Cross-Lagged Panel Analysis of Depression and Behavioral Dysfunction in the First Year After Moderate-to-Severe Traumatic Brain Injury

Timely treatment of depression and behavioral dysfunction after moderate-to-severe traumatic brain injury (TBI) could improve health, function, and quality of life. The authors hypothesized that 6-month depression would be the stronger contributor to later depression and behavioral dysfunction in a sample of 88 adults with moderate-to-severe TBI. A structural equation modeling cross-lagged panel analysis, adjusting for all 6-month predictors, revealed that 6-month depression had a stronger relationship to 12-month depression (β_stand=0.55, p=0.002) and behavioral dysfunction (β_stand=0.41, p=0.004) than did 6-month behavioral dysfunction (β_stand=0.17, p=0.270, β_stand=0.30, p=0.035). Depression may be in the developmental pathway to behavioral dysfunction, triggering a cycle of reciprocal causality.