Brain injury beliefs, self-awareness, and coping: A preliminary cluster analytic study based within the self-regulatory model

Abstract

The interplay between individuals' subjective beliefs about traumatic brain injury, their coping style and their self-awareness might provide a more helpful guide to rehabilitation goals than looking at these factors in isolation. We therefore conducted a preliminary study to determine whether the Self-Regulatory Model can identify different clusters of individuals according to belief schemata, and to explore whether clusters differed across measures of coping and self-awareness. The Illness Perception Questionnaire-Revised was administered to 37 participants with severe traumatic brain injury (TBI), along with the Ways of Coping Checklist-Revised and the European Brain Injury Questionnaire. Clinicians also rated clients' level of difficulties using the latter scale, and the discrepancy between client and clinician scores was used as a measure of self-awareness. Hierarchical cluster analysis distinguished three groups based on profiles of subjective beliefs about TBI, labelled "low control/ambivalent", "high salience", and "high optimism". The high salience group was characterised by beliefs about serious consequences of the injury and greater self-awareness, and reported a greater range of coping strategies. The other two groups showed lower levels of awareness but differed in coping styles, with the low control/ambivalent group showing a trend towards more avoidance coping against a background of lower perceived control.

Role of older adult's illness schemata in coping with Mild Cognitive Impairment

“…However, in contrast to two previous studies [29,30], in this study controllability did not differ by cluster, and participants in all clusters endorsed strong beliefs that MCI is controllable through personal effort and medical treatment. Strong beliefs about controllability over cognition-related problems are consistent with previous studies of both cognitively normal older adults [31] and older adults with MCI [7].…”

“…Previous studies of illness schemata in persons with cognitive disorders secondary to brain injury [29] and in hypertension [30] had similar results. In those studies, 3 clusters of illness representations emerged with one cluster representing a large number of symptoms plus negative beliefs while the other two clusters had relatively fewer symptoms and positive beliefs.…”

The adaptation process following acute onset disability: an interactive two-dimensional approach applied to acquired brain injury

“…The group with better awareness reported a greater overall use of a variety of coping strategies. 70 In the long term, Ownsworth et al did not find differences in emotional adjustment between groups with good and poor awareness. However, the poor awareness group scored significantly lower on independent living skills.…”

Changes in Self-Reported Pre- to Postinjury Coping Styles in the First 3 Years After Traumatic Brain Injury and the Effects on Psychosocial and Emotional Functioning and Quality of Life

“…There might be an interaction between an individual's subjective beliefs about the injury (eg, about its controllability or perceived duration) and level of awareness of difficulties. 15 Further, cognitive difficulties may influence the successful application of a coping strategy. Patients with executive problems may have greater difficulty implementing productive coping strategies and may rely on avoidance strategies, which are considered maladaptive.…”