Curvis, Will and Simpson, Jane (2015) Self-esteem and social anxiety following brain injury. PhD thesis, Lancaster University.
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Abstract
Empirical studies and theoretical models discussing psychological and psychosocial wellbeing following brain injury have increasingly suggested the importance of rehabilitation interventions which take into account the psychological resources of the individual, as opposed to focusing solely on cognitive or physical impairment. The first paper systematically reviewed 27 quantitative studies to identify predictors or correlates of self-esteem following acquired brain injury (ABI) in adulthood. Various psychological variables are associated with low self-esteem, including greater changes in perceived identity and self-concept, poorer adjustment and higher levels of perceived loss. Higher self-esteem appears to be related to greater physical and functional impairment. The relationship between self-esteem and cognitive impairment is unclear. Low self-esteem is also strongly related to depression and poorer psychological outcomes following ABI. The second paper describes a research project exploring social anxiety following traumatic brain injury (TBI). Despite the impact of TBI on physical, cognitive and social outcomes, no research to date has explored the role of psychological factors influencing the development of social anxiety. Hierarchical multiple regression was used to investigate demographic, clinical and psychological factors associated with social anxiety in a sample of 85 people who had experienced TBI. Psychological variables (self-esteem, locus of control, self-efficacy) provide a significant contribution to the amount of explained variance in social anxiety (above that explained by demographic and clinical variables). Moreover, perceived stigma independently predicted social anxiety. The findings support the importance of psychological variables in the development of social anxiety, and the significant role of stigma highlights the need for both individualised and societal interventions. The third paper offers a critical appraisal of the research project, identifying key strengths and limitations in addition to discussing reflections on the process of conducting the study. The results and implications of the study are discussed, with particular focus on social models of disability.