This thesis aimed to explore the psychosocial impact and outcomes following brain injury, and comprises of the following chapters;
The first chapter consists of a systematic literature review and meta-analysis, investigating the efficacy of Cognitive Behavioural Therapy (CBT) based interventions at reducing anxiety symptoms following traumatic brain injury (TBI). Ten randomised controlled trials met the identified inclusion criteria. The results of the meta-analysis revealed a small, but statistically significant main effect of CBT at reducing symptoms of anxiety in individuals who had sustained a TBI. The clinical implications and limitations of this review are discussed.
The second chapter contains an exploratory research study investigating potential associations between cognitive functioning, self-awareness and social isolation following acquired brain injury. Twenty-seven participants were recruited from a community brain injury rehabilitation service and completed questionnaires and neuropsychological measures investigating self-awareness, social isolation and cognitive functioning (i.e. working memory, mental flexibility and disinhibition). Results indicated that general cognitive functioning was not associated with self-reported experiences of social isolation, however increased disinhibition and reduced self-awareness were associated with greater quantity of family contact, but not acquaintances. Poor self-awareness, specifically the underestimation of difficulties, may be protective against emotional loneliness. Demographic factors, including rurality and marital status are likely also important. Clinical implications, considerations for future research and limitations of this study are discussed.
The final chapter explores the outcomes of the meta-analysis and empirical paper, considering implications for theory, research and clinical practice. A reflective commentary concludes the thesis.