Self-Rated Executive Functions in Mild Traumatic Brain Injury

Prior research has found that individuals with a pre-injury psychiatric history report greater difficulty with executive functioning after mild traumatic brain injury (mTBI). The present study examined self-rated executive functioning after the acute phase of recovery in individuals with mTBI having no prior psychiatric history. Participants included 59 individuals with mTBI and 27 healthy comparison subjects (HC). They completed the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and Beck Depression Inventory-II. Participants had no prior history of psychiatric diagnosis based on semi-structured interview. In those with a valid BRIEF-A, the mTBI group (n = 54; days since injury: M = 465.04, SD = 146.92, range = 315-1144) endorsed poorer executive functioning than the HC group (n = 24) on several BRIEF-A scales. Only the Working Memory and Inhibit scales remained significant after adjusting for group differences in education and depression score, but they did not survive adjustment for multiple comparisons. The mean standardized scores for the mTBI group were well within normal limits across scales. Furthermore, there were no group differences on any BRIEF-A scales for percentage of participants with clinically elevated scores. Individuals with mTBI and no prior psychiatric history did not endorse significant executive dysfunction. Our findings support previous literature indicating that self-rated executive dysfunction in those with mTBI after the acute phase of recovery is likely due to factors other than brain injury, such as subclinical symptoms of depression.