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Neurological Rehabilitation

Prevalence and Correlates of Repetitive Head Injury in a Moderate to Severe TBI Rehabilitation Sample

Thursday, October 23, 2025
2:15 PM - 3:30 PM MT
Location: Session Room - 250 DEF
Disclosure(s):
Rosalie Ellis, DO: No financial relationships to disclose
Librada Callender, MPH, PhD: No financial relationships to disclose
Background and/or Objectives: To examine the prevalence of repetitive head injury (RHI) exposure among individuals receiving inpatient rehabilitation for moderate to severe traumatic brain injury (TBI), and to identify demographic and mental health characteristics associated with RHI.

Design: Secondary analysis of a subset of data collected through a multi-site, cross-sectional observational cohort study.

Setting : Telephone surveys at 1-, 2-, 5-years post-injury and every 5 years thereafter.

Participants : A total of 2409 participants recruited from inpatient rehabilitation for moderate to severe TBI.

Interventions: None

Main Outcome Measures: RHI was assessed by Step 3 of the Ohio State University TBI Identification Method (OSU TBI-ID), which asks “Have you ever had a period of time in which you experienced multiple, repeated impacts to your head (e.g. history of abuse, contact sports, military duty)?” Mental Health outcomes were assessed by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder questionnaire (GAD-7).

Results: 212 participants (9%) were identified as having RHI . Those with RHI (RHI+) were more likely to be male [X2 (1, N=2409) =24, p < .001] and white [X2 (1, N=2385) =6.4, p = .01] compared to those without RHI (RHI-). The median age of the cohort at the time of index TBI was 30 years old for RHI+ (IQR 22, 44) and 36 years old for RHI- (IQR 24,52). In the overall cohort, 29% and 14 % screened positive for depression and anxiety, respectively. Rates of anxiety/depression did not differ by RHI exposure [X2 (1, N=2363) =1.1, p = .29] or depression [X2 (1, N=2377) =0.9, p = .34].

Conclusions: Repetitive head injury exposure was identified in nearly 1 in 10 individuals undergoing inpatient rehabilitation for moderate to severe TBI and was more common among younger, white males. However, RHI exposure was not associated with higher rates of depression or anxiety in this cohort. These findings highlight the need for further research.