Defense Date


Document Type


Degree Name

Master of Science


Counseling Psychology

First Advisor

Paul Perrin

Second Advisor

Bruce Rybarczyk

Third Advisor

Juan Arango


A traumatic brain injury (TBI) can have a host of negative consequences including impairments to motor and cognitive function and can result in a decrease in quality of life (i.e., life satisfaction). TBI is one of the leading causes of death and disability worldwide and disproportionately affects Native Americans, who have the highest rates of TBI among all races in the U.S. and elevated likelihood for fatality and severe complications. The current study used a subsample of the national TBI Model Systems Database of 80 demographically and injury severity matched Native American and White individuals (total n = 160) to investigate whether disparities in functional and life satisfaction outcomes exist over the 5 years after injury, and if so, whether demographic and injury-related covariates account for them. A series of hierarchical linear models found that Native Americans demonstrated significantly lower Functional Independence Measure (FIM) Cognitive and Motor trajectories than did Whites; however, life satisfaction was comparable. Further, FIM cognitive trajectories changed differentially over time, with Native Americans demonstrating declining cognitive function over time relative to a slight increase in White individuals; however, this differential movement dissipated with the addition of employment status at the time of injury and type of health insurance held by the person with TBI. These results demonstrate a profound need to further investigate the cultural and contextual variables unique to Native Americans that underlie these differences and highlight the importance of culturally responsive treatment and rehabilitation in bridging the gap in recovery.


Jack D. Watson

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission


Available for download on Thursday, December 07, 2023