Factors associated with self-esteem following acquired brain injury in adults: A systematic review

ABSTRACT

Self-esteem is potentially a key factor in psychological and psychosocial well-being following acquired brain injury (ABI). The current review aimed to identify, synthesise and appraise all existing quantitative empirical studies on predictors or correlates of self-esteem following ABI in adulthood. In total, 27 papers met the inclusion criteria. A range of clinical factors were related to self-esteem after ABI, including the degree of physical and functional impairment. It is unclear if cognitive impairment is related to high or low self-esteem. Additionally, psychological variables such as coping styles, adjustment and perception of problems or rehabilitation are related to self-esteem following ABI. Depression is strongly associated with low self-esteem, alongside anxiety, psychological distress and quality of life. Limitations of the available research and recommendations for clinical practice and further research are discussed. In particular, there is a need to engage with contemporary theoretical understandings of self-esteem, integrated with and supported by developments in how self-esteem is conceptualised and measured over time in an ABI population. The findings of the review suggest that self-esteem is an important factor to consider following ABI, particularly in the context of developing individualised, formulation-driven rehabilitation interventions that take into account biological, social and psychological factors.

KEYWORDS:

• Self-esteem
• acquired brain-injury
• rehabilitation
• psychological

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 As discussed above, self-image, self-concept and self-worth are generally considered distinct theoretical constructs. However, the terms were included in the search strategy to ensure all relevant articles examining self-esteem were identified as these descriptive terms can contain some overlap.

2 Two studies (Keppel & Crowe, 2000; Ponsford et al., 2013) included participants under the age of 18. As the majority of participants used in both studies were over 18, the studies were included in the review.