Neurobehavioral Symptoms by Gender and Experience of Nightmares After Traumatic Brain Injury

Purpose/Objective: The purpose of this study is to assess how neurobehavioral symptoms following traumatic brain injury (TBI) may differ based on gender and the experience of nightmares. Research Method/Design: This cross-sectional study of community-dwelling adults ≥3 months post-TBI (n = 110) assessed differences in neurobehavioral symptoms between women (n = 41) and men (n = 69) by experience of nightmares. Outcome measures included the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Behavioral Assessment Screening Tool subscales for negative affect, substance abuse, executive functioning, fatigue, impulsivity, and maladaptive coping. Results: N = 22 participants (n = 7 women, n = 15 men) experienced nightmares at least "sometimes" over the past 2 weeks. Nightmares were associated with more substance abuse, negative affect, fatigue, maladaptive coping, depressive symptoms, and anxiety symptoms (ps < .02). Women reported more negative affect, maladaptive coping, depressive symptoms, and anxiety symptoms (ps < .05) than men. Men experiencing nightmares reported more substance use than men without nightmares (p = .036), a difference not seen in women (p = .233). Women experiencing nightmares reported more impulsivity than women without nightmares (p = .028), a difference not seen in men (p = .559). Conclusions/Implications: Nightmares, post-TBI, are associated with more neurobehavioral symptoms. However, symptom patterns associated with nightmares may differ by gender. Nightmares may be a symptom of, or contribute to, sleep disruptions post-TBI or may indicate other conditions, like posttraumatic stress disorder. Future research should examine gender differences in neurobehavioral symptoms post-TBI in the context of nightmares and/or sleep disorders.