Profiles of emotional and behavioral sequelae following acquired brain injury: Cluster analysis of the Personality Assessment Inventory

Due to the multidimensional nature of symptom complaints within the acquired brain injury (ABI) population, emotional and behavioral profiles obtained from using comprehensive validated measures often yield more relevant information than tools that assess for symptoms of a single diagnostic disorder. The current study used the Personality Assessment Inventory (PAI) to detect emotional and behavioral profiles in a sample of 440 adult ABI patients. Using a rigorous three-step cluster analytic approach, seven clusters were identified, indicating that half of the sample (50%) showed clinically significant affective and behavioral symptoms typified by multiple Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I and/or II features. Two of the subtypes showed severe and diverse affective symptoms but were distinguished from each other by antisocial features and substance use. Two other subtypes, with predominantly internalized presentations, were characterized by mainly depressive and somatic features, and the second by mild anxiety and cognitive disturbance. One group, predominantly externalized presentation, showed high substance use and antisocial features. The other part of the sample (50%) had no significant affective or behavioral complaints but were characterized by two profile types classified as essentially normal, but distinguishable by one having an increased tendency to minimize symptoms. Sex, age, marital status, education/preinjury, and vocation typified various subtypes. The identified profiles taken in the context of important demographic information can provide descriptive insight into the nature of postinjury affective and behavioral symptoms, facilitating more comprehensive conceptualization of the client's needs that can be addressed through more tailored interventions.