Post-Traumatic Stress Symptoms and Depression Strongly Associated with Emotional Regulation Deficits in Individuals with Traumatic Brain Injury

Authors

  • Iszati Afiqah Iskandar Zulkarnain Universiti Sains Malaysia
  • Mohd Faizal Mohd Zulkifly Universiti Sains Malaysia

DOI:

https://doi.org/10.31436/imjm.v25i02.3368

Keywords:

Traumatic brain injury, post-traumatic stress symptoms, depressive symptoms, emotional regulation, expressive suppression

Abstract

INTRODUCTION: Traumatic brain injury (TBI) is frequently linked to psychological challenges, including post-traumatic stress symptoms (PTSS), depressive symptoms, and emotional regulation difficulties. Despite the high prevalence of these issues in individuals with TBI, research on their interrelationships remains limited. This study aims to investigate the prevalence of PTSS, depressive symptoms, and emotional regulation difficulties among individuals with TBI and to explore the relationships between these challenges. MATERIALS AND METHODS: A cross-sectional study was conducted with 150 individuals with a history of TBI. Participants completed self-report measures: the Post-Traumatic Stress Disorder Checklist (PCL), the Patient Health Questionnaire (PHQ-9), and the Emotion Regulation Questionnaire (ERQ). Descriptive statistics and correlation tests were employed to assess the prevalence and interrelationships between the variables. RESULTS: The results revealed that 80.7% of participants met the clinical threshold for PTSS, 83.3% exhibited moderate to severe depressive symptoms, and 32% demonstrated low cognitive reappraisal scores. Additionally, 74% of participants showed medium to high levels of expressive suppression. Strong positive correlations were found between expressive suppression and PTSS (Spearman’s ρ=0.532, p<0.001) and between PTSS and depressive symptoms (Spearman’s ρ=0.728, p<0.001). CONCLUSION: The study highlights significant psychological challenges in individuals with TBI, emphasizing the role of emotional regulation in the co-occurrence of PTSS and depressive symptoms. These findings suggest that emotional regulation strategies, particularly expressive suppression, play a crucial role in the psychological outcomes of TBI. Future research should focus on longitudinal studies to better understand these relationships and their long-term implications.

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Published

09.09.2026

How to Cite

Iskandar Zulkarnain, I. A., & Mohd Zulkifly, M. F. (2026). Post-Traumatic Stress Symptoms and Depression Strongly Associated with Emotional Regulation Deficits in Individuals with Traumatic Brain Injury. IIUM Medical Journal Malaysia, 25(02). https://doi.org/10.31436/imjm.v25i02.3368