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Archives of Assessment Psychology

Abstract

Prior traumatic brain injuries (TBIs) are common among individuals who later sustain a moderate-to-severe TBI (msTBI), and cumulative injury models suggest repeated TBIs may worsen long-term cognitive outcomes. This study tested whether prior TBI history independently contributes to cognitive performance one year after an index msTBI beyond demographic and injury-severity factors. Data were drawn from the Traumatic Brain Injury Model Systems National Database (N = 6,880 enrolled since 2017). 2,773 participants completed the Brief Test of Adult Cognition by Telephone at one-year follow-up. Hierarchical regression models evaluated whether prior TBI history accounted for incremental variance in overall cognitive status and in executive functioning and verbal memory, after adjusting for age, sex, education, race, post-traumatic amnesia duration, and Glasgow Coma Scale score. Demographic and injury-severity variables significantly explained cognitive outcomes. Prior TBI history did not account for additional variance in overall cognitive performance (ΔR² = .001, p = .863), executive functioning (ΔR² = .000, p = .867), or verbal memory (ΔR² = .000, p = .992). Effect sizes associated with prior TBI were negligible across models. These results suggest that cumulative injury effects may be more strongly reflected in functional, psychiatric, or long-term outcomes than in short-form cognitive test performance during the subacute-to-chronic recovery stage and may be overshadowed by the severity of the index injury.

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