Research has highlighted the significant adjustment for individuals with TBI, particularly in relation to identity change, appraisal and coping. The themes of wanting normality and changing life perspective which were dominant in the current study highlight the significance of the transition phase in the process of adjustment and that transition is characterized by adapting to a new normality.

: A combination of sentinel events and personal and environmental factors influences the perceptions of individuals and their families regarding the success of the transition from hospital to home.

Emotional distress after traumatic brain injury (TBI) often presents as a range of neurobehavioural and emotional reactions rather than distinct disorders. This study adopted a transdiagnostic approach with the aim of identifying psychological processes common to depression, anxiety and global distress after TBI. Fifty participants with TBI (aged 19-66 years, 12-65 months post-injury) completed measures of threat appraisals and avoidance behaviour (Appraisal of Threat and Avoidance Questionnaire), selfdiscrepancy (Head Injury Semantic Differential Scale III), emotion dysregulation (Difficulties in Emotion Regulation Scale), worry (Penn State Worry Questionnaire), negative self-focused attention (Self-Focus Sentence Completion) and emotional distress (Depression Anxiety Stress Scales and Brief Symptom Inventory). Significant correlations were found among the proposed transdiagnostic variables (r s = .29-.82, p<.05). A principal components analysis revealed two underlying factors; 1) threats to self and 2) emotion dysregulation. Only the emotion dysregulation factor accounted for significant unique variance in levels of depression, anxiety and global distress (sr 2 = .12-.17). Such findings indicate the need for interventions to target difficulties in identifying and regulating emotions after TBI to facilitate emotional adjustment.

Preliminary research supports that acquired brain injury (ABI) can act as a catalyst for positive psychological changes, and that such posttraumatic growth (PTG) increases with time since injury. In this study, posttraumatic growth refers to positive psychological changes in domains including interpersonal relationships, new possibilities, personal strength, spirituality and appreciation for life. This study aimed to identify associations between levels of subjective impairment and depressive symptoms at discharge, and PTG at 6-months postdischarge following ABI. Sixty participants (73% male) with ABI (Mean days of hospitalisation = 32.92, SD = 40.74) were consecutively recruited from an inpatient rehabilitation unit at discharge and were administered measures of subjective impairment (Mayo-Portland Adaptability Index–4; MPAI-4) and depression (Depression, Anxiety Stress Scales; DASS). Participants were followed up at 6-months postdischarge and administered the Post-Traumatic Growth Inventory, DASS and MPAI-4. The results indicated that levels of PTG reported at six months postdischarge were relatively modest and ranged between no to very small degree of change (‘spirituality’) and a small to moderate degree of change (‘a greater appreciation of life’). Level of subjective impairment at discharge significantly predicted overall level of PTG at 6-months follow-up (β =.40, p < .05, sr2 = .28). Further, at 6-months postdischarge, individuals with a greater appreciation for life reported significantly higher levels of subjective impairment (r = .35; p < .01) and depressive symptoms (r = .34, p < .01) at that time point. These findings indicate that individuals who perceive greater functional consequences of their ABI are more likely to experience PTG. Further, the process of reevaluating priorities and values in life after ABI may be associated with emotional distress during the early stages of community reintegration.

This research highlights the benefit of using the SEQ to systematically record the occurrence of sentinel events in order to better understand the process of transition from hospital to home following ABI.