title: Self-esteem as a predictor of psychological distress after severe acquired brain injury: an exploratory study.
abstract: This study explored the effects of severe acquired brain injury (ABI) on self-esteem. A within-subjects design investigated 22 severe ABI survivors' self-reported responses on measures of self-esteem, mood and awareness of deficit. Data on cognitive ability and awareness of degree of executive impairment were included in the analysis. Self-esteem was measured using Rosenberg's Self-Esteem Scale (Rosenberg) and psychological distress by the Hospital Anxiety and Depression Scale (HADS). Self-esteem was found to be consistent over a two-week interval. Participants reported that their self-esteem had suffered following ABI when contrasting their current self-esteem with their retrospective perceptions. Self-esteem was highly correlated with psychological distress. More intact cognitive functioning and awareness of deficit were associated with lower self-esteem. The paradoxical finding that survivors who were more impaired cognitively and/or less aware of their deficits reported higher self-esteem poses an ethical dilemma for clinicians. It is hoped that this finding, along with the consistency of self-esteem ratings sparks further debate about how best to address issues of self-esteem among severe ABI survivors, particularly in the context of psychological distress, during rehabilitation.
authors.affiliation: St Andrew's Healthcare, Townsend Division, Northampton, UK. scooper-evans@standrew.co.uk
authors.forename: Samantha
authors.initials: S
authors.lastname: Cooper-Evans
authors.forename: Nick
authors.initials: N
authors.lastname: Alderman
authors.forename: Caroline
authors.initials: C
authors.lastname: Knight
authors.forename: Michael
authors.initials: M
authors.lastname: Oddy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness / Q000502:physiology; D001526:Behavioral Symptoms / Q000175:diagnosis* / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications*; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011581:Psychological Tests; D012649:Self Concept; D012647:Self-Assessment; D055815:Young Adult