Planful versus avoidant coping: behavior of individuals with moderate-to-severe traumatic brain injury during a psychosocial stress test.

Many people who sustain traumatic brain injuries (TBI) have poor psychosocial outcomes that have been related to the use of avoidant coping. A major obstacle to understanding the mechanisms of this relationship are the self-report measures by which coping has been traditionally evaluated. The purpose of the present study was to compare coping behavior during a simulated real-world stress test with self-reported coping. People with moderate-to-severe TBI and matched controls completed the Baycrest Psychosocial Stress Test (BPST) where coping behavior was evaluated, and also completed the Ways of Coping Questionnaire (WOC). While there were no group differences in self- or significant-other-reported behavior on the WOC, the TBI group engaged in more avoidant than planful behavior on the BPST, while the control group displayed the opposite pattern of behavior. Moreover, in the control group there were positive relations between behavior on the BPST and self-reported coping on the WOC, but no such relation within the TBI group. Secondary analyses allowed for TBI participants to be characterized as "planners" or "avoiders." This is the first study, to our knowledge, to report behavioral differences in coping post-TBI. Future work investigating the moderators of these differences may have significant implications for rehabilitative intervention.