Associations between illness perceptions, self-criticism, self-reassurance and recovery outcomes following traumatic brain injury

Prescott, Lindsay and Jackman, Lorraine and Curvis, Will (2020) Associations between illness perceptions, self-criticism, self-reassurance and recovery outcomes following traumatic brain injury. PhD thesis, Lancaster University.

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Abstract

Section one presents a systematic literature review examining the relationship between injury perceptions and persistent post-concussion symptoms (PPCS), quality of life (QoL) and psychological distress outcomes in individuals following traumatic brain injury (TBI). Four databases were systematically searched using key words and thesaurus terms related to the concepts noted above. 12 papers were included in the final review. Findings suggest that the attribution of m re symptoms to the TBI, a perception that symptoms will last a long time, have more negative consequences and a stronger emotional reaction to the TBI, are more likely to be associated with increased PPCS. The identity, timeline, consequences, concern, emotional representations and personal control subscales were significantly associated with QoL outcomes following TBI. Longitudinal studies emphasise the predictive ability of injury perceptions following TBI which gives attention to the role of clinical psychology in acute management and follow-up of those who have suffered a TBI. Clinical implications and limitations of the review are discussed. Section two reports on an empirical investigation into the relationship between selfcriticism and both symptomatic (PPCS) and post-TBI depression in a sample of 41 adults who sustained a mild to moderate TBI between 3 and 12 months previous. Significant moderate effect size correlations between both self-criticism and self-reassurance with each of the outcomes assessed (early onset PPCS, late-enduring PPCS and post-TBI depression) were found. A series of multiple regression analyses evidenced that self-criticism demonstrated significant predictive ability above previously known predictors for enduring PPCS and also post-TBI depression. Self-reassurance did not demonstrate predictive ability. Limitations and clinical implications are discussed and include the relevance of self-criticism to both preventative and therapeutic intervention for individuals following TBI. Section three includes a critical appraisal of the thesis and processes involved in undertaking the above two research papers.