Krpan Katherine M, Stuss Donald T, Anderson Nicole D
Department of Psychology, University of Toronto, Canada.
Brain Inj. 2011;25(10):989-96. doi: 10.3109/02699052.2011.597045. Epub 2011 Jul 12.
Avoidant coping has consistently been related to negative outcomes following traumatic brain injury (TBI), although the mechanisms of this relationship are not clear. A recent study demonstrated that people with moderate-to-severe TBI engaged in more avoidant than planful coping behaviour during a psychosocial stress test, while their matched healthy counterparts engaged in the opposite pattern. The purpose of the current study was to evaluate the neuropsychological, physiological and psychological differences between planners and avoiders with TBI.
Eighteen people with moderate-to-severe TBI completed the Baycrest Psychosocial Stress Test (BPST) where coping behaviour was evaluated and physiological measures recorded. Participants also completed a series of questionnaires and a neuropsychological test battery.
Compared to avoiders, planners had better executive function, were more psychologically and physiologically reactive and performed better on the BPST. Dysfunction on tests assessing executive abilities was the best predictor of avoidant coping, while physiological and psychological reactivity were the best predictors of planful coping.
This study is the first to document differences between planners and avoiders with TBI. Understanding the determinants of coping following TBI will allow for more sophisticated and targeted rehabilitative intervention.
回避应对一直与创伤性脑损伤（TBI）后的负面结果相关，尽管这种关系的机制尚不清楚。最近一项研究表明，在社会心理压力测试中，中重度TBI患者比有计划的应对行为更多地采用回避应对行为，而与之匹配的健康对照者则呈现相反的模式。本研究的目的是评估TBI患者中采用有计划应对者和回避应对者之间的神经心理学、生理和心理差异。
18名中重度TBI患者完成了Baycrest社会心理压力测试（BPST），在测试中评估应对行为并记录生理指标。参与者还完成了一系列问卷和神经心理测试组。
与回避应对者相比，有计划应对者具有更好的执行功能，在心理和生理上更具反应性，并且在BPST上表现更好。评估执行能力的测试中的功能障碍是回避应对的最佳预测指标，而生理和心理反应性是有计划应对的最佳预测指标。
本研究首次记录了TBI患者中有计划应对者和回避应对者之间的差异。了解TBI后应对的决定因素将有助于进行更复杂、更有针对性的康复干预。
