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Changes in Self-Reported Pre- to Postinjury Coping Styles in the First 3 Years After Traumatic Brain Injury and the Effects on Psychosocial and Emotional Functioning and Quality of Life

Gregório, Gisela Wolters PhD; Gould, Kate R. DPsych; Spitz, Gershon BA (Hons); van Heugten, Caroline M. PhD; Ponsford, Jennie L. PhD

Journal of Head Trauma Rehabilitation: May/June 2014 - Volume 29 - Issue 3 - p E43–E53
doi: 10.1097/HTR.0b013e318292fb00
Original Articles

Objective: To examine the influence of self-reported preinjury coping on postinjury coping, psychosocial functioning, emotional functioning, and quality of life at 1 year following traumatic brain injury (TBI).

Setting: Inpatient hospital and community.

Participants: One hundred seventy-four participants with TBI.

Design: Prospective, longitudinal design. Participants were assessed at 5 time points: after emerging from posttraumatic amnesia, and at 6, 12, 24, and 36 months postinjury.

Main Measures: Coping Scale for Adults–Short Version; Quality of Life Inventory; Sydney Psychosocial Reintegration Scale; Hospital Anxiety and Depression Scale.

Results: High preinjury use of nonproductive coping style predicted high use of nonproductive coping, more anxiety, and lower psychosocial functioning at 1 year postinjury. Increased use of nonproductive coping and decreased use of productive coping predicted poorer psychosocial outcome at 1 year post-TBI. Use of both productive and nonproductive coping decreased in the first 6 to 12 months post-TBI relative to preinjury. Unlike productive coping, nonproductive coping reached preinjury levels within 3 years postinjury.

Conclusion: The findings support identification of individuals at risk of relying on nonproductive coping and poorer psychosocial outcome following TBI. In addition, the results emphasize the need to implement timely interventions to facilitate productive coping and reduce the use of nonproductive coping in order to maximize favorable long-term psychosocial outcome.

Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands (Drs Wolters Gregório and van Heugten); Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia (Drs Gould and Ponsford and Mr Spitz); School of Psychology and Psychiatry, Faculty of Medicine, Nursing, and Health Science, Monash University, Clayton, Victoria, Australia (Drs Gould and Ponsford and Mr Spitz); and Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Alfred Hospital, Melbourne, Australia (Drs Gould and Ponsford).

Corresponding Author: Jennie L. Ponsford, PhD, School of Psychology and Psychiatry, Monash University, Clayton Campus, Clayton, VIC 3800, Australia (

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins