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