the Sexual Functioning subscale score. Poorer Relationship Quality and Self-esteem scores on the BIQS were predicted by older age at injury and higher levels of depression. Lower Mood score on the BIQS was associated with shorter posttraumatic amnesia duration, younger age, and higher levels of depression. Self-esteem was associated positively with sexuality outcome.

Conclusions: Therapeutic interventions for sexuality need to focus on depression where indicated and self-esteem and address specific barriers to social participation and opportunities for sexual contact in individuals who are less independent in ADL.

School of Psychology and Psychiatry, Monash University (Drs Ponsford, Downing, and Stolwyk); Monash-Epworth Rehabilitation Research Centre (Drs Ponsford and Downing); and National Trauma Research Institute (Dr Ponsford), Melbourne, Victoria, Australia.

Corresponding Author: Jennie L. Ponsford, PhD, School of Psychology and Psychiatry, Monash University, Bldg 17, Wellington Rd, Clayton, Melbourne 3800, Victoria, Australia (

This project is funded by the Transport Accident Commission, through the Institute for Safety, Compensation and Recovery Research.

The authors thank all participants involved in this project who gave so generously of their time.

The authors declare no conflicts of interest.

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