Cognitive beliefs following severe traumatic brain injury: association with post-injury employment status

In this exploratory study, the cognitive beliefs of 19 severely traumatically brain-injured (TBI) patients were assessed to determine their association with post-injury employment status (that is, full-time, part-time or unemployed). Cognitive measures included the Multidimensional Health Locus of Control (MHLC) scale, the Revised Internal-External Scale (RIES) and the Beck Hopelessness Scale (BHS). Patients who did not return to their pre-injury level of employment (n = 10) were found to have lower MHLC Internal, higher RIES Powerful Others locus of control beliefs, and higher BHS scores as compared with a group of patients who returned to their pre-injury employment status (n = 9). In addition, longer lengths of post-traumatic amnesia, longer hospital stays and lower-prestige occupations post-injury were associated with poorer employment status. No differences were present between the groups in age, years of education, Glasgow Coma Scale on admission, length of coma, months post-injury, or pre-injury occupation. These results suggest that cognitive beliefs are a potential target for further research in TBI outcome.