Development and predictors of psychological adjustment during the course of community-based rehabilitation of traumatic brain injury: A preliminary study
Abstract
The aim of the study was to describe the development and predictors of psychological adjustment during community-based traumatic brain injury (TBI) rehabilitation. Forty-two adolescent and adult individuals with TBI (mean age 32 years, 88% male, median post-traumatic amnesia 11 days) participated in a single-group, longitudinal design study. The main measures used were the Reactions to Impairment and Disability Inventory, Adjustment subscale; Sydney Psychosocial Reintegration Scale; Hospital Anxiety and Depression Scale; and Self-awareness of Deficits Interview. At rehabilitation start, individuals differed significantly from each other with respect to their level of psychological adjustment. Individual trajectories of psychological adjustment were highly variable. However, for the sample as a whole, psychological adjustment did not change during the course of rehabilitation (multilevel regression models; p > .05). Good psychological adjustment was related to low levels of emotional distress and a small discrepancy between current and aspired functional status. Poor functional status had a more minor impact on psychological adjustment in individuals with poor self-awareness than in individuals with high levels of self-awareness. The results confirm parts of theoretical models of psychological adjustment to acquired brain injury, especially the importance of goal refinement. However, the results need to be treated cautiously, given the limited sample size.
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Better adjustment following acquired brain injury is strongly associated with higher subjective wellbeing and lower emotional distress.
“Better adjustment following ABI is strongly associated with higher subjective wellbeing and lower emotional distress (Carroll & Coetzer, 2011;Doering et al., 2011;Schönberger et al., 2014).”
From A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma) (2022) · cites this paper as Schönberger et al., 2014
Higher subjective wellbeing and emotional distress have been strongly associated with better adjustment following acquired brain injury.
“Higher subjective wellbeing and emotional distress have been strongly associated with better adjustment following ABI (Carroll & Coetzer, 2011;Doering et al., 2011;Schönberger et al., 2014).”
From A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma) (2022) · cites this paper as Schönberger et al., 2014
Better adjustment following ABI is strongly associated with higher subjective wellbeing and lower emotional distress.
“Better adjustment following ABI is strongly associated with higher subjective wellbeing and lower emotional distress (Carroll & Coetzer, 2011;Doering et al., 2011;Schönberger et al., 2014).”
From A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma) (2022) · cites this paper as Schönberger et al., 2014
Cites
The hospital anxiety and depression scale
Snaith, R. P., & Zigmond, A. S. (1986) · BMJ · doi:10.1136/bmj.292.6516.344 · Cited by 879 · see citing works
Identity, grief and self-awareness after traumatic brain injury
Carroll, E., & Coetzer, R. (2011) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2011.555972 · Cited by 177 · cited 4× · see citing works
“Both Carroll and Coetzer (2011) and Cantor et al. (2005) report that self-discrepancies after TBI were related to emotional distress.”
BackgroundResultInfluentialOwnsworth, T., Fleming, J., Strong, J., Radel, M., Chan, W., & Clare, L. (2007) · Neuropsychological Rehabilitation · doi:10.1080/09602010600615506 · Cited by 113 · see citing works
Cooper-Evans, S., Alderman, N., Knight, C., & Oddy, M. (2008) · Neuropsychological Rehabilitation · doi:10.1080/09602010801948516 · Cited by 78 · see citing works
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Sathananthan, N., Dimech-Betancourt, B., Morris, E., Vicendese, D., Knox, L., Gillanders, D., Das Nair, R., & Wong, D. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2021.1971094 · Cited by 31 · see citing works
“Better adjustment following ABI is strongly associated with higher subjective wellbeing and lower emotional distress (Carroll & Coetzer, 2011; Doering et al., 2011; Schönberger et al., 2014).”
BackgroundSelf-citationSathananthan, N., Morris, E., Gillanders, D., das Nair, R., Knox, L., & Wong, D. (2025) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2024.2359992 · Cited by 14 · see citing works
“Engagement in these psychological and behavioural aspects of adjustment has been strongly associated with higher wellbeing and quality of life (Carroll & Coetzer, 2011; Schönberger et al., 2014).”
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- Authors
- Schönberger, M., Ponsford, J., McKay, A., Wong, D., Spitz, G., Harrington, H., & Mealings, M.
- Affiliations
- University of Freiburg (DE)
- Epworth Hospital (AU)
- Monash University (AU)
- Corresponding author
- Schönberger, Michael
- Venue
- Neuropsychological Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2014-02-18
- Volume
- 24
- Issue
- 2
- Pages
- 202-219
- ISSN
- 0960-2011 (ISSN-L)
- 1464-0694
- OpenAlex
- W2168397047
- Cited by
- 14
- References
- 4
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 2 · 2017: 1 · 2016: 5 · 2015: 1
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychological Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- traumatic brain injury, psychological adjustment, community-based rehabilitation, acquired brain injury, emotional distress, functional status, goal refinement, predictors of adjustment, adolescents and adults
- MeSH terms
- Adaptation, Psychological, Adult, Brain Injuries, Female, Humans, Longitudinal Studies, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychotherapy, Treatment Outcome, Young Adult
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