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Abstract
Chronic emotional problems involving irritability, anxiety, and depression have been widely documented in survivors of traumatic brain injury (TBI). Previous research has speculated that such emotional sequelae of TBI result from a post-traumatic syndrome (influenced by physiogenic factors), psychogenic factors (involving pre-morbid personality and influenced by the nature of the trauma), or from malingering to arouse sympathy, escape work or to receive compensation. Most research with TBI populations has focused upon assessing physical parameters of brain-behavior relationships. Traditional areas of focus in rehabilitation, furthermore, have had limited applications in the treatment of patients' emotional difficulties. The present investigation evaluated psychological processes (personality) that appeared likely to play a role in the development of emotional problems.
Scales that were utilized in this study included the Disability Rating Scale, the North Carolina Internal-External Control Scale, the Health Locus of Control Scale, the Belief In Personal Control Scale, the Beck Hopelessness and Depression Inventories, the Spielberger State-Trait Anxiety Inventory, and the Personality Assessment Schedule. A novel approach to test administration was developed to assess patients with a very wide range of physical and cognitive handicaps. It was predicted and confirmed that the personality characteristics of locus of control and learned resourcefulness mediate aspects of patients' subjective distress. Implications of these results for case management and further research were also suggested.
