A study of the influence of cognitive complaints,cognitive performance and symptoms of anxiety and depression on self-efficacy in patients with acquired brain injury

Abstract

Objective:

To examine the relationship between self-efficacy for managing brain injury–specific symptoms and cognitive performance, subjective cognitive complaints and anxiety and depression symptoms in patients with acquired brain injury (ABI).

Design:

Clinical cohort study.

Setting:

General hospitals, rehabilitation centres.

Subjects:

A total of 122 patients with newly ABI (mean age = 54.4 years (SD, 12.2)) were assessed at discharge home from inpatient neurorehabilitation or at start of outpatient neurorehabilitation after discharge home from acute hospital. Mean time since injury was 14.1 weeks (SD, 8.6).

Main measures:

Self-efficacy was measured using the Traumatic Brain Injury (TBI) Self-Efficacy Questionnaire (SEsx), mean score = 82.9 (SD, 21.8). Objective cognitive performance was measured with the Symbol Digit Modalities Test (SDMT), mean z-score = −1.36 (SD, 1.31). Anxiety and depression symptoms were measured with the Hospital Anxiety and Depression Scale (HADS), cognitive complaints with the self-rating form of the Dysexecutive Questionnaire (DEX-P).

Results:

Higher levels of subjective cognitive complaints and higher levels of anxiety and depression symptoms were significantly associated with lower self-efficacy (β = −0.35; P = .001 and β =−0.43; P < .001, respectively). Objective cognitive performance was not significantly associated with self-efficacy (β = 0.04, P = .53). DEX-P scores accounted for 42% and HADS scores for 7% of the total 57% variance explained. Objective cognitive performance did not correlate significantly with subjective cognitive complaints (r = −.13, P = .16).

Conclusion:

Control over interfering emotions and mastery over brain injury–associated symptoms seems important in the development of self-efficacy for managing brain injury–specific symptoms.

Keywords

Self-efficacy neuropsychological rehabilitation cognitive impairment emotional distress brain injury

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References

Bandura

Self-efficacy: the exercise of control. New York: W. H. Freeman and Company, 1997.

Brands

IMH

Kohler

Stapert

, et al. Influence of self-efficacy and coping on quality of life and social participation after acquired brain injury: a 1-year follow-up study. Arch Phys Med Rehabil 2014; 95: 2327–2334.

Dumont

Gervais

Fougeyrollas

, et al. Toward an explanatory model of social participation for adults with traumatic brain injury. J Head Trauma Rehabil 2004; 19: 431–444.

Brock

Black

Cotton

, et al. Goal achievement in the six months after inpatient rehabilitation for stroke. Disabil Rehabil 2009; 31: 880–886.

Brands

IMH

Stapert

Kohler

, et al. Life goal attainment in the adaptation process after acquired brain injury: the influence of self-efficacy and of flexibility and tenacity in goal pursuit. Clin Rehabil 2015; 29: 611–622.

Genis

Camic

Harvey

Anxiety related to discharge from inpatient neurorehabilitation: exploring the role of self-efficacy and internal health control beliefs. Neuropsychol Rehabil 2016; 26: 191–215.

Lewin

Jobges

Werheid

The influence of self-efficacy, pre-stroke depression and perceived social support on self-reported depressive symptoms during stroke rehabilitation. Neuropsychol Rehabil 2013; 23: 546–562.

Longworth

Deakins

Rose

, et al. The nature of self-esteem and its relationship to anxiety and depression in adult acquired brain injury. Neuropsychol Rehabil 2018; 28: 1078–1094.

Volz

Mobus

Letsch

, et al. The influence of early depressive symptoms, social support and decreasing self-efficacy on depression 6 months post-stroke. J Affect Disord 2016; 206: 252–255.

10.

Peter

Muller

Post

, et al. Depression in spinal cord injury: assessing the role of psychological resources. Rehabil Psychol 2015; 60: 67–80.

11.

Lowe

Cockshott

Greenwood

, et al. Self-efficacy as an appraisal that moderates the coping-emotion relationship: associations among people with rheumatoid arthritis. Psychol Health 2008; 23: 155–174.

12.

Mole

Demeyere

The relationship between early post-stroke cognition and longer term activities and participation: a systematic review. Neuropsychol Rehabil. Epub ahead of print 30 April 2018. DOI: 10.1080/09602011.2018.1464934.

13.

Aben

Ponds

Heijenbrok-Kal

, et al. Memory complaints in chronic stroke patients are predicted by memory self-efficacy rather than memory capacity. Cerebrovasc Dis 2011; 31: 566–572.

14.

Jongen

Wesnes

van Geel

, et al. Does self-efficacy affect cognitive performance in persons with clinically isolated syndrome and early relapsing remitting multiple sclerosis? Mult Scler Int 2015; 2015: 960282.

15.

Van Rijsbergen

MWA

Mark

de Kort

PLM

, et al. Subjective cognitive complaints after stroke: a systematic review. J Stroke Cerebrovasc Dis 2014; 23: 408–420.

16.

Cicerone

Azulay

Perceived self-efficacy and life satisfaction after traumatic brain injury. J Head Trauma Rehabil 2007; 22: 257–266.

17.

Zigmond

Snaith

RP.

The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67: 361–370.

18.

Spinhoven

Ormel

Sloekers

PPA

, et al. A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 1997; 27: 363–370.

19.

Burgess

Alderman

Evans

JON

, et al. The ecological validity of tests of executive function. J Int Neuropsychol Soc 1998; 4: 547–558.

20.

Smith

Symbol digit modalities test. Los Angeles, CA: Western Psychological Services, 1982.

21.

De Bie

. 1987 Standaardvragen 1987: Voorstellen voor uniformering van vraagstellingen naar achtergrondkenmerken en interviews [Standard questions 1987: proposal for uniformization of questions regarding background variables and interviews]. Leiden: Leiden University Press.

22.

Brands

IMH

Kohler

Stapert

, et al. Psychometric properties of the Coping Inventory for Stressful Situations (CISS) in patients with acquired brain injury. Psychol Assess 2014; 26: 848–856.

23.

Brands

IMH

Kohler

Stapert

, et al. How flexible is coping after acquired brain injury? A one-year prospective study investigating coping patterns and influence of self-efficacy, executive functioning and self-awareness. J Rehabil Med 2014; 46: 869–875.

24.

Stulemeijer

Vos

Bleijenberg

, et al. Cognitive complaints after mild traumatic brain injury: things are not always what they seem. J Psychosom Res 2007; 63: 637–645.

25.

Nijsse

van Heugten

van Mierlo

, et al. Psychological factors are associated with subjective cognitive complaints 2 months post-stroke. Neuropsychol Rehabil 2017; 27: 99–115.

26.

Tang

Lau

Mok

, et al. Impact of anxiety on health-related quality of life after stroke: a cross-sectional study. Arch Phys Med Rehabil 2013; 94: 2535–2541.

27.

Donnellan

Hickey

Hevey

, et al. Effect of mood symptoms on recovery one year after stroke. Int J Geriatr Psychiatry 2010; 25: 1288–1295.

28.

Spitz

GBA

Schonberger

Ponsford

The relations among cognitive impairment, coping style, and emotional adjustment following traumatic brain injury. J Head Trauma Rehabil 2013; 28: 116–125.

29.

Stulemeijer

van der Werf

Andriessen

, et al. Leventhal’s self-regulation model; an alternative approach for understanding the discrepancy between cognitive complaints and neuropsychological performance in patients with mild traumatic brain injury. PhD Thesis, Radboud University, Nijmegen, 2008.

30.

Leventhal

Phillips

Burns

The Common-Sense Model of Self-Regulation (CSM): a dynamic framework for understanding illness self-management. J Behav Med 2016; 39: 935–946.

31.

Lorig

Holman

Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med 2003; 26: 1–7.

32.

Brands

IMH

Wade

Stapert

, et al. The adaptation process following acute onset disability: an interactive two-dimensional approach applied to acquired brain injury. Clin Rehabil 2012; 26: 840–852.

33.

Scheenen

Spikman

de Koning

, et al. Patients ‘at risk’ of suffering from persistent complaints after mild traumatic brain injury: the role of coping, mood disorders, and post-traumatic stress. J Neurotrauma 2017; 34: 31–37.

34.

Krpan

Stuss

Anderson

ND.

Coping behaviour following traumatic brain injury: what makes a planner plan and an avoider avoid?

Brain Inj 2011; 25: 989–996.

35.

Rakers

Scheenen

Westerhof-Evers

, et al. Executive functioning in relation to coping in mild versus moderate-severe traumatic brain injury. Neuropsychology 2018; 32: 213–219.

36.

Gregorio

Ponds

Smeets

, et al. Associations between executive functioning, coping, and psychosocial functioning after acquired brain injury. Br J Clin Psychol 2015; 54: 291–306.

37.

Anson

Ponsford

Coping and emotional adjustment following traumatic brain injury. J Head Trauma Rehabil 2006; 21: 248–259.

38.

Wolters

Stapert

Brands

IMH

, et al. Coping styles in relation to cognitive rehabilitation and quality of life after brain injury. Neuropsychol Rehabil 2010; 20: 587–600.

39.

Wolters

Stapert

Brands

IMH

, et al. Coping following acquired brain injury: predictors and correlates. J Head Trauma Rehabil 2011; 26: 150–157.

40.

Gregorio

Gould

Spitz

GBA

, et al. 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. J Head Trauma Rehabil 2014; 29: E43–E53.

41.

Dawson

Schwartz

Winocur

, et al. Return to productivity following traumatic brain injury: cognitive, psychological, physical, spiritual, and environmental correlates. Disabil Rehabil 2007; 29: 301–313.

42.

Scheenen

van der Horn

de Koning

, et al. Stability of coping and the role of self-efficacy in the first year following mild traumatic brain injury. Soc Sci Med 2017; 181: 184–190.

43.

43 Brands

IMH

Custers

van Heugten

. Selfefficacy and quality of life after low-intensity neuropsychological rehabilitation: a pre-post intervention study. Neurorehabil 2017; 40: 587–594.

44.

44 Simblett

Yates

Wagner

, et al. Computerized cognitive behavioral therapy to treat emotional distress after stroke: a feasibility randomized controlled trial. JMIR Ment Health 2017; 4: e16.

45.

Anson

Ponsford

Evaluation of a coping skills group following traumatic brain injury. Brain Inj 2006; 20: 167–178.

46.

Backhaus

Ibarra

Parrott

, et al. Comparison of a cognitive-behavioral coping skills group to a peer support group in a brain injury population. Arch Phys Med Rehabil 2016; 97: 281–291.

47.

Tam

HMK

Lam

CLM

Huang

, et al. Age-related difference in relationships between cognitive processing speed and general cognitive status. Appl Neuropsychol Adult 2015; 22: 94–99.