Coping Following Traumatic Brain Injury:The Need for Contextually Sensitive Assessment
Kendall, E. Shum, D. Lack, B. Bull, S. Fee, C
Abstract: Psychosocial adjustment problems following traumatic brain injury (TBI) frequently present a major barrier for rehabilitation. The ability to cope has been linked with psychological well-being following stressful and traumatic events, but has been poorly examined in the area of TBI. In terms of conceptualisation, most coping research has adopted the Lazarus and Folkman (1984) dichotomy of coping, namely problem-focused and emotion-focused. Despite the popularity of this theory, recent conceptualisations of coping have suggested that other dimensions are equally important and require investigation in the TBI area. However, measurement of coping continues to provide a major barrier for research in this area, particularly given the potential difficulties associated with self-report data in people with TBI. The current study used a contextually sensitive assessment technique to test current conceptualisations of coping in the TBI population. Specifically, the study examined coping strategies and styles in response to four stressful video-based scenarios. Rather than using a self-report questionnaire to assess predetermined coping strategies, participants spontaneously provided their own coping strategies, which were then coded into distinct coping strategies. The strategies were categorised into four groups according to their focus (emotion or problem) and approach (active or passive). Both the number and type of coping strategies differed across situations, providing support for the use of a contextually sensitive measurement technique. Further, the theoretically expected pattern of relationships was found between coping types and outcomes. However, these relationships differed across situations and over time, confirming suggestions that coping efficacy may differ depending on the demands of the situation and that chronic situations such as TBI may have an impact on coping style over time.