Trajectories of Happiness 5 Years Following Medical Discharge for Traumatic Disability: Differences Between Insider and Outsider Perspectives

We studied the predictive impact of proxy ‘‘outsider’’ reports, injury type, and functional independence on trajectories of happiness over the first 5 years following medical treatment for a traumatic spinal cord injury, brain injury, severe burns or interarticular fractures (total N = 1,271). It was anticipated that lower functional independence and outsider status would predict lower happiness trajectories, with injury type having little effect over time. A measure of functional impairment and the life satisfaction index containing the items that assessed happiness were administered 12, 24, 48, and 60 months post-discharge. Trajectory modeling revealed that lower functional independence significantly predicted lower happiness, regardless of injury type. Outsider reports predicted significantly higher happiness scores than the insiders reported themselves. These differences persisted across time and injury type. Additional analyses found that insider/outsider status accounted for one percent of the variance in happiness scores and functional independence accounted for twenty percent of the variance. Moreover, for all injury groups, there was no evidence for changes in happiness trajectories over time. Outsider accounts differ significantly from insider estimations of variables of positive adjustment accounts but explain little variation in the reports of happiness overall and still have practical and clinical value as secondary sources of information about positive emotional experiences, particularly when reports from the ‘‘insider’’ are not possible.