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Attributions and Expectations for the Behavior of Persons With Brain Injury: The Effect of Visibility of Injury

McClure, John DPhil; Patel, Gauranga Jeram BSc(Hons); Wade, Kim PhD

Journal of Head Trauma Rehabilitation: September/October 2011 - Volume 26 - Issue 5 - p 392–396
doi: 10.1097/HTR.0b013e3181f8fd34
Original Articles

Objective: To determine whether visible markers of brain injury shape people's causal attributions for the behaviors of the person with the injury and their expectations that those behaviors will persist for 5 years.

Design: Experimental scenarios described an adolescent boy with a brain injury (pictured either with or without a head scar) who showed 4 behavior changes relating to sleep, anger, self-confidence, and motivation.

Setting: Victoria University of Wellington.

Participants: University student volunteers (N = 249).

Measures: For each behavior, ratings of attributions to either the brain injury or to adolescence and estimates that the behaviors would persist for 5 years.

Results: Attributions to brain injury correlated with expectations that the behaviors would persist. Participants attributed the behaviors more to the brain injury than to adolescence in the scar condition but not in the no-scar condition.

Conclusions: Visible markers of brain injury such as scars are spurious markers of severity that shape attributions for actions of persons with the injury and expectations that problematic behaviors will persist. The results inform strategies for correcting misunderstandings about brain injury and enhancing rehabilitation.

Victoria University of Wellington, Wellington, New Zealand (Dr McClure and Mr Jeram Patel); and University of Warwick, Coventry, United Kingdom (Dr Wade).

Corresponding Author: John McClure, DPhil, School of Psychology, Victoria University of Wellington, PO Box 600, Wellington, New Zealand (

The authors declare no conflict of interest

© 2011 Lippincott Williams & Wilkins, Inc.