Evaluating a theory of stress and adjustment when predicting long-term psychosocial outcome after brain injury

Abstract

Kendall and Terry (1996) include many psychosocial predictors in their theoretical model that explains individual differences in psychosocial adjustment (Lazarus & Folkman, 1984). The model depicts appraisal and coping variables as mediating relationships between situation factors, environmental and personal resources, and multidimensional outcome. The aim of this study was to explore these theoretical relationships at very late stages of recovery from traumatic brain injury. A total of 131 participants who were more than 10 years post-injury (mean 5 15.31 years) completed several psychosocial measures relating to outcome dimensions comprising employment, community integration, life satisfaction, quality of life (QoL), and emotion. There was no evidence that appraisal and coping variables mediated relationships between psychosocial and any of the outcome variables. However, when appraisal and coping variables were combined with psychosocial variables as direct predictors of outcome, every outcome except employment status was reliably predicted, accounting for between 31 and 46% of the variance. Personality significantly influenced all predicted outcomes. Self-efficacy contributed to the prediction of all outcomes except QoL. Data did not support for the theory of stress and adjustment as a framework for explaining the nature of predictive relationships between psychosocial variables and very long-term, multidimensional outcome after brain injury. (JINS, 2006, 12, 359-367.)

Perceived social support and locus of control after a traumatic brain injury (TBI)

“…It should be emphasized that future research is needed to further investigate the relation between rehabilitation and these variables [42]. It is therefore necessary to take these variables into account if we are to improve the rehabilitation of TBI patients.…”

Influence of Self-Efficacy and Coping on Quality of Life and Social Participation After Acquired Brain Injury: A 1-Year Follow-Up Study

“…In the chronic stage after brain injury, this positive association was already known. 6,7,9 Furthermore, increasing self-efficacy seemed to mitigate the negative influence of emotion-oriented coping on health-related QOL, suggesting that high self-efficacy has a protective effect. This stress-buffering effect of high self-efficacy is well documented in healthy people 33 and patients with cancer.…”

“…6 As a general concept, higher general self-efficacy has been related to better QOL and social participation in TBI. [7][8][9] However, because all studies were conducted cross-sectionally in the chronic stage after TBI, one cannot determine whether self-efficacy in the early stage after brain injury is predictive for better long-term QOL and social participation.…”

Development of Depressive Symptoms During Early Community Reintegration After Traumatic Brain Injury

“…Lifestyle stressors have been found to influence emotional adjustment in long-term TBI (Rutterford & Wood, 2006); however, the emotional impact of early transition events after TBI has been largely overlooked. Research by Turner et al (2009) identified that individuals with brain injury viewed the hospital-to-home transition more favorably when greater progress was made in resuming their preinjury lifestyle.…”