IMPACT OF TRAUMATIC BRAIN INJURY ON GENERAL RELATIONSHIP AND SEXUALITY

Abstract

Cognitive rehabilitation is the main focus within the traditional approach of Traumatic Brain Injury (TBI) management. To what extent post-TBI sexuality might be incorporated within this rehabilitation program, was the main focus of the current study. In order to investigate intimate relationships, sexuality and associated factors following TBI in Bangladesh, a total of 165 TBI patients, 53 intimate partners (IP) and 43 family members (FM) of TBI survivors were studied between October 2019 and December 2020. To compare the findings, 71 normal control (NC) sample was also recruited using an online survey. Mean age for TBI was 32 years and there were 156 males and 9 females. Mean age for NC was 36 years, and there were 42 males and 29 females. The TBI sample rated frontal system, relationship and sexuality questionnaires for themselves. The IP sample gave proxy ratings on frontal system and sexuality but self-rating on relationship and burden questionnaire. The FM sample gave self-ratings on burden and proxy ratings on the frontal system questionnaire. Compared to pre-injury levels, Post TBI intimate relationship satisfaction (IRS) significantly declined both for TBI [t (80)=3.71 , p< .001] and IP [t (49)=6.47 , p< .001] group. Current IRS of IP was significantly lower than that of the TBI group (p= .04) and NC group (p= .02). Current IRS of IP group was significantly correlated at the .01 level with the patient’s apathy [(A) r= -.424], disinhibition [(D) r=-.595], executive dysfunction [(ED) r=-.485], and theory of mind [(ToM) r=-.493]. Sexuality decreased among 49% of patients but also increased among 18%. Patients underwent neurosurgery experienced significantly more problems with sexuality [t (95.907) = -2.17, p = .038]. Compared to NC overall sexuality of TBI was significantly lower [t (164.97) = - 6.69, p <.001] and was significantly correlated with GCS (r=.337), cognitive ability (r=.355), A (r=.569),

and ToM (r=-.404). Patients satisfied with sexuality showed significantly better prognosis on A (p<.001), ED (p=.002), ToM (p<.001), IRS (p=.01) and RTW (p=.008). Intimate partner’s level of burden was significantly correlated with patient’s sexuality (r=-.414) and behavior problems (r=.580). Therefore, the assessment, formulation and treatment of postTBI

intimate relationships, sexuality and frontal system behavior problems should be undertaken within neurorehabilitation so as to promote quality of life and improve treatment prognosis.