Cognitive moderators of outcome following traumatic brain injury: A conceptual model and implications for rehabilitation

Abstract

This paper presents a conceptual model describing the relationships between quality of life outcomes following traumatic brain injury (TBI), coping patterns, and beliefs regarding self-efficacy to assist health-care professionals in understanding the complexity of social and psychological sequelae of TBI. The mode hypothesizes that long-lasting cognitive, behavioural, emotional psychiatric, and interpersonal after-effects of TBI may create a real life 'learned helplessness' with consequent deficits in coping, and altered locus of control beliefs. As a result, TBI patients are at risk for developing self-limiting belief systems about their effectiveness in altering significant events that may result in over-generalizing the effects that TBI has in their day-to-day lives. Subsequently, a feedback loop may be set up where their beliefs in not being able to influence outcomes are not tested, life chances are further restricted, outcomes are suboptimal, and quality of life is reduced. The clinical and theoretical implications of this model are discussed, and an expanded model with future research directions is suggested.

Changes in the coping styles of spouses and the influence of these changes on their psychosocial functioning the first year after a patient's stroke

“…The coping style is influenced by the appraisal of a stressful situation, and it affects psychosocial outcomes either negatively or positively [8]. Infrequent use of passive coping strategies and high use of reframing and seeking spiritual support have been associated with better adjustment outcomes in caregivers of patients with acquired brain injury, such as stress reduction and a high quality of life [9][10][11].…”

Executive function and metacognitive self-awareness after Severe Traumatic Brain Injury

“…These discrepancy scores can range from 268 to 68. Higher discrepancy scores are associated with more severe SA deficits, while negative scores are rare and might show a patient's overestimation of his impairment (Cicerone, 1991;Prigatano & Altman, 1990), possibly due to a high level of emotional distress (Fleming et al, 1998;Godfrey et al, 1993) or to the development of self-limiting belief systems in which TBI patients overrate the effects of their injury in everyday life (Moore & Stambrook, 1995).…”

Anxiety related to discharge from inpatient neurorehabilitation: Exploring the role of self-efficacy and internal health control beliefs

“…In the case of ABI, selfreport data may be adversely affected by cognitive difficulties (Port, Willmott & Charlton, 2008). Nevertheless, the use of Likert scales comprising relatively short and concrete items has been shown to yield accurate data in such populations (Moore et al, 1995). This seemed to be the case in the current study as all measures demonstrated good internal consistency reliability (Cronbach, 1951).…”

“…Accordingly, findings supported theoretical assumptions that self-efficacy may be derived through causal attributions (Schwarzer & Renner, 2000). For example, Moore et al (1995) proposed an overlap between control and self-efficacy beliefs following TBI, such that "generalized expectancies [...] arising from pervasive non-contingent and suboptimal outcomes in many aspects of the TBI patient's life, lead to feelings of low personal control over the environment and contribute to lowered self-efficacy" (p. 118).…”

“…With regard to TBI, Moore, Stambrook and Wilson (1995) propose a "model of cognitive beliefs and appraisals following TBI", wherein it is suggested that:…”