The relationship between resilience, emotional distress, and community participation outcomes following traumatic brain injury.

: To determine how resilience is associated with social participation outcomes in persons with traumatic brain injury (TBI), in the context of emotional distress, demographics, and injury-related factors. : Individuals with a history of TBI recruited the following stay at three rehabilitation facilities in the USA. : 201 community-dwelling persons with medically documented TBI ranging in severity from mild to severe. : Prospective cohort observational study. Data were collected at two time points, approximately 6 months apart. : TBI-QOL; PART-O : Resilience at baseline was moderately to strongly correlated with baseline psychological distress variables (= -.66) and social participation variables (.33 to.57). In regression analyses, resilience was directly associated with social participation outcomes and formed a significant interaction with emotional distress in some models. Resilience failed to show a relationship with social participation at 6-month follow-up, when controlling for baseline social participation. : Though related to emotional distress, self-reported resilience makes a unique contribution to predicting outcomes over time following brain injury, and may impact the relationship between stress and negative participation outcomes. As such, it is possible interventions that promote resilience may mitigate distress and promote community integration.