Self-esteem and social anxiety following brain injury

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

Factors associated with self-esteem following acquired brain injury in adults:a systematic review

Self-esteem is potentially a key factor in psychological and psychosocial well-being following acquired brain injury (ABI). The current review aimed to identify, synthesise and appraise all existing quantitative empirical studies on predictors or correlates of self-esteem following ABI in adulthood. In total, 27 papers met the inclusion criteria. A range of clinical factors were related to self-esteem after ABI, including the degree of physical and functional impairment. It is unclear if cognitive impairment is related to high or low self-esteem. Additionally, psychological variables such as coping styles, adjustment and perception of problems or rehabilitation are related to self-esteem following ABI. Depression is strongly associated with low self-esteem, alongside anxiety, psychological distress and quality of life. Limitations of the available research and recommendations for clinical practice and further research are discussed. In particular, there is a need to engage with contemporary theoretical understandings of self-esteem, integrated with and supported by developments in how self-esteem is conceptualised and measured over time in an ABI population. The findings of the review suggest that self-esteem is an important factor to consider following ABI, particularly in the context of developing individualised, formulation-driven rehabilitation interventions that take into account biological, social and psychological factors

Social anxiety following traumatic brain injury:an exploration of associated factors

Social anxiety (SA) following traumatic brain injury (TBI) has the potential to affect an individual’s general psychological well-being and social functioning, however little research has explored factors associated with its development. The present study used hierarchical multiple regression to investigate the demographic, clinical and psychological factors associated with SA following TBI. A sample of 85 people who experienced TBI were recruited through social media websites and brain injury services across the North-West of England. The overall combined biopsychosocial model was significant, explaining 52–54.3% of the variance in SA (across five imputations of missing data). The addition of psychological variables (self-esteem, locus of control, self-efficacy) made a significant contribution to the overall model, accounting for an additional 12.2–13% of variance in SA above that explained by demographic and clinical variables. Perceived stigma was the only significant independent predictor of SA (B = .274, p = .005). The findings suggest that psychological variables are important in the development of SA following TBI and must be considered alongside clinical factors. Furthermore, the significant role of stigma highlights the need for intervention at both an individualised and societal level

Self-compassion and coping in chronic illness groups

The aim of this research was to explore self-compassion and its associations with psychological outcomes and coping, in both general and specific chronic illness groups. In chapter 1, quantitative research that explored the relationships between self-compassion and outcomes of psychological distress (i.e. depression, anxiety and/or stress) and coping was synthesised. This included adult chronic illness populations samples. To identify relevant literature, four academic databases were systematically searched. The findings of the review highlighted self-compassion consistently correlated with depression, anxiety and stress, as well as adaptive and maladaptive coping strategies. It also explained unique variance across studies. Subtle differences were observed across conditions and samples in the strength of relationships, but results overall highlight the need for interventions developed to enhance self-compassion in chronic illness groups. In chapter 2, a qualitative research study explored coping and self-compassion in a sample of adolescents living with epilepsy. Adolescents were invited to take part in interviews, and Interpretative Phenomenological Analysis (IPA) was used to develop themes from the narratives of five adolescents. Three superordinate themes were constructed: (i) Learning about my condition and my experiences: “Getting answers and people explaining things…it makes massive lifesaving differences”, (ii) Dealing with the thought takeover: “I try not to think on it to move on” and (iii) Being in an accepting bubble: “I know that people have got my back”. These findings indicate how coping and self-compassion are situated within the sample, and what interventions might support how young people manage an unpredictable, individual condition like epilepsy. In chapter 3, a critical appraisal was conducted to outline the main findings, reflections around the key decisions, the study process and personal considerations noted throughout

Relationships between Reading Ability and Child Mental Health: Moderating Effects of Self-Esteem

Objective: Children with reading difficulties are at elevated risk for externalising (e.g., conduct disorder) and internalising (e.g., anxiety and depression) mental health problems. Reading ability is also negatively associated with self-esteem, a consistent predictor of child and adolescent mental health more broadly. This study examined whether self-esteem moderated and/or mediated relationships between reading ability and mental health. Method: One hundred and seventeen children (7-12 years) completed standardised reading assessments (Castles and Coltheart Test 2; CC2) and self-report measures of mental health (Strengths and Difficulties Questionnaire; SDQ) and self-esteem (Coopersmith Self-esteem Inventory). Non-verbal intelligence (IQ) was measured using the block design and matrix reasoning subscales of the Wechsler Abbreviated Scale of Intelligence, and was controlled for in all multivariate analyses. Results: Reading ability was negatively associated with internalising symptoms. This relationship was not moderated by self-esteem. Poor readers also reported more total difficulties and externalising symptoms, but only at low levels of self-esteem. There was no evidence that self-esteem mediated relationships between reading ability and mental health. Conclusions: Poor reading was associated with internalising symptoms. Self-esteem moderated the impact of reading ability on total difficulties and externalising symptoms, with high self-esteem buffering against negative impacts of poor reading. However, the reliability of the self-esteem scale used in the study was poor and findings need replication using a reliable and valid self-esteem measure, as well as other measures of child mental health. If replicated, future research should examine whether interventions aiming to improve self-esteem can reduce the risk of externalising problems in children with reading difficulties

The KiVa antibullying program in primary schools in Chile, with and without the digital game component: study protocol for a randomized controlled trial.

BACKGROUND: Bullying is a major problem worldwide and Chile is no exception. Bullying is defined as a systematic aggressive behavior against a victim who cannot defend him or herself. Victims suffer social isolation and psychological maladjustment, while bullies have a higher risk for conduct problems and substance use disorders. These problems appear to last over time. The KiVa antibullying program has been evaluated in Finland and other European countries, showing preventive effects on victimization and self-reported bullying. The aims of this study are (1) to develop a culturally appropriate version of the KiVa material and (2) to test the effectiveness of the KiVa program, with and without the online game, on reducing experiences of victimization and bullying behavior among vulnerable primary schools in Santiago (Chile), using a cluster randomized controlled trial (RCT) design with three arms: (1) full KiVa program group, (2) partial KiVa (without online game) program group and (3) control group. METHODS AND DESIGN: This is a three-arm, single-blind, cluster randomized controlled trial (RCT) with a target enrolment of 1495 4th and 5th graders attending 13 vulnerable schools per arm. Students in the full and partial KiVa groups will receive universal actions: ten 2-h lessons delivered by trained teachers during 1 year; they will be exposed to posters encouraging them to support victims and behave constructively when witnessing bullying; and a person designated by the school authorities will be present in all school breaks and lunchtimes using a visible KiVa vest to remind everybody that they are in a KiVa school. KiVa schools also will have indicated actions, which consist of a set of discussion groups with the victims and with the bullies, with proper follow-up. Only full KiVa schools will also receive an online game which has the aim to raise awareness of the role of the group in bullying, increase empathy and promote strategies to support victimized peers. Self-reported victimization, bullying others and peer-reported bullying actions, psychological and academic functioning, and sense of school membership will be measured at baseline and 12 months after randomization. DISCUSSION: This is the first cluster RCT of the KiVa antibullying program in Latin America. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: NCT02898324 . Registered on 8 September 2016

Exploring the Role of Explicit and Implicit Self-Esteem and Self-Compassion in Anxious and Depressive Symptomatology Following Acquired Brain Injury

[EN] Objectives Acquired brain injury (ABI) can lead to the emergence of several disabilities and is commonly associated with high rates of anxiety and depression symptoms. Self-related constructs, such as self-esteem and self-compassion, might play a key role in this distressing symptomatology. Low explicit (i.e., deliberate) self-esteem is associated with anxiety and depression after ABI. However, implicit (i.e., automatic) self-esteem, explicit-implicit self-discrepancies, and self-compassion could also significantly contribute to this symptomatology. The purpose of the present study was to examine whether implicit self-esteem, explicit-implicit self-discrepancy (size and direction), and self-compassion are related to anxious and depressive symptoms after ABI in adults, beyond the contribution of explicit self-esteem. Methods The sample consisted 38 individuals with ABI who were enrolled in a long-term rehabilitation program. All participants completed the measures of explicit self-esteem, implicit self-esteem, self-compassion, anxiety, and depression. Pearson's correlations and hierarchical regression models were calculated. Results Findings showed that both self-compassion and implicit self-esteem negatively accounted for unique variance in anxiety and depression when controlling for explicit self-esteem. Neither the size nor direction of explicit-implicit self-discrepancy was significantly associated with anxious or depressive symptomatology. Conclusions The findings suggest that the consideration of self-compassion and implicit self-esteem, in addition to explicit self-esteem, contributes to understanding anxiety and depression following ABI.Lorena Desdentado is supported by a FPU doctoral scholarship (FPU18/01690) from the Spanish Ministry of Universities. 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The development of cross-cultural recognition of vocal emotion during childhood and adolescence

Humans have an innate set of emotions recognised universally. However, emotion recognition also depends on socio-cultural rules. Although adults recognise vocal emotions universally, they identify emotions more accurately in their native language. We examined developmental trajectories of universal vocal emotion recognition in children. Eighty native English speakers completed a vocal emotion recognition task in their native language (English) and foreign languages (Spanish, Chinese, and Arabic) expressing anger, happiness, sadness, fear, and neutrality. Emotion recognition was compared across 8-to-10, 11-to-13-year-olds, and adults. Measures of behavioural and emotional problems were also taken. Results showed that although emotion recognition was above chance for all languages, native English speaking children were more accurate in recognising vocal emotions in their native language. There was a larger improvement in recognising vocal emotion from the native language during adolescence. Vocal anger recognition did not improve with age for the non-native languages. This is the first study to demonstrate universality of vocal emotion recognition in children whilst supporting an “in-group advantage” for more accurate recognition in the native language. Findings highlight the role of experience in emotion recognition, have implications for child development in modern multicultural societies and address important theoretical questions about the nature of emotions

Income and social rank influence UK children's behavioral problems : a longitudinal analysis

Children living in low‐income households face elevated risks of behavioral problems, but the impact of absolute and relative income to this risk remains unexplored. Using the U.K. Millennium Cohort Study data, longitudinal associations between Strengths and Difficulties Questionnaire scores and absolute household income, distance from the regional median and mean income, and regional income rank were examined in 3‐ to 12‐year‐olds (n = 16,532). Higher absolute household incomes were associated with lower behavioral problems, while higher income rank was associated with lower behavioral problems only at the highest absolute incomes. Higher absolute household incomes were associated with lower behavioral problems among children in working households, indicating compounding effects of income and socioeconomic advantages. Both absolute and relative incomes therefore appear to influence behavioral problems