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The Relations Among Cognitive Impairment, Coping Style, and Emotional Adjustment Following Traumatic Brain Injury

Spitz, Gershon BA; Schönberger, Michael PhD; Ponsford, Jennie PhD

Section Editor(s): Caplan, Bruce PhD, ABPP; Bogner, Jennifer PhD, ABPP

Journal of Head Trauma Rehabilitation: March/April 2013 - Volume 28 - Issue 2 - p 116–125
doi: 10.1097/HTR.0b013e3182452f4f
Original Articles

Objective: To examine the direct, mediated, and moderated associations among cognition, coping, and emotional adjustment following traumatic brain injury (TBI).

Design: Cross-sectional, single-group design.

Participants: Ninety-seven participants with mild to severe TBI recruited from their rehabilitation hospital and assessed on average 19 months postinjury.

Measures: The BIRT Memory and Information Processing Battery, Doors Test from the Doors and People Test, Hayling Sentence Completion Test, Controlled Oral Word Association Test, Trail Making Test, Digit Span, Symbol Digit Modalities Test–Oral Version, Hospital Anxiety and Depression Scale, and the Coping Scale for Adults.

Results: Poorer performance on measures of memory, executive functions, and attention and information processing was associated with greater levels of self-reported depression and anxiety. No mediated relation was found between cognition and emotional adjustment. However, the use of adaptive coping strategies was found to moderate the relation between the Hayling A—a measure of information processing speed—and self-reported depression.

Conclusions: Greater impairments in cognition directly predicted higher levels of anxiety and depression following TBI. In addition, the results suggest that the use of adaptive coping strategies has a greater effect on levels of depression for individuals with poor information processing speed.

School of Psychology and Psychiatry, Monash University (Mr Spitz and Drs Schönberger and Ponsford), and Monash-Epworth Rehabilitation Research Centre Epworth Hospital (Mr Spitz and Drs Schönberger and Ponsford), Clayton, Victoria, Australia; and Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany (Dr Schönberger).

Corresponding Author: Gershon Spitz, BA, School of Psychology and Psychiatry, Monash University, Clayton Campus, Clayton, VIC 3800, Australia (

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.