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Predictors of Sexual Functioning and Satisfaction 1 Year Following Traumatic Brain Injury: A TBI Model Systems Multicenter Study

Sander, Angelle M. PhD; Maestas, Kacey Little PhD; Nick, Todd G. PhD; Pappadis, Monique R. MEd; Hammond, Flora M. MD; Hanks, Robin A. PhD, ABPP; Ripley, David L. MD, MS

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

Journal of Head Trauma Rehabilitation: May/June 2013 - Volume 28 - Issue 3 - p 186–194
doi: 10.1097/HTR.0b013e31828b4f91
Original Articles

Objective: To investigate predictors of sexual functioning 1 year following traumatic brain injury (TBI).

Design: Prospective cohort study.

Setting: Community.

Participants: A total of 255 persons with TBI (187 males; 68 females) who had been treated at 1 of 6 TBI Model Systems inpatient rehabilitation units and were living in the community.

Main Measures: Derogatis Interview for Sexual Functioning-Self-Report (DISF-SR); Global Satisfaction With Sexual Functioning (Global Sexual Satisfaction Index); Participation Assessment With Recombined Tools-Objective; Patient Health Questionnaire-9.

Results: Older age, female gender, and more severe injury were associated with greater sexual dysfunction 1 year following injury. As age increased from 24 to 49 years, the odds of sexual impairment increased more than 3-fold (95% confidence interval: 1.82-5.88). Females had a 2.5 increase in odds of sexual impairment compared with males (95% confidence interval: 1.23–5.26). Greater social participation was predictive of better sexual functioning. Dissatisfaction with sexual functioning was predicted by older age and depression.

Conclusions and Implications: Older persons and females appear to be at greater risk for sexual dysfunction after TBI and may benefit from specialized assessment and treatment services. Relationships were identified between social participation and sexual function and between depression and sexual satisfaction that may serve as clinical indicators for further assessment and intervention. Further research is needed to elucidate these relationships and identify effective clinical approaches.

Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System, Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Dr Sander); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Dr Maestas); Departments of Pediatrics and Biostatistics, College of Medicine and Public Health, University of Arkansas for Medical Sciences, Little Rock (Dr Nick); Brain Injury Research Center, TIRR Memorial Hermann, Graduate College of Social Work, University of Houston, Houston, Texas (Ms Pappadis); Carolinas Rehabilitation, Carolinas HealthCare System, Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (Dr Hammond); Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Rehabilitation Institute of Michigan, Detroit (Dr Hanks); and Craig Hospital, Rehabilitation Institute of Chicago, Chicago, Illinois (Dr Ripley).

Corresponding Author: Angelle M. Sander, PhD, Brain Injury Research Center, 2323 South Shepherd Dr, Ste. 907, Houston, TX 77019 (

The NIDRR Traumatic Brain Injury 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 (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. H133A070043, H133B031117, H133A080044, H133A070042, H133A070013, H133A080045, H133A070022).

The authors declare no conflicts of interest.

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