Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands (Drs Wolters Gregório and van Heugten); Monash-Epworth Rehabilitation Research Centre, Epworth Hospital, Richmond, Victoria, Australia (Drs Gould and Ponsford and Mr Spitz); School of Psychology and Psychiatry, Faculty of Medicine, Nursing, and Health Science, Monash University, Clayton, Victoria, Australia (Drs Gould and Ponsford and Mr Spitz); and Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Alfred Hospital, Melbourne, Australia (Drs Gould and Ponsford).
J Head Trauma Rehabil. 2014 May-Jun;29(3):E43-53. doi: 10.1097/HTR.0b013e318292fb00.
To examine the influence of self-reported preinjury coping on postinjury coping, psychosocial functioning, emotional functioning, and quality of life at 1 year following traumatic brain injury (TBI).
Inpatient hospital and community.
One hundred seventy-four participants with TBI.
Prospective, longitudinal design. Participants were assessed at 5 time points: after emerging from posttraumatic amnesia, and at 6, 12, 24, and 36 months postinjury.
Coping Scale for Adults-Short Version; Quality of Life Inventory; Sydney Psychosocial Reintegration Scale; Hospital Anxiety and Depression Scale.
High preinjury use of nonproductive coping style predicted high use of nonproductive coping, more anxiety, and lower psychosocial functioning at 1 year postinjury. Increased use of nonproductive coping and decreased use of productive coping predicted poorer psychosocial outcome at 1 year post-TBI. Use of both productive and nonproductive coping decreased in the first 6 to 12 months post-TBI relative to preinjury. Unlike productive coping, nonproductive coping reached preinjury levels within 3 years postinjury.
The findings support identification of individuals at risk of relying on nonproductive coping and poorer psychosocial outcome following TBI. In addition, the results emphasize the need to implement timely interventions to facilitate productive coping and reduce the use of nonproductive coping in order to maximize favorable long-term psychosocial outcome.
探讨创伤性脑损伤（TBI）后 1 年时自我报告的伤前应对方式对伤后应对方式、心理社会功能、情绪功能和生活质量的影响。
住院医院和社区。
174 名 TBI 患者。
前瞻性、纵向设计。参与者在 5 个时间点接受评估：从创伤后遗忘中恢复后，以及受伤后 6、12、24 和 36 个月。
成人应对量表简短版；生活质量量表；悉尼心理社会康复量表；医院焦虑抑郁量表。
高伤前非生产性应对方式的使用预测了伤后 1 年时非生产性应对方式的高使用、更高的焦虑和更低的心理社会功能。非生产性应对方式的增加和生产性应对方式的减少预测了 TBI 后 1 年时较差的心理社会结局。与伤前相比，TBI 后 6 至 12 个月内，生产性和非生产性应对方式均减少。与生产性应对方式不同，非生产性应对方式在伤后 3 年内恢复到伤前水平。
这些发现支持识别在 TBI 后依赖非生产性应对方式和较差心理社会结局风险较高的个体。此外，结果强调需要及时实施干预措施，以促进生产性应对方式，并减少非生产性应对方式的使用，从而最大限度地提高有利的长期心理社会结局。
