Research Reports - Associations between executive functioning, coping, and psychosocial functioning after acquired brain injury

Br J Clin Psychol. 2015 Jan 14

Wolters Gregório G(1), Ponds RW, Smeets SM, Jonker F, Pouwels CG, Verhey FR, van Heugten CM

OBJECTIVES: To examine the relationships between executive functioning, coping,
depressive symptoms, and quality of life in individuals with neuropsychiatric
symptoms after acquired brain injury (ABI).
DESIGN: Cross-sectional study.
METHODS: Individuals (n = 93) in the post-acute and chronic phase (>3 months)
after ABI and their significant others (N = 58) were recruited from outpatient
clinics of four mental health centres in the Netherlands. Outcome measures were
the Trail Making Test, Stroop Colour Word Test, Frontal Systems Behavioural
Scale, Utrecht Coping List, Patient Health Questionnaire, and Life Satisfaction
Questionnaire. Data were analysed with multiple regression analyses.
RESULTS: Self-reported executive dysfunction was associated with greater use of
passive coping styles (β = .37, p < .01), and passive coping, in turn, was
associated with lower quality of life (β = -.57, p < .001) and more depressive
symptoms (β = .65, p < .001). Problem-focused coping was associated with higher
quality of life among individuals who reported better executive functioning
(β = -.94, p < .05). Performances on executive functioning tests were not
associated with coping, depressive symptoms, or quality of life.
CONCLUSIONS: For clinicians, these data indicate that individuals who report
greater difficulties with executive functioning after ABI are inclined to use
maladaptive passive coping styles, which should be targeted in treatment. In
comparison, individuals who report greater difficulties with executive
functioning should not be prompted to use problem-focused coping styles. These
individuals may benefit from other coping styles, such as the use of seeking
social support or acceptance of problems.
PRACTITIONER POINTS: Coping influences the association between executive
functioning and quality of life. Individuals who report difficulties with
executive functioning after ABI may be inclined to use passive coping styles,
which are maladaptive. Problem-focused coping strategies may be more useful for
individuals who have strong executive abilities. This study was a cross-sectional
study; thus, a cause-and-effect relationship could not be established between
executive functioning, coping, and psychosocial functioning. As this research was
part of standard clinical care, non-traditional tests for executive functioning
were not administered.

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