Research Reports - How stable is coping in patients with neuropsychiatric symptoms after acquired brain injury?

J Neurotrauma. 2015 Nov 19. [Epub ahead of print]

Wolters Gregório G(1,)(2), Ponds RW(1,)(3), Smeets SM(1), Jonker F(4), Pouwels
CG(2), van Heugten CM(1,)(5).

The objective of the study was to examine changes in coping and their predictors
in patients in the chronic phase after an acquired brain injury with prominent
neuropsychiatric symptoms. Patients with brain injury were recruited from
consecutive admissions to the outpatient clinics of four mental health centers in
the Netherlands. Patients received psychoeducation and/or one or more individual
treatment sessions that were not targeting coping styles. Forty-two patients and
thirty-two significant others participated. Patients reported a significantly
greater use of passive and avoidance coping than both the general population and
patients with brain injury without neuropsychiatric symptoms. There were
statistically significant increases in avoidance coping between T1 and T2
(t = 2.0; p < 0.05). Less neuropsychiatric symptoms at T1 were associated with
increases in avoidance coping, and more neuropsychiatric symptoms were associated
with decreases in avoidance coping (β = -3.3; p < 0.001). Patients'
underestimation of their deficits at T1 was associated with greater increases in
active coping (β = -2.33; p < 0.05) than were patients' accurate estimation and
overestimation of deficits at T1. Self-reported executive functioning at T1 was
not associated with changes in coping. In conclusion, avoidance coping increased
in the chronic phase after brain injury. The changes in coping could partially be
explained by the level of neuropsychiatric symptoms and the level of
self-awareness but not by self-reported executive functioning, which should be
considered in treatment programs. 

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