Research Reports - Executive functioning in relation to coping in mild versus moderate-severe traumatic brain injury

Neuropsychology. 2017 Oct 16. doi: 10.1037/neu0000399. [Epub ahead of print]

Rakers SE, Scheenen ME, Westerhof-Evers HJ, de Koning ME, van der Horn HJ, van
der Naalt J, Spikman JM.

OBJECTIVE: To examine associations between executive functioning (EF) and coping
styles, separately for mild and moderate-severe traumatic brain injury (TBI) in
the chronic phase postinjury.
METHOD: Patients with mild (n = 47) and moderate-severe TBI (n = 59) were
included, in addition to healthy controls (HCs; n = 51). Assessment consisted of
EF tests (Trail Making Test, Zoo Map Test, Controlled Oral Word Association Test)
and questionnaires examining EF (Dysexecutive Questionnaire) and coping styles
(Utrecht Coping List).
RESULTS: Moderate-severe TBI patients showed significant more EF deficits, lower
active coping and higher passive coping than mild TBI patients and HCs, whereas
mild TBI patients did not differ from HCs. In the moderate-severe TBI group, a
higher number of self-reported EF problems was related to lower levels of active
coping, r = -.43, p < .01 and higher levels of passive coping, r = .58, p < .001,
with proxy-reports relating to lower levels of active coping, r = -.33, p < .05.
For mild TBI, a higher amount of self-reported EF problems was related to lower
levels of active coping, r = -.38, p < .05 and higher levels of passive coping, r
= .55, p < .001, with proxy-reports relating to higher levels of passive coping,
r = .39, p < .05. Except for mental flexibility, EF performances were not
associated with coping.
CONCLUSIONS: This study shows strong associations between reported EF problems in
daily life and coping styles. For moderate-severe TBI, proxy-reports may reflect
EF impairments that complicate active problem-solving. However, reported EF
problems by mild and moderate-severe TBI patients are also likely to reflect a
psychological distress related to the way patients are inclined to deal with
stressing situations that put a demand on their executive abilities.  

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