Psychosocial changes perceived by closed-head-injured adults and their families

Responses of 20 closed-head-injured adults with moderate to good recovery (Glascow Coma Outcome Scale), 20 controls, and 13 family members were statistically compared in a questionnaire study of the relative importance of cognitive, emotional, and physical changes. Perceptions of preinjury psychosocial and preinjury and postinjury employment status were also evaluated. Significant changes in psychosocial functioning were perceived. Cognitive changes were rated as more extreme than changes in emotions by head-injured subjects, whereas ratings of cognitive, emotional, or physical changes did not differ significantly in ratings of family members. A between-group comparison indicated that family members tended to rate emotional changes as more extreme than did head-injury subjects. Degree of physical change was the only change that was correlated in the responses of head-injured subjects and family members. Differences in perceptions may limit long-term progress in rehabilitation. Explanations for the results include differences between family members and head-injured adults in awareness and understanding of the cognitive and emotional sequelae to head injury. Implications for involving families in counseling of head-injured adults are discussed.