title: The Impact of Traumatic Brain Injury on Self-Identity: A Systematic Review of the Evidence for Self-Concept Changes.
abstract: OBJECTIVE
  This review systematically appraised the evidence for changes to self-identity after traumatic brain injury (TBI) in adults and investigated associations between self-concept changes and neurocognitive and psychosocial functioning.
  
  
  METHODS
  Systematic searches of 4 databases (PsycINFO, PubMed, CINAHL, and Cochrane Systematic Review Database) were undertaken from January 1983 to July 2014. Empirical studies were included if they used a quantitative measure of pre-/postinjury changes in self-concept after TBI or compared levels of self-concept between TBI and control participants.
  
  
  RESULTS
  Fifteen studies met the review criteria and, despite methodological differences, provided mostly evidence of negative changes to self-concept. However, stability in self-concept and positive changes to sense of self were also reported in some studies. Furthermore, levels of self-esteem and personality characteristics did not significantly differ between participants with TBI and orthopedic/trauma controls. Negative self-concept changes were associated with emotional distress in 3 studies.
  
  
  CONCLUSIONS
  People with TBI most commonly experience negative changes in self-identity; however, such changes are also reported after other traumatic events or injuries. Greater consistency in measurement of self-identity change and use of longitudinal designs is recommended to improve understanding of factors contributing to self-concept changes after TBI and to guide clinical interventions.
authors.affiliation: School of Applied Psychology and Behavioural Basis of Health Program, Griffith Health Institute, Griffith University, Mt Gravatt, Queensland, Australia (Drs Beadle, Ownsworth, and Shum); School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia (Dr Fleming); and Princess Alexandra Hospital, Woolloongabba, Queensland, Australia (Dr Fleming).
authors.forename: Elizabeth Jane
authors.initials: EJ
authors.lastname: Beadle
authors.forename: Tamara
authors.initials: T
authors.lastname: Ownsworth
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fleming
authors.forename: David
authors.initials: D
authors.lastname: Shum
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000523:psychology*; D005260:Female; D006801:Humans; D007062:Identification, Psychological; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D055815:Young Adult