Beyond anger: emotion regulation and social connectedness in veterans with traumatic brain injury

ABSTRACT

Primary objective: Patients with traumatic brain injury (TBI) often present with emotion dysregulation. Most TBI rehabilitation has addressed this impairment primarily in relation to anger, irritability and aggressiveness. Yet, emotion regulation (ER) may have broader ramifications for psychological well-being. The present study examined ER’s association to several aspects of social connectedness.

Research design: Cross-sectional study

Methods and procedures: 83 veterans with TBI who were outpatients at a VA medical rehabilitation service were interviewed in their homes. A 5-item ER subscale, drawn from the Patient Competency Rating Scale, was subjected to psychometric analysis and examined as a predictor of five social connectedness measures: community reintegration (CR), interpersonal functioning, quality of relationship with key family members and social role limitations due to physical problems and due to emotional problems. Sociodemographic, military and medical information was also collected.

Main outcomes and results: The ER subscale showed good psychometric properties. ER contributed significantly to CR, interpersonal functioning and limitations in social roles. This underscores ER’s role in social connectedness among veterans with TBI.

Conclusions: Impairments in ER should be regarded as a risk factor for poor interpersonal outcomes, a target for mental health treatment and a focus for interventions aimed at improving psychological well-being in TBI.

KEYWORDS:

• Veterans
• emotional self-regulation
• depression
• social roles
• functional competence

Acknowledgments

This material is the result of work supported with resources and the use of facilities at the Philadelphia VA Medical Center. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the United States government, the Eunice Kennedy Shriver National Institute of Child Health & Human Development or the National institutes of Health.

Declaration of interest

The authors report no conflicts of interest. This work was supported by Grant Number R21 HD068857-01 from the National Center for Medical Rehabilitation Research of the Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health.