The Relative Importance of Metacognitive Skills, Emotional Status, and Executive Function in Psychosocial Adjustment Following Acquired Brain Injury

Abstract

To examine the interrelationships between metacognitive skills and measures of emotional status and executive function following acquired brain injury (ABI), and examine their relative importance to psychosocial outcomes. A cross-sectional multicentre study employing correlational and multiple regression analyses. Sixty-seven adults with ABI living in the community, on average 4.4 years (SD = 4.7) postinjury. Sydney Psychosocial Reintegration Scale, Self-Awareness of Deficits Interview, Self-Regulation Skills Interview, Hospital Anxiety Depression Scale, Beck Hopelessness Scale, and standardized measures of executive function. Metacognitive skills correlated with level of hopelessness and executive measures of idea generation and error self-regulation. The best predictor of psychosocial outcome was depressive symptoms, with specific outcomes additionally related to error self-regulation and intellectual awareness. The findings highlight the need to evaluate interventions targeting depression and metacognitive skills to improve psychosocial outcomes.