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Western Journal of Nursing Research
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Psychological and Biological Correlates of Fatigue After Mild-to-Moderate Traumatic Brain Injury

Esther Bay

Michigan State University, baye{at}msu.edu

Yan Xie

Michigan State University

Relationships between chronic perceived stress, cortisol response (area under the curve) and posttraumatic brain injury fatigue were examined with persons from outpatient settings. Seventy-five injured persons with traumatic brain injury and their relatives/significant others participated in this cross-sectional study. Using interviews and self-reported data from the Neurofunctional Behavioral Inventory, the Perceived Stress Scale, the Profile of Mood States-Fatigue subscale, the McGill Pain Scale, as well as self-collection of salivary cortisol over a 12-hour period ( N = 50), we found that perceived chronic stress explained 40% of the variance in fatigue until depressive symptoms and pain were in the model. Hypocortisolemia was evident. Somatic symptom frequency and perceived chronic stress represented 50% of the variability in post-TBI fatigue. Fatigue and stress management interventions, as suggested in the Centers for Disease Control Acute Concussion guidelines, may be beneficial in reducing this common symptom.

Key Words: mental health • neurology • depression • anxiety/stress • fatigue • descriptive quantitative

This version was published on October 1, 2009

Western Journal of Nursing Research, Vol. 31, No. 6, 731-747 (2009)
DOI: 10.1177/0193945909334856
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