Understanding adjustment following traumatic brain injury: is the Goodness-of-Fit coping hypothesis useful?

Coping efforts have been recognised as an important aspect of resilience following traumatic brain injury, but little is known about what constitutes effective coping in this population. This longitudinal research examined the usefulness of the Goodness-of-Fit hypothesis, drawn from the Lazarus and Folkman [(1984). Stress, appraisal and coping. NY: Springer.] theory of stress and coping, as a way of understanding coping effectiveness. The hypothesis suggests that the nature and success of specific coping strategies will be associated with the controllability of the event. If an event is relatively uncontrollable, then emotion-focused or perception-focused coping may be more effective than problem-focused coping. In contrast, a controllable event may be best managed through problem-focused coping. Ninety people with traumatic brain injury, drawn from the inpatient rehabilitation unit of a major metropolitan hospital in Australia, and their relatives participated in this longitudinal study. No support was found for the Goodness-of-Fit model, either in the short term or the long term. Although the use of problem-focused coping strategies was positively associated with short-term and long-term role functioning, it was not associated with long-term emotional well-being if the situation was perceived to be controllable. The findings suggest that the persistent use of problem-focused coping in response to the difficulties created by traumatic brain injury can be associated with emotional distress in the long term. Reasons for this finding are explored and its implications are discussed.