Coping behaviour following traumatic brain injury: what makes a planner plan and an avoider avoid?

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.