Stability of normal personality traits after traumatic brain injury

Abstract

Objective: To test the hypothesis that changes in personality traits are evident after traumatic brain injury (TBI) using current models of normal adult personality variation.

Design: Comparison of inception cohort and control group at two measurement occasions.

Setting: A large urban academic medical center.

Participants: Retrospective personality assessments were obtained from significant others of 21 TBI patients within 30 days of injury and at 6-month follow-up and from a control group of significant others of 25 persons without neurological history twice over a 6-month interval.

Main outcome measures: Five scales-Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness-from the revised NEO Personality Inventory (NEO PI-R), Form R, and an observer rating scale for retrospective estimates of change (REC).

Results: Significant score changes were found for only one of the five trait domains in the patient sample; controls showed minimal changes overall. Patients' Extraversion scores declined to average levels at 6-month follow-up, diminishing premorbid differences between patients and controls on this dimension. Subjective change estimates made by raters after follow-up reflected perceptions of increased neuroticism in patients that were inconsistent with the serial NEO PI-R data the raters provided.

Conclusions: The absence of systematic changes in personality trait scores among the patients cautions against presuming that such changes account for the behavior of TBI patients.