Life goals after brain injury in the light of the dual process approach: Empirical evidence and implications for neuropsychological rehabilitation

Abstract

Sequelae of acquired brain injury endanger the realisation of important life-goals. Discrepancies arise between the importance attached to a goal and the success in realising it. This study investigates goal discrepancies and their influence on patients' subjective well-being (SWB) in different rehabilitation stages. Life-goals, SWB and daily functioning were assessed in 130 neurological inpatients and 42 outpatients by self-report questionnaires. Both patient groups reported greater discrepancies between importance and success of life-goals than a normative sample of healthy controls. In multiple regression modelling, goal discrepancy predicted SWB in the inpatient sample even when controlling for the influence of ABI-related functional limitations. Of significant influence were the discrepancies in the domains of intimacy and achievement. In the respective analysis of the outpatient sample, goal discrepancy was not a significant predictor of SWB when accounting for functional limitations. A post-hoc analysis examined the inter-relation between functional limitations and goal discrepancy. Functional limitations influenced the ratings of successful goal realisation, yet they had less impact on the importance attached to a goal. The findings highlight the importance of patients' life-goals for successful neuropsychological rehabilitation. They indicate a need for further research considering goal adjustment processes in the face of chronic functional impairment.

Keywords:

• Neuropsychological rehabilitation
• Life-goals
• Subjective well-being
• Dual-process approach

Acknowledgments

The authors would like to thank the supporting neuropsychologists of “Asklepios Neurologische Klinik Bad Salzhausen”, “Vivantes Rehabilitations GmbH” in Berlin, “Neurologische Rehabilitationsklinik Godeshöhe” in Bonn Bad Godesberg and “Asklepios Kliniken Schildautal” as well as Antje Hartmann, Anna Coellen, Kerstin Dreger, Bruno Dietsche and Marcel Bredenpohl for their assistance in data collection.