Early life experiences, shame and emotional adjustment following adult brain injury

This thesis focuses on psychological aspects of acquired brain injury (ABI). It explores coping styles and emotional adjustment through a systematic literature review and empirical research project respectively. The literature review identified 36 quantitative studies exploring relationships between coping styles and psychological variables, such as anxiety, depression, cognition and appraisals, in people with a traumatic brain injury (TBI). This found some moderately strong relationships, such as between ‘maladaptive’ coping styles and psychological difficulties. It also highlighted the complexity of coping style measurement, identifying their relationships with psychological variables and the limitations of applying psychological theories from general populations to TBI survivors. The empirical research explored relationships between early life experiences, shame and emotional adjustment following ABI for the first time. Ninety five participants completed an anonymous survey including measures of these variables, injury related and sociodemographic information. Correlational, multiple regression and mediation analysis identified early life experiences were related to shame. Shame was found to be related to, and a significant individual predictor of, emotional adjustment. Shame was also found to mediate the relationship between early life experiences and emotional adjustment. These findings highlight the importance of both pre and post-ABI psychosocial factors in emotional adjustment following an ABI, but the need for further research in this area. The critical appraisal summarises the key findings of these papers, the development of the research, key decisions and challenges, research strengths and weaknesses, personal reflections and future challenges. Overall, this thesis highlights the importance and value of research to clinical psychologists, but also its limitations in complex populations such as ABI. It also highlights the need in ABI clinical and research work for improved empirically supported theoretical models, but also the use of individualised formulations that consider a wide range of both pre and post-ABI factors, such as adverse early life experiences.