COGNITIVE MODERATORS OF OUTCOME FOLLOWING TRAUMATIC BRAIN INJURY - A CONCEPTUAL-MODEL AND IMPLICATIONS FOR REHABILITATION

This paper presents a conceptual model describing the relationships be tween quality of life outcomes following traumatic brain injury (TBI), coping patterns, and beliefs regarding self-efficacy to assist health -care professionals in understanding the complexity of social and psyc hological sequelae of TBI. The model hypothesizes that long-lasting co gnitive, behavioural, emotional psychiatric, and interpersonal after-e ffects of TBI may create a real life 'learned helplessness' with conse quent deficits in coping, and altered locus of control beliefs. As a r esult, TBI patients are at risk for developing self-limiting belief sy stems about their effectiveness in altering significant events that ma y result in over-generalizing the effects that TBI has in their day-to -day lives. Subsequently, a feedback loop may be set up where their be liefs in not being able to influence outcomes are not tested, life cha nces are further restricted, outcomes are suboptimal, and quality of l ife is reduced. The clinical and theoretical implications of this mode l are discussed, and an expanded model with future research directions is suggested.