Long-term consequences of electrical injury: neuropsychological predictors of adjustment.

ABSTRACT

OBJECTIVE: Electrical injury (EI) produces an assortment of consequences for individuals. Survivors perform poorly on measures of attention and mental speed, memory, and emotional functioning. Moreover, sequelae are not always reported immediately following injury and often increase over the months following injury. It remains unclear whether the observed increase in neuropsychological and emotional symptoms over time is attributable to the delayed physical effects of EI or other factors that arise subsequent to injury, such as difficulty adjusting to post-injury limitations. METHOD: The current study utilized archival data to compare the neuropsychological and emotional complaints of EI survivors at two points during recovery, hypothesizing that Time 1 data would predict participants' outcome at Time 2. Specifically, those with worse neuropsychological performance and greater depressive symptomatology at Time 1 would have worse long-term adjustment to injury and psychological symptomatology. RESULTS: Multiple regression analyses revealed a significant predictive effect of Time 1 neurocognitive performance and depressive symptomatology on Time 2 adjustment to injury, psychological distress, and return to work. Participants with greater depressive symptomatology endorsed during the initial neuropsychological evaluation had substantially more difficulty with overall psychosocial adjustment to electrical injury. Moreover, depressive symptomatology persisted or worsened over the course of recovery. CONCLUSIONS: Findings demonstrate that poor outcome 4 years after EI is largely predicated by early emotional sequelae. Early screening and specialized interventions are needed to address psychological symptomatology among EI survivors.