Developmental models of social cognition in assessing the role of family stress in relatives' predictions following traumatic brain injury

Abstract

The present study extended the utilization of developmental models of social cognition to the investigation of stress and relatives' perception of traumatic brain injury (TBI) survivors. Structured interviews were conducted with 21 TBI survivors utilizing interpersonal negotiation strategies (INS) and self understanding (self) in the framework of Selman's model of social perspective-taking and Damon and Hart's multidimensional model of self understanding. A relative group composed of 21 participants was interviewed and their predictions of the responses of the TBI survivors to the action domain of the INS stories were obtained. The relative participant group was also administered the Beck Anxiety and Depression Inventories and Leeds Scales of Depression and Anxiety. The relationships among relative groups' predictive scores, INS and self domains and stress levels were analysed. The result of the survivor groups responses on INS and self were in agreement with the previous findings that TBI survivors respond at psychosocially immature levels. Comparison of INS action scores obtained by the survivor group and predicted by relative group were within one developmental level of each other in 874% of the cases. Fifty-two per cent of the relative group scored in mild to moderate or greater depression and 48% scored in the mild to moderate range of anxiety on the Beck scales. Pearson correlation coefficients indicated significant negative correlations between Beck scores and predictive INS scores. ANOVA indicated significantly higher Beck depression scores in relatives of TBI survivors living in residential facilities than relatives of TBI survivors in an outpatient treatment programme. The study supports the view that developmental social cognition methods appear to advance our understanding of psychosocial adjustments and relatives' perceptions of social cognition in TBI survivors.