Investigating the Impact of Self-Criticism and Self-Reassurance on the Experience of Distress People with Traumatic Brain Injuries

Abstract

Objective: To examine whether psychological processes involved in self-appraisal and responses to aversive internal experiences are significant factors in understanding the levels of distress experienced by people following Traumatic Brain Injury (TBI). Participants: One hundred and fifteen people with TBI completed a set of questionnaires. Design: A cross-sectional/observational design employing a multiple hierarchical regression analysis. Main Measures: Emotional distress as measured by Depression Anxiety and Stress Scale – 21 item (DASS-21); self-criticism and self-reassurance as measured by Forms of Self-Criticism/Attacking and Self-Reassurance Scale (FSCRS); psychological inflexibility as measured by Flexibility of Responses to Self-Critical Thoughts (FoReST). Result: Self-criticism, self-reassurance and psychological inflexibility explained an additional 30% of variance in emotional distress beyond demographic, clinical and injury-related factors, with only self-criticism making a significant independent contribution. Exploratory moderation analysis revealed that there was no significant effect on emotional distress when considering the interaction between self-criticism with self-reassurance and psychological inflexibility. Conclusion: While emotional distress is common following TBI, there remains no demographic, clinical or injury-related factors that have demonstrated consistent associations with the level of emotional distress experienced. The present study demonstrates that psychological factors, relating to personal evaluations, explains considerable variance in emotional distress beyond demographic and injury-related factors. These processes may help identify those at risk of poorer emotional outcomes following TBI, and targeting these processes via psychological interventions may improve emotional wellbeing in these people.