Research Reports - The impact of traumatic brain injury on self-identity: A systematic review of the evidence for self-concept changes

J Head Trauma Rehabil. 2015 Jun 19

Beadle EJ(1), Ownsworth T, Fleming J, Shum D

OBJECTIVES: This review systematically appraised the evidence for changes to
self-identity after traumatic brain injury (TBI) in adults and investigated
associations between self-concept changes and neurocognitive and psychosocial
METHODS: Systematic searches of 4 databases (PsycINFO, PubMed, CINAHL, and
Cochrane Systematic Review Database) were undertaken from January 1983 to July
2014. Empirical studies were included if they used a quantitative measure of
pre-/postinjury changes in self-concept after TBI or compared levels of
self-concept between TBI and control participants.
RESULTS: Fifteen studies met the review criteria and, despite methodological
differences, provided mostly evidence of negative changes to self-concept.
However, stability in self-concept and positive changes to sense of self were
also reported in some studies. Furthermore, levels of self-esteem and personality
characteristics did not significantly differ between participants with TBI and
orthopedic/trauma controls. Negative self-concept changes were associated with
emotional distress in 3 studies.
CONCLUSIONS: People with TBI most commonly experience negative changes in
self-identity; however, such changes are also reported after other traumatic
events or injuries. Greater consistency in measurement of self-identity change
and use of longitudinal designs is recommended to improve understanding of
factors contributing to self-concept changes after TBI and to guide clinical

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