Abstract
This longitudinal study tested the utility of a psychosocial model of functional adjustment following traumatic brain injury (TBI). In addition to including the well-recognized relationships between neuro-cognitive and physical factors, the model suggests that subjective psychosocial variables (i.e., self-esteem and perceived social support) predict vocational adjustment through mediator variables, such as the severity of the individual's subjective appraisal of his or her situation. Ninety participants with TBI and their relatives participated in the study. Considerable support was found for the proposed relationships in that the prediction of vocational adjustment was improved beyond initial vocational adjustment by both psychosocial factors. Further, these factors appeared to influence vocational adjustment as a result of their impact on subjective appraisal. However, there also appeared to be a neurological basis for persistent vocational adjustment difficulties. As proposed, lower levels of emotional distress were associated with better vocational adjustment. The current findings have significant implications for the rehabilitation and vocational treatment of people with TBI. In particular, the model can foster the development of a preventative focus in TBI vocational rehabilitation. Specifically, it is possible to provide a potentially cost-effective way of identifying those individuals who are most likely to experience difficulties in the future and assisting them to maintain and develop the psychosocial resources and subjective appraisals that will improve their emotional and vocational well being.
Get full access to this article
View all access options for this article.