title: Associations between executive functioning, coping, and psychosocial functioning after acquired brain injury.
abstract: OBJECTIVE
  To examine the relationships between executive functioning, coping, depressive symptoms, and quality of life in individuals with neuropsychiatric symptoms after acquired brain injury (ABI).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Individuals (n = 93) in the post-acute and chronic phase (>3 months) after ABI and their significant others (N = 58) were recruited from outpatient clinics of four mental health centres in the Netherlands. Outcome measures were the Trail Making Test, Stroop Colour Word Test, Frontal Systems Behavioural Scale, Utrecht Coping List, Patient Health Questionnaire, and Life Satisfaction Questionnaire. Data were analysed with multiple regression analyses.
  
  
  RESULTS
  Self-reported executive dysfunction was associated with greater use of passive coping styles (β = .37, p < .01), and passive coping, in turn, was associated with lower quality of life (β = -.57, p < .001) and more depressive symptoms (β = .65, p < .001). Problem-focused coping was associated with higher quality of life among individuals who reported better executive functioning (β = -.94, p < .05). Performances on executive functioning tests were not associated with coping, depressive symptoms, or quality of life.
  
  
  CONCLUSIONS
  For clinicians, these data indicate that individuals who report greater difficulties with executive functioning after ABI are inclined to use maladaptive passive coping styles, which should be targeted in treatment. In comparison, individuals who report greater difficulties with executive functioning should not be prompted to use problem-focused coping styles. These individuals may benefit from other coping styles, such as the use of seeking social support or acceptance of problems.
  
  
  CONCLUSIONS
  Coping influences the association between executive functioning and quality of life. Individuals who report difficulties with executive functioning after ABI may be inclined to use passive coping styles, which are maladaptive. Problem-focused coping strategies may be more useful for individuals who have strong executive abilities. This study was a cross-sectional study; thus, a cause-and-effect relationship could not be established between executive functioning, coping, and psychosocial functioning. As this research was part of standard clinical care, non-traditional tests for executive functioning were not administered.
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands.|Department ABI Huize Padua, GGZ Oost Brabant, Boekel, The Netherlands.
authors.forename: Gisela
authors.initials: G
authors.lastname: Wolters Gregório
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands.|Adelante, Rehabilitation Centre, Hoensbroek, The Netherlands.
authors.forename: Rudolf W H M
authors.initials: RW
authors.lastname: Ponds
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands.
authors.forename: Sanne M J
authors.initials: SM
authors.lastname: Smeets
authors.affiliation: Department Vesalius, Altrecht GGZ, Den Dolder, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Jonker
authors.affiliation: Department ABI Huize Padua, GGZ Oost Brabant, Boekel, The Netherlands.
authors.forename: Climmy G J G
authors.initials: CG
authors.lastname: Pouwels
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands.
authors.forename: Frans R
authors.initials: FR
authors.lastname: Verhey
authors.affiliation: Faculty of Health, Medicine and Life Sciences, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, The Netherlands.|Faculty of Psychology and Neuroscience, Department of Neuropsychology and Psychopharmacology, Maastricht University, The Netherlands.
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Heugten
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D056344:Executive Function; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D009426:Netherlands; D010045:Outpatients; D011788:Quality of Life; D057566:Self Report; D012919:Social Behavior; D012944:Social Support; D011795:Surveys and Questionnaires
keywords: adaptation; brain injuries; executive function; neuropsychological tests; psychological; quality of life