Quality of Life Research

, Volume 26, Issue 4, pp 893–902 | Cite as

Mindful creativity matters: trajectories of reported functioning after severe traumatic brain injury as a function of mindful creativity in patients’ relatives: a multilevel analysis

  • Chiara S. HallerEmail author
  • Colin M. Bosma
  • Kush Kapur
  • Ross Zafonte
  • Ellen J. Langer



The objective of the present investigation was to examine the association of mindful creativity with the trajectory of recovery (emotional, interpersonal, cognitive, and total functioning) of patients with severe TBI.


This was drawn from a subsample of an adult prospective cohort study on severe TBI in Switzerland; patients and their relatives were assessed at 3, 6, and 12 months (patients N = 176, relatives N = 176). Predictor measures were assessed using Mindful Creativity Scale—short form and time (trajectory of functioning of the patient over time). Outcome measures were assessed using Patient Competency Rating Scale for Neuro-rehabilitation (PCRS-NR; measuring emotional, interpersonal, cognitive, and total functioning post-injury). All measures were assessed at each time point. Mixed linear models were run separately for ages >50 and ≤50 (i.e., bimodal distribution).


Patients’ mindful creativity showed no significant association with patients’ functioning across time in any of the models. In all age groups, interpersonal functioning decreased across time (slope>50 = −4.66, p = .037; slope≤50 = −7.19, p = .007). Interestingly, in age group ≤50, interpersonal functioning increased when looking at relative mindful creativity by time (slope = 1.69, p = .005). Additionally, relatives mindful creativity was significantly associated with patients’ functioning in age group ≤50: (a) patients’ total functioning (slope = 0.18, p = .03) and (b) cognitive functioning (slope = 0.72, p = .020).


Relatives’ mindful creativity was significantly associated with patients’ functioning after severe TBI. Implications for treatment and future research are discussed.


Mindfulness Creativity Severe traumatic brain injury Functioning of the patient Association with the relative 



Traumatic brain injury




Prefrontal cortex


Anterior cingulate cortex


Posterior parietal cortex


Abbreviated Injury Scale of the head region


Mindful Creativity Scale—short version


Langer Mindfulness Scale


Patient Competency Rating Scale for Neuro-rehabilitation


Akaike information criterion


Statistical manual of mental disorders


Post-traumatic stress disorder


Patient-relevant endpoints after brain injury from traumatic accidents



Many thanks to the PEBITA team for their passion and support ( Profound thanks to all the participants.

Compliance with ethical standard

Conflict of interest

All authors declare that they have no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee of the respective cantons.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Chiara S. Haller
    • 1
    • 2
    Email author
  • Colin M. Bosma
    • 1
  • Kush Kapur
    • 3
    • 4
  • Ross Zafonte
    • 5
  • Ellen J. Langer
    • 1
  1. 1.Department of PsychologyHarvard UniversityCambridgeUSA
  2. 2.Division of Public PsychiatryMassachusetts Mental Health CenterBostonUSA
  3. 3.Harvard Medical SchoolBostonUSA
  4. 4.Clinical Research Center and Department of NeurologyBoston Children’s HospitalBostonUSA
  5. 5.Department of Physical Medicine and RehabilitationSpaulding Rehabilitation Hospital, Massachusetts General Hospital, Harvard Medical SchoolCambridgeUSA

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