Skip to main content
SpringerLink
Log in

Gender Differences in Cognitive and Emotional Adjustment to Traumatic Brain Injury

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

This study examined gender differences in cognitive and emotional status after traumatic brain injury (TBI) among 262 men and 140 women with TBI referred for neuropsychological evaluations. In this cross-sectional study, cognition was measured in terms of both absolute level of functioning (i.e., raw/standard scores) and estimated decline from premorbid levels expressed as z-deficit scores in the following domains: intelligence [Wechsler Adult Intelligence Scale—Revised (WAIS-R)], memory and attention [Wechsler Memory Scale—Revised (WMS-R)], processing speed (Trails A), and cognitive flexibility (Trails B). Emotional functioning was measured in terms of depression (Beck Depression Inventory) and general emotional distress (Brief Symptom Inventory). Kruskal–Wallis nonparametric one-way ANOVAs indicated that women and men differed significantly on 2 of 8 raw/standard cognitive scores [men demonstrated lower WMS-R General Memory (p < .05) and Trails B scores (p < .0001) and 4 of 8 relative decline scores [women demonstrated more estimated change in VIQ (Verbal IQ) [p < .0001], FSIQ (Full Scale IQ) [p < .01], and Attention (p < .01)]; men demonstrated greater estimated z-decline scores on Trails B (p < .01)]. Women reported significantly higher levels of depression (p < .01), but men endorsed significantly greater general psychological distress (p < .05). Research and assessment recommendations are suggested.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Agency for Health Care Policy Research. (1998). Rehabilitation for traumatic brain injury [On–line], Summary, evidence report/technology assessment: Number 2. Available: www.ahcpr.gov/clinic/tbisumm.htm

  • Alfano, D. P., Neilson, P. M., & Fink, M. P. (1993). Long–term psychosocial adjustment following head or spinal cord injury. Neuropsychiatry, Neuropsychology and Behavioral Neurology, 6(2), 117–125.

    Google Scholar 

  • Andreasen, N. C., Flaum, M., Swayze, V., II, O'Leary, D. S., Alliger, R., Cohen, G., Ehrhardt, J., & Yuh, W. T. C. (1993). Intelligence and brain structure in normal individuals. American Journal of Psychiatry, 150(1), 130–134.

    Google Scholar 

  • Beck, A. T., Ward, Ch. H., Mendelson, M., Mock, J., & Erbaugh, J. K. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Google Scholar 

  • Burton, L. A., & Volpe, B. T. (1988). Sex differences in emotional status of traumatically brain–injured patients. Journal of Neurologic Rehabilitation, 2, 151–157.

    Google Scholar 

  • Dawson, D. R., & Chipman, M. (1995). The disablement experienced by traumatically brain–injured adults living in the community. Brain Injury, 9(4), 339–353.

    Google Scholar 

  • Derogatis, L. R. (1993). Administration, scoring and procedures manual (3rd ed.). Minneapolis: National Computer Systems, Inc.

    Google Scholar 

  • Farace, E., & Alves, W. M. (2000). Do women fare worse? A metaanalysis of gender differences in outcome after traumatic brain injury. Neurosurgery Focus [On–line], 8(1). Retrieved from the World Wide Web on 07/05/2000 at: neurology.medscape.com/AANS/NF/2000/v08.n01/nf0801.07.fara/nf0801.07.fara01.html

  • Fromm–Auch, C., & Yeudall, C. T. (1983). Normative data for the Halstead Reitan neuropsychological tests. Journal of Clinical Neuropsychology, 5, 221–228.

    Google Scholar 

  • Gerberich, S. G., Gibson, R. W., Fife, D., Mandel, J. S., Aeppli, D., Le, C. T., Maxwell, R., Rolnick, S. J., Renier, C., Burlew, M., & Matross, R. (1997). Effects of brain injury on college academic performance. Neuroepidemiology, 16, 1–14.

    Google Scholar 

  • Groswasser, Z., Cohen, M., & Keren, O. (1998). Female TBI patients recover better than males. Brain Injury, 12(9), 805–808.

    Google Scholar 

  • Hayes, Z. L., & Waller, T. G. (1994). Gender differences in adult readers: A process perspective. Canadian Journal of Behavioral Science, 26(3), 421–437.

    Google Scholar 

  • Inglis, J., & Lawson, J. S. (1982). A meta–analysis of sex differences in the effects of unilateral brain damage on intelligence test results. Canadian Journal of Psychology, 36(4), 670–683.

    Google Scholar 

  • Jastak, S., & Wilkinson, G. S. (1984). WRAT–R:Wide Range Achievement Test—Revised administration manual. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Johnstone, B., Callahan, C. D., Kapila, C. J., & Bouman, D. E. (1996). Concurrent reading tests as estimates of premorbid intelligence in neurologically impaired patients: The superiority of the WRAT–R reading subtest. Archives of Clinical Neuropsychology, 11, 513–519.

    Google Scholar 

  • Johnstone, B., Hexum, C. L., & Ashkanazi, G. (1995). Extent of cognitive decline in traumatic brain injury based on estimates of premorbid intelligence. Brain Injury, 9(4), 377–384.

    Google Scholar 

  • Johnstone, B. J., Schopp, L. H., Harper, J., & Koscuilek, J. (1999). Neuropsychological impairments, vocational outcomes, and financial costs for individuals with traumatic brain injury receiving state vocational rehabilitation services. Journal of Head Trauma Rehabilitation, 14, 10–22.

    Google Scholar 

  • Kaplan, S. P. (1990). Social support, emotional distress, and vocational outcomes among persons with brain injuries. Rehabilitation Counseling Bulletin, 34(1), 16–23.

    Google Scholar 

  • Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., Wittchen, H.–U., & Kendler, K. S. (1994). Lifetime and 12–month prevalence of DSM–III–R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19.

    Google Scholar 

  • Kinsella, G., Moran, C., Ford, B., & Ponsford, J. (1988). Emotional disorder and its assessment within the severe head injured population. Psychological Medicine, 18, 57–63.

    Google Scholar 

  • Levy, J., & Heller, W. (1992). Gender differences in human neuropsychological function. In A. A. Gerall, H. Moltz, & I. L. Ward (Eds.), Sexual differentiation: Vol. 11. Handbook of behavioral neurobiology. New York: Plenum Press.

    Google Scholar 

  • National Center for Injury Prevention and Control. (2000). Epidemiology of traumatic brain injury in the United States [Online], Centers for Disease Control & Prevention, May 1, 2000. Available: http://www.cdc.gov/ncipc/dacrrdp/tbi.htm

  • McGlone, J. (1980). Sex differences in functional brain asymmetry: A critical survey. Behavioral and Brain Sciences, 3, 215–227.

    Google Scholar 

  • McMordie, W. R., Barker, S. L., & Paolo, T. M. (1990). Return to work (RTW) after head injury. Brain Injury, 4(1), 57–69.

    Google Scholar 

  • Millis, S. R., & Dijkers, M. (1993). Use of the Recognition Memory Test in traumatic brain injury. Brain Injury, 7(1), 53–58.

    Google Scholar 

  • O'Neill, J., Hibbard, M. R., Brown, M., Jaffe, M., Sliwinski, M., Vandergoot, D., & Weiss, M. J. (1998). The effect of employment on quality of life and community integration after traumatic brain injury. Journal of Head Trauma Rehabilitation, 13(4), 68–79.

    Google Scholar 

  • Reitan, R. M. (1986). Trail making test: Manual for administration and scoring. Tuscon, AZ: Reitan Neuropsychological Laboratory.

    Google Scholar 

  • Roof, R. L., Duvdevani, R., & Stein, D. G. (1993). Gender influences outcome of brain injury: Progesterone plays a protective role. Brain Research, 607(1–2), 333–336.

    Google Scholar 

  • Segalowitz, S. J., & Lawson, S. (1995). Subtle symptoms associated with self–reported mild head injury. Journal of Learning Disabilities, 28(5), 309–319.

    Google Scholar 

  • Sliwinski, M., Gordon, W. A., & Bogdany, J. (1998). The Beck Depression Inventory: Is it a suitable measure of depression for individuals with traumatic brain injury? Journal of Head Trauma Rehabilitation, 13(4), 40–46.

    Google Scholar 

  • Stein, D. G. (1995). Gender, progesterone and the early stages of brain injury. Restorative Neurology and Neuroscience, 8, 105.

    Google Scholar 

  • TBI Model Systems National Data Center. (1998). TBIfacts and figures, 3 [On–line]. Available: www.tbism.org/to/ffjune98.html.

  • Trudel, T. M., Tryon, W.W., & Purdum, C. M. (1998). Awareness of disability and long–term outcome after traumatic brain injury. Rehabilitation Psychology, 43(4), 267–281.

    Google Scholar 

  • Turkheimer, E., & Farace, E. (1992). A reanalysis of gender differences in IQ scores following unilateral brain lesions. Psychological Assessment, 4(4), 498–501.

    Google Scholar 

  • Veltman, J. C., Brouwer, W. H., van Zomeren, A. H., & van Wolffelaar, P. D. (1996). Central executive aspects of attention in subacute severe and very severe closed head injury patients: Planning, inhibition, flexibility, and divided attention. Neuropsychology, 10(3), 357–367.

    Google Scholar 

  • Wechsler, D. (1981). Wechsler Adult Intelligence Scale—Revised manual. New York: Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (1987). Manual for the Wechsler Memory Scale— Revised. San Antonio: Psychological Corporation.

    Google Scholar 

  • Weissman, M. M., Bland, R., Joyce, P. R., Newman, S., Wells, J. E.,& Wittchen, H.–U. (1993). Sex differences in rates of depression: Cross–national perspectives. Journal of Affective Disorders, 29, 77–84.

    Google Scholar 

  • Willer, B. S., Allen, K. M., Liss, M., & Zicht, M. S. (1991). Problems and coping strategies of individuals with traumatic brain injury and their spouses. Archives of Physical Medicine and Rehabilitation, 72, 460–464.

    Google Scholar 

  • Wilkinson, G. (1993). WRAT3: Wide range achievement test administration manual (3rd ed.). Wilmington, DE: Wide Range.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, University of Missouri-Columbia School of Medicine, Columbia, Missouri

    Laura H. Schopp, Cheryl L. Shigaki, Brick Johnstone & Heather A. Kirkpatrick

Authors
  1. Laura H. Schopp
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cheryl L. Shigaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brick Johnstone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Heather A. Kirkpatrick
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schopp, L.H., Shigaki, C.L., Johnstone, B. et al. Gender Differences in Cognitive and Emotional Adjustment to Traumatic Brain Injury. Journal of Clinical Psychology in Medical Settings 8, 181–188 (2001). https://doi.org/10.1023/A:1011369620254

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1011369620254

Search

Navigation