A study of the influence of cognitive complaints, cognitive performance and symptoms of anxiety and depression on self-efficacy in patients with acquired brain injury

Objective: To examine the relationship between self-efficacy for managing brain injury–specific symptoms and cognitive performance, subjective cognitive complaints and anxiety and depression symptoms in patients with acquired brain injury (ABI). Design: Clinical cohort study. Setting: General hospitals, rehabilitation centres. Subjects: A total of 122 patients with newly ABI (mean age = 54.4 years (SD, 12.2)) were assessed at discharge home from inpatient neurorehabilitation or at start of outpatient neurorehabilitation after discharge home from acute hospital. Mean time since injury was 14.1 weeks (SD, 8.6). Main measures: Self-efficacy was measured using the Traumatic Brain Injury (TBI) Self-Efficacy Questionnaire (SEsx), mean score = 82.9 (SD, 21.8). Objective cognitive performance was measured with the Symbol Digit Modalities Test (SDMT), mean z-score = −1.36 (SD, 1.31). Anxiety and depression symptoms were measured with the Hospital Anxiety and Depression Scale (HADS), cognitive complaints with the self-rating form of the Dysexecutive Questionnaire (DEX-P). Results: Higher levels of subjective cognitive complaints and higher levels of anxiety and depression symptoms were significantly associated with lower self-efficacy (β = −0.35; P =.001 and β =−0.43; P <.001, respectively). Objective cognitive performance was not significantly associated with self-efficacy (β = 0.04, P =.53). DEX-P scores accounted for 42% and HADS scores for 7% of the total 57% variance explained. Objective cognitive performance did not correlate significantly with subjective cognitive complaints (r = −.13, P =.16). Conclusion: Control over interfering emotions and mastery over brain injury–associated symptoms seems important in the development of self-efficacy for managing brain injury–specific symptoms.

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