Sexual Functioning 1 Year After Traumatic Brain Injury: Findings From a Prospective Traumatic Brain Injury Model Systems Collaborative Study

Sander AM, Maestas KL, Pappadis MR, Sherer M, Hammond FM, Hanks R, and the NIDRR Traumatic Brain Injury Model Systems Module Project on Sexuality After TBI. Sexual functioning 1 year after traumatic brain injury: findings from a prospective Traumatic Brain Injury Model Systems collaborative study.ObjectiveTo investigate the incidence and types of sexual difficulties in men and women with traumatic brain injury (TBI) 1 year after injury, as well as their comfort level in discussing problems with health care professionals.DesignProspective cohort study.SettingCommunity.ParticipantsPersons with TBI (N=223; 165 men and 58 women) who had been treated at 1 of 6 participating TBI Model Systems inpatient rehabilitation units and were living in the community.InterventionsNone.Main Outcome MeasuresDerogatis Interview for Sexual Functioning-self-report (DISF-SR); Global Sexual Satisfaction Index (GSSI); structured interview regarding changes in sexual functioning; and comfort level discussing sexuality with health care professionals.ResultsWomen with TBI scored significantly below the normative sample for all subscales of the DISF-SR, including sexual cognition/fantasy, arousal, sexual behavior/experience, and orgasm. Men scored significantly below the normative sample on all scales except arousal. Women reported greater dysfunction than men for sexual cognition/fantasy and arousal. Twenty-nine percent of participants reported dissatisfaction with sexual functioning on the GSSI, with a greater percentage of men reporting dissatisfaction. Sixty-eight percent of participants indicated that they would spontaneously raise issues of sexual difficulties with health care professionals, while the remainder would either bring it up only if directly asked or would not discuss it at all.ConclusionsSexual difficulties were present in a substantial portion of community-dwelling people with TBI at 1 year after injury. Educational interventions to increase awareness among people with TBI and rehabilitation professionals are warranted, as well as interventions to improve sexual functioning.