Premorbid personality characteristics and attachment style moderate the effect of injury severity on occupational outcome in traumatic brain injury: another aspect of reserve.

The concept of "reserve" has been proposed to account for the mismatch between brain pathology and its clinical expression. Prior efforts to characterize this concept focused mostly on brain or cognitive reserve measures. The present study was a preliminary attempt to evaluate premorbid personality and emotional aspects as potential moderators in moderate-to-severe traumatic brain injury. Using structural equation modeling and multiple regression analyses, we found that premorbid personality characteristics provided the most robust moderator of injury severity on occupational outcome. Findings offer preliminary support for premorbid personality features as another relevant reserve construct in predicting outcome in this population.