That which doesn’t kill us can make us stronger (and more satisfied with life): The contribution of personal and social changes to well-being after acquired brain injury

Abstract

This study examined the roles of personal and social changes on the relationship between injury severity and life satisfaction among individuals with acquired brain injury (ABI). Personal change (i.e. having developed a survivor identity, identity strength), social changes (i.e. improved social relationships, support from services), injury severity (i.e. length of time in coma) and well-being (i.e. life satisfaction) were assessed in a sample of 630 individuals with ABIs. A counterintuitive positive relationship was found between injury severity and life satisfaction. Bootstrapping analyses indicated that this relationship was mediated by personal and social changes. Although identity strength was the strongest individual mediator, both personal and social changes each explained unique variance in this relationship. These findings suggest that strategies that strengthen personal identity and social relationships may be beneficial for individuals recovering from ABIs.

Injury characteristics and EQ-5D as predictors of personal wellbeing after injury

“…Injury severity and its influence on wellbeing or life satisfaction has been the subject of much discussion over the years, with studies often showing results contrary to expectations (Albrecht & Devlieger, 1999;Jones et al, 2011;Post & Noreau, 2005). Many of these studies have focussed on more serious trauma, such as spinal cord injury.…”

“…More specifically, many studies have concentrated on people with spinal cord or traumatic brain injury. Interestingly, results from many of these studies have reported better life satisfaction and quality of life than was expected (Albrecht & Devlieger, 1999;Dijkers, 2004;Jones et al, 2011;Post & Noreau, 2005). Some explanations for this propose a "response shift" (Dijkers, 2004) or adaptation process (Menzel, Dolan, Richardson, & Olsen, 2002), whereby people adapt to challenges presented to them by changing their internal standard of expectations.…”

“…There may also be a sense of surviving a major life event from which one can learn (Albrecht & Devlieger, 1999). Furthermore, services and supports surrounding a severely injured individual can provide much-needed practical, psychological and social support that can impact on wellbeing (Jones et al, 2011). If such support is not available, it is likely that anatomical severity will not be the main influence on wellbeing, and that the inability to self-care, participate in usual activities, or maintain social networks and social functioning may be more important (Dijkers, 2004;Fuhrer, 2000;Post & Noreau, 2005).…”

Beyond Crisis Care in Brain Injury Rehabilitation in Australia

“…17 At present, the postacute coordination of rehabilitation arrangements largely falls to consumers and their families. 18 The task of mobilizing complex support systems can be impossible for people with brain injury, who are vulnerable to reduced social networks 10,12 and who may have a compromised ability to form and maintain social linkages with others.…”

“…At this time, it is not uncommon for significant social and behavioral challenges to emerge including impulsiveness, sexual disinhibition, aggression, diminished insight, and poor judgment. [8][9][10] These behaviors complicate the process of regaining employment, re-establishing financial independence, and maintaining relationships, resulting in social isolation, unemployment, poverty, poor health, criminal behavior, and family breakdown. Ironically, as reported elsewhere, 2 there is a long-term cost benefit of providing early psychosocial intervention to people with brain injury.…”