title: Stability of coping and the role of self-efficacy in the first year following mild traumatic brain injury.
abstract: Coping, the psychological adaptation to stressors and serious life events, has been found to have a great influence on the development and persistence of posttraumatic complaints. Coping has received much attention for having been found to be modifiable in treatment following mild traumatic brain injury (mTBI) and for its potential to identify the Patients who are at risk of suffering from long-term complaints. Currently, coping styles are assumed to be stable over time. Although interventions to facilitate adaptive coping are given at different time intervals after the injury, little is known about spontaneous changes in preferred strategies over time following mTBI. This study aimed to investigate the stability of different coping styles over a one-year period following mTBI (at two weeks', six and twelve months' post-injury) and to investigate the relation between coping styles and feelings of self-efficacy.
  
  
  
  We included 425 mTBI patients (Glasgow Coma Scale [GCS] score 13-15) admitted to three Level-1 trauma centers in the Netherlands as part of a prospective follow-up study. All participants filled out The Utrecht Coping List (UCL) to determine their position on seven coping subscales.
  
  
  
  Most coping styles showed a decrease over time, except for positive reframing, which showed a decrease and then increased. Interestingly, the passive coping style was found to stabilize over time within the year after injury. High feelings of self-efficacy were related to a high active coping style (r = 0.36), and low feelings of self-efficacy with passive coping (r = -0.32).
  
  
  
  These results hold important possibilities for the use of the passive coping strategy as an inclusion criterion for intervention studies and an entry point for treatment itself. Considering the intertwinement of coping with self-efficacy, improving feelings of self-efficacy could form an effective part of an intervention to improve outcome.
authors.affiliation: Department of Neuropsychology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: m.e.scheenen@umcg.nl.
authors.forename: Myrthe E
authors.initials: ME
authors.lastname: Scheenen
authors.affiliation: Department of Neurology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: h.j.van.der.horn@umcg.nl.
authors.forename: Harm J
authors.initials: HJ
authors.lastname: van der Horn
authors.affiliation: Department of Neurology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: m.e.de.koning@umcg.nl.
authors.forename: Myrthe E
authors.initials: ME
authors.lastname: de Koning
authors.affiliation: Department of Neurology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: j.van.der.naalt@umcg.nl.
authors.forename: Joukje
authors.initials: J
authors.lastname: van der Naalt
authors.affiliation: Department of Neuropsychology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, The Netherlands. Electronic address: j.m.spikman@umcg.nl.
authors.forename: Jacoba M
authors.initials: JM
authors.lastname: Spikman
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001924:Brain Concussion / Q000150:complications / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D020377:Self Efficacy; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Coping; Mild traumatic brain injury; Self-efficacy; Stability