ORIGINAL ARTICLE Role of Character Strengths in Outcome After Mild Complicated to Severe Traumatic Brain Injury: A Positive Psychology Study Robin A. Hanks, PhD, a Lisa J. Rapport, PhD, b Brigid Waldron-Perrine, PhD, a Scott R. Millis, PhD a From the a Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, MI; and b Department of Psychology, Wayne State University College of Liberal Arts and Sciences, Detroit, MI. Abstract Objective: To examine the effects of character strengths on psychosocial outcomes after mild complicated to severe traumatic brain injury (TBI). Design: Prospective study with consecutive enrollment. Setting: A Midwestern rehabilitation hospital. Participants: Persons with mild complicated to severe TBI (NZ65). Interventions: Not applicable. Main Outcome Measures: Community Integration Measure, Disability Rating Scale, Modified Cumulative Illness Rating Scale, Positive and Negative Affect Schedule, Satisfaction with Life Scale, Values in Action Inventory of Strengths, and Wechsler Test of Adult Reading. Results: Character virtues and strengths were moderately associated with subjective outcomes, such that there were fewer and less strong associations between character virtues/strengths and objective outcomes than subjective outcomes. Specifically, positive attributes were associated with greater life satisfaction and perceived community integration. Fewer and less strong associations were observed for objective well-being; however, character strengths and virtues showed unique value in predicting physical health and disability. Positive affectivity was not mean- ingfully related to objective outcomes, but it was significantly related to subjective outcomes. In contrast, negative affectivity was related to objective but not subjective outcomes. Conclusions: Given the strength of the associations between positive aspects of character or ways of perceiving the world and positive feelings about one’s current life situation, treatments focused on facilitating these virtues and strengths in persons who have experienced TBI may result in better perceived outcomes and potentially subsequently lower comorbidities. Archives of Physical Medicine and Rehabilitation 2014;95:2096-102 ª 2014 by the American Congress of Rehabilitation Medicine Rehabilitation specialists have focused on the prediction of defi- cits and the identification of interventions that ease the impact of traumatic brain injury (TBI). 1 Some researchers, however, have challenged the field to focus on the prediction and augmentation of character strengths. 1-5 Positive psychology promotes the idea that professionals should be as concerned with strength as with weakness, a natural fit for TBI rehabilitation that facilitates pos- itive outcomes. Research on character strengths is crucial given recent empirical evidence that psychological “well-being” and “ill-being” act more like distinct constructs than extreme ends of a single continuum. 6 As such, the assumption that easing suffering will augment happiness may not be tenable. Peterson and Seligman 7 proposed a classification scheme of human virtues and strengths, in which strengths can also be conceptualized as character traits, and virtues are classes of character strengths. Their classification of strengths of virtues 7 posits the existence of 6 major “virtues” that show individual differences but relative cross-cultural stability: wisdom, courage, humanity, justice, temperance, and transcendence. 2 Within each An audio podcast accompanies this article. Listen at www.archives-pmr.org. Supported by the U.S. Department of Education-National Institute on Disability and Reha- bilitation ResearcheThe Field Initiated Project (grant no. H133G080064). Disclosures: none. 0003-9993/14/$36 - see front matter ª 2014 by the American Congress of Rehabilitation Medicine http://dx.doi.org/10.1016/j.apmr.2014.06.017 Archives of Physical Medicine and Rehabilitation journal homepage: www.archives-pmr.org Archives of Physical Medicine and Rehabilitation 2014;95:2096-102