OBJECTIVE To investigate the association of sexuality with sociodemographic (age, sex, education), medical (injury severity, time since injury), physical (fatigue, pain, independence), neuropsychological (memory, attention, executive function), psychological (depression, anxiety, self-esteem), and social participation factors after traumatic brain injury (TBI). DESIGN Survey. Individuals with TBI completed measures at a mean average of 2.78 years post-injury (range = 1-10.3 years). SETTING All participants were community based at the time of data collection. PARTICIPANTS Eighty-four individuals with TBI consecutively recruited after discharge from rehabilitation and 88 age-, sex- and education-matched controls recruited from the general community. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE Brain Injury Questionnaire of Sexuality (BIQS). RESULTS Individuals with TBI performed significantly worse on sexuality, mood and self-esteem measures compared to the healthy control group, supporting previous findings. Research findings highlighted a range of significant correlations between sociodemographic, physical, neuropsychological, psychological and social participation factors and sexuality outcomes after TBI. In the multiple regression model, older age, greater depression and lower self-esteem were significant predictors of poorer sexuality post-injury. Further analyses indicated that depression mediated the independent relationships between lower social participation and greater fatigue with a decline in sexuality after TBI. CONCLUSIONS These findings support sexuality changes after TBI as a multidimensional construct, highlighting depression as a key mechanism through which other factors may impact sexual functioning. Further research is needed to target assessment and intervention services for sexuality problems after TBI.

中文翻译：

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了解创伤性脑损伤后性行为的多维本质

目的 调查性与社会人口统计学（年龄、性别、教育）、医学（伤害严重程度、受伤后的时间）、身体（疲劳、疼痛、独立）、神经心理学（记忆、注意力、执行功能）、心理（抑郁、创伤性脑损伤 (TBI) 后的焦虑、自尊）和社会参与因素。设计调查。TBI 患者在受伤后平均 2.78 年（范围 = 1-10.3 年）完成测量。设置 所有参与者在数据收集时都是基于社区的。参与者 在康复出院后连续招募了 84 名患有 TBI 的人，并从一般社区招募了 88 名年龄、性别和教育相匹配的对照。干预 不适用。主要结果测量性行为脑损伤问卷 (BIQS)。结果 与健康对照组相比，TBI 患者在性、情绪和自尊方面的表现明显更差，支持先前的发现。研究结果强调了社会人口学、身体、神经心理学、心理和社会参与因素与 TBI 后性行为结果之间的一系列显着相关性。在多元回归模型中，年龄较大、抑郁程度较高和自尊心较低是受伤后性行为较差的重要预测因素。进一步的分析表明，抑郁介导了较低的社会参与度和较高的疲劳度之间的独立关系，以及 TBI 后性欲下降。结论 这些发现支持 TBI 后的性行为变化是一个多维结构，强调抑郁症是其他因素可能影响性功能的关键机制。需要进一步研究针对 TBI 后性问题的评估和干预服务。