Investigating the Impact of Self-Criticism and Self-Reassurance on the Experience of Distress People with Traumatic Brain Injuries
Main Article Content
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.
Keywords:
brain injury, emotional distress, self-criticism, self-reassurance, psychological inflexibility.
Article Details
How to Cite
JACKSON, Cerian F et al.
Investigating the Impact of Self-Criticism and Self-Reassurance on the Experience of Distress People with Traumatic Brain Injuries.
Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4684>. Date accessed: 16 may 2024.
doi: https://doi.org/10.18103/mra.v11i11.4684.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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30. Gilbert P. Compassion: Conceptualisations, research and use in psychotherapy. Routledge; 2005.
31. Hayes SC. Acceptance and Commitment Therapy and the New Behavior Therapies: Mindfulness, Acceptance, and Relationship. In: Hayes S, Follette V, Linehan M, eds. Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York, NY: Guilford Press; 2004:1-29.
32. Gilbert P. Introducing compassion-focused therapy. Advances in psychiatric treatment. 2009;15(3):199-208.
33. Gilbert P. Compassion focused therapy: Distinctive features. Routledge; 2010.
34. Gilbert P, Clarke M, Hempel S, Miles JN, Irons C. Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology. 2004;43(1):31-50.
35. Ashworth F, Gracey F, Gilbert P. Compassion focused therapy after traumatic brain injury: Theoretical foundations and a case illustration. Brain Impairment. 2011;12(2):128-139.
36. Kangas M, McDonald S. Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury. Neuropsychological Rehabilitation. 2011;21(2):250-276.
37. Hermanto N, Zuroff DC. The social mentality theory of self-compassion and self-reassurance: The interactive effect of care-seeking and caregiving. The Journal of social psychology. 2016;156(5):523-535.
38. MacBeth A, Gumley A. Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical psychology review. 2012;32(6):545-552.
39. Campos RC, Besser A, Ferreira R, Blatt SJ. Self-criticism, neediness, and distress among women undergoing treatment for breast cancer: A preliminary test of the moderating role of adjustment to illness. International Journal of Stress Management. 2012;19(2):151.
40. Wilson K, Hayes S, Strosahl K. Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press; 2003.
41. Masuda A, Price M, Anderson PL, Wendell JW. Disordered eating-related cognition and psychological flexibility as predictors of psychological health among college students. Behavior Modification. 2010;34(1):3-15.
42. Masuda A, Tully EC. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. Journal of Evidence-Based Complementary & Alternative Medicine. 2012;17(1):66-71.
43. Vowles KE, McCracken LM. Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes. Behaviour research and therapy. 2010;48(2):141-146
44. Van Bost G, Van Damme S, Crombez G. The role of acceptance and values in quality of life in patients with an acquired brain injury: a questionnaire study. PeerJ. 2017;5:e3545.
45. Whiting DL, Deane FP, Simpson GK, Ciarrochi J, Mcleod HJ. Acceptance and Commitment Therapy delivered in a dyad after a severe traumatic brain injury: A feasibility study. Clinical Psychologist. 2017.
46. Gracey F, Evans JJ, Malley D. Capturing process and outcome in complex rehabilitation interventions: A “Y-shaped” model. Neuropsychological Rehabilitation. 2009;19(6):867-890.
47. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods. 2009;41(4):1149-1160.
48. Department of Defense and Department of Veterans Affairs. Traumatic Brain Injury Task Force. 2008;
https://www.hsdl.org/?view&did=482727. Accessed 18 May 2018.
49. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy. 1995;33(3):335-343.
50. Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour research and therapy. 1997;35(1):79-89.
51. Henry JD, Crawford JR. The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample. British journal of clinical psychology. 2005;44(2):227-239.
52. von Steinbüchel N, Wilson L, Gibbons H, et al. Quality of Life after Brain Injury (QOLIBRI): scale validity and correlates of quality of life. Journal of neurotrauma. 2010;27(7):1157-1165.
53. Sunderland A, Harris JE, Baddeley AD. Do laboratory tests predict everyday memory? A neuropsychological study. Journal of verbal learning and verbal behavior. 1983;22(3):341-357.
54. Royle J, Lincoln NB. The Everyday Memory Questionnaire–revised: Development of a 13-item scale. Disability and Rehabilitation. 2008;30(2):114-121.
55. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of neurology. 1989;46(10):1121-1123.
56. Ziino C, Ponsford J. Measurement and prediction of subjective fatigue following traumatic brain injury. Journal of the International Neuropsychological Society. 2005;11(4):416-425.
57. White R, Larkin P, McCluskey J, Lyold J, H M. The development of the Flexibility of Responses to Self-Critical Thoughts Scale (FoRest). Journal of Contextual Behavioural Science. In submission.
58. Baião R, Gilbert P, McEwan K, Carvalho S. Forms of self‐criticising/attacking & self‐reassuring scale: Psychometric properties and normative study. Psychology and Psychotherapy: Theory, Research and Practice. 2015;88(4):438-452.
59. Duarte PAdS. The Three-Factor Eating Questionnaire-R21: A confirmatory factor analysis in a Portuguese sample. Paper presented at: The three-factor eating questionnaire-R21: a confirmatory factor analysis in a portuguese sample2015.
60. Fann JR, Bombardier CH, Vannoy S, et al. Telephone and in-person cognitive behavioral therapy for major depression after traumatic brain injury: a randomized controlled trial. Journal of Neurotrauma. 2015;32(1):45-57.
61. Wood, R L, Alderman, N., Worthington, A. Neurobehavioural Rehabilitation. In: Agrawal, N., Faruqui, R. & Bodani, M. Oxford Textbook of Neuropsychiatry. Oxford University Press; 2020 Aug 25
62. Jackson, H.F., Hague, G., Daniels, L, Aguilar, R. Carr, D. & Kenyon, W. Structure to Self- Structuring: Infrastructures and Processes in Neurobehavioural Rehabilitation. Neurorehabilitation, 2014, 34, 681–694.
2. Van Velzen J, Van Bennekom C, Edelaar M, Sluiter JK, Frings-Dresen M. How many people return to work after acquired brain injury?: a systematic review. Brain injury. 2009;23(6):473-488.
3. Kreutzer JS, Sima AP, Marwitz JH, Lukow I, Herman R. Marital instability after brain injury: an exploratory analysis. Neurorehabilitation. 2016;38(3):271-279.
4. Fann JR, Burington B, Leonetti A, Jaffe K, Katon WJ, Thompson RS. Psychiatric illness following traumatic brain injury in an adult healthMaintenance organization population. Archives of General Psychiatry. 2004;61(1):53-61.
5. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US soldiers returning from Iraq. New England Journal of Medicine. 2008;358(5):453-463.
6. Rosenthal M, Christensen BK, Ross TP. Depression following traumatic brain injury. Archives of Physical Medicine and Rehabilitation. 1998;79(1):90-103.
7. Bombardier CH, Fann JR, Temkin NR, Esselman PC, Barber J, Dikmen SS. Rates of major depressive disorder and clinical outcomes following traumatic brain injury. Jama. 2010;303(19):1938-1945.
8. Rao V, Bertrand M, Rosenberg P, et al. Predictors of new-onset depression after mild traumatic brain injury. The Journal of neuropsychiatry and clinical neurosciences. 2010;22(1):100-104.
9. Whelan-Goodinson R, Ponsford JL, Schönberger M, Johnston L. Predictors of psychiatric disorders following traumatic brain injury. The Journal of head trauma rehabilitation. 2010;25(5):320-329.
10. Seel R, Kreutzer J, Rosenthal M. Depression After Traumatic Brain Injury: A National Institute on Disability and Rehabilitation Research Model Systems Multicenter Investigation. Year Book of Psychiatry & Applied Mental Health. 2004;2004(1):289-290.
11. Kendall E. Psychosocial adjustment following closed head injury: A model for understanding individual differences and predicting outcome. Neuropsychological Rehabilitation. 1996;6(2):101-132.
12. Wood RL, Rutterford NA. Demographic and cognitive predictors of long-term psychosocial outcome following traumatic brain injury. Journal of the International Neuropsychological Society. 2006;12(3):350-358.
13. Konrad C, Geburek A, Rist F, et al. Long-term cognitive and emotional consequences of mild traumatic brain injury. Psychological medicine. 2011;41(6):1197-1211.
14. Belmont A, Agar N, Hugeron C, Gallais B, Azouvi P. Fatigue and traumatic brain injury. Paper presented at: Annales de réadaptation et de médecine physique2006.
15. Englander J, Bushnik T, Oggins J, Katznelson L. Fatigue after traumatic brain injury: Association with neuroendocrine, sleep, depression and other factors. Brain Injury. 2010;24(12):1379-1388.
16. Glenn MB, O'Neil-Pirozzi T, Goldstein R, Burke D, Jacob L. Depression amongst outpatients with traumatic brain injury. Brain injury. 2001;15(9):811-818.
17. Sigurdardottir S, Andelic N, Roe C, Schanke A. Identifying longitudinal trajectories of emotional distress symptoms 5 years after traumatic brain injury. Brain injury. 2014;28(12):1542-1550.
18. Nochi M. Loss of self in the narratives of people with traumatic brain injuries: A qualitative analysis. Social Science and Medicine. 1998;46(7):869-878.
19. Nochi M. Reconstructing self-narratives in coping with traumatic brain injury. Social Science & Medicine. 2000;51(12):1795-1804.
20. Jumisko E, Lexell J, Söderberg S. The meaning of living with traumatic brain injury in people with moderate or severe traumatic brain injury. Journal of Neuroscience Nursing. 2005;37(1):42.
21. Häggström A, Lund ML. The complexity of participation in daily life: A qualitative study of the experiences of persons with acquired brain injury. Journal of Rehabilitation Medicine. 2008;40(2):89-95.
22. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology. 1988;56(6):893.
23. Beck AT, Steer RA, Brown GK. Beck depression inventory-II. Vol 78. Psychological Corporation1996.
24. Ashworth F, Clarke A, Jones L, Jennings C, Longworth C. An exploration of compassion focused therapy following acquired brain injury. Psychology and Psychotherapy: Theory, Research and Practice. 2015;88(2):143-162.
25. Gertler P, Tate RL, Cameron ID. Nonpharmacological interventions for depression in adults and children with traumatic brain injury. Cochrane Database of Systematic Reviews. 2012(5).
26. Simpson GK, Tate RL, Whiting DL, Cotter RE. Suicide prevention after traumatic brain injury: A randomized controlled trial of a program for the psychological treatment of hopelessness. The Journal of Head Trauma Rehabilitation. 2011;26(4):290-300.
27. Bedard M, Felteau M, Marshall S, et al. 1494–Mindfulness-based cognitive therapy reduces depression symptoms in people who have a traumatic brain injury: results from a randomized controlled trial. European Psychiatry. 2013;28:1.
28. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy. 2006;44(1):1-25.
29. Gilbert P. Social mentalities: Internal 'social' conflicts and the role of inner warmth and compassion in cognitive therapy. In: Gilbert P, Bailey K, eds. Genes on the Couch: Explorations in Evolutionary Psychotherapy. London, UK: Psychology Press; 2000:118-150.
30. Gilbert P. Compassion: Conceptualisations, research and use in psychotherapy. Routledge; 2005.
31. Hayes SC. Acceptance and Commitment Therapy and the New Behavior Therapies: Mindfulness, Acceptance, and Relationship. In: Hayes S, Follette V, Linehan M, eds. Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York, NY: Guilford Press; 2004:1-29.
32. Gilbert P. Introducing compassion-focused therapy. Advances in psychiatric treatment. 2009;15(3):199-208.
33. Gilbert P. Compassion focused therapy: Distinctive features. Routledge; 2010.
34. Gilbert P, Clarke M, Hempel S, Miles JN, Irons C. Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology. 2004;43(1):31-50.
35. Ashworth F, Gracey F, Gilbert P. Compassion focused therapy after traumatic brain injury: Theoretical foundations and a case illustration. Brain Impairment. 2011;12(2):128-139.
36. Kangas M, McDonald S. Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury. Neuropsychological Rehabilitation. 2011;21(2):250-276.
37. Hermanto N, Zuroff DC. The social mentality theory of self-compassion and self-reassurance: The interactive effect of care-seeking and caregiving. The Journal of social psychology. 2016;156(5):523-535.
38. MacBeth A, Gumley A. Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical psychology review. 2012;32(6):545-552.
39. Campos RC, Besser A, Ferreira R, Blatt SJ. Self-criticism, neediness, and distress among women undergoing treatment for breast cancer: A preliminary test of the moderating role of adjustment to illness. International Journal of Stress Management. 2012;19(2):151.
40. Wilson K, Hayes S, Strosahl K. Acceptance and commitment therapy: an experiential approach to behavior change. New York: Guilford Press; 2003.
41. Masuda A, Price M, Anderson PL, Wendell JW. Disordered eating-related cognition and psychological flexibility as predictors of psychological health among college students. Behavior Modification. 2010;34(1):3-15.
42. Masuda A, Tully EC. The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. Journal of Evidence-Based Complementary & Alternative Medicine. 2012;17(1):66-71.
43. Vowles KE, McCracken LM. Comparing the role of psychological flexibility and traditional pain management coping strategies in chronic pain treatment outcomes. Behaviour research and therapy. 2010;48(2):141-146
44. Van Bost G, Van Damme S, Crombez G. The role of acceptance and values in quality of life in patients with an acquired brain injury: a questionnaire study. PeerJ. 2017;5:e3545.
45. Whiting DL, Deane FP, Simpson GK, Ciarrochi J, Mcleod HJ. Acceptance and Commitment Therapy delivered in a dyad after a severe traumatic brain injury: A feasibility study. Clinical Psychologist. 2017.
46. Gracey F, Evans JJ, Malley D. Capturing process and outcome in complex rehabilitation interventions: A “Y-shaped” model. Neuropsychological Rehabilitation. 2009;19(6):867-890.
47. Faul F, Erdfelder E, Buchner A, Lang A-G. Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior research methods. 2009;41(4):1149-1160.
48. Department of Defense and Department of Veterans Affairs. Traumatic Brain Injury Task Force. 2008;
https://www.hsdl.org/?view&did=482727. Accessed 18 May 2018.
49. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour research and therapy. 1995;33(3):335-343.
50. Brown TA, Chorpita BF, Korotitsch W, Barlow DH. Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour research and therapy. 1997;35(1):79-89.
51. Henry JD, Crawford JR. The short‐form version of the Depression Anxiety Stress Scales (DASS‐21): Construct validity and normative data in a large non‐clinical sample. British journal of clinical psychology. 2005;44(2):227-239.
52. von Steinbüchel N, Wilson L, Gibbons H, et al. Quality of Life after Brain Injury (QOLIBRI): scale validity and correlates of quality of life. Journal of neurotrauma. 2010;27(7):1157-1165.
53. Sunderland A, Harris JE, Baddeley AD. Do laboratory tests predict everyday memory? A neuropsychological study. Journal of verbal learning and verbal behavior. 1983;22(3):341-357.
54. Royle J, Lincoln NB. The Everyday Memory Questionnaire–revised: Development of a 13-item scale. Disability and Rehabilitation. 2008;30(2):114-121.
55. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD. The fatigue severity scale: application to patients with multiple sclerosis and systemic lupus erythematosus. Archives of neurology. 1989;46(10):1121-1123.
56. Ziino C, Ponsford J. Measurement and prediction of subjective fatigue following traumatic brain injury. Journal of the International Neuropsychological Society. 2005;11(4):416-425.
57. White R, Larkin P, McCluskey J, Lyold J, H M. The development of the Flexibility of Responses to Self-Critical Thoughts Scale (FoRest). Journal of Contextual Behavioural Science. In submission.
58. Baião R, Gilbert P, McEwan K, Carvalho S. Forms of self‐criticising/attacking & self‐reassuring scale: Psychometric properties and normative study. Psychology and Psychotherapy: Theory, Research and Practice. 2015;88(4):438-452.
59. Duarte PAdS. The Three-Factor Eating Questionnaire-R21: A confirmatory factor analysis in a Portuguese sample. Paper presented at: The three-factor eating questionnaire-R21: a confirmatory factor analysis in a portuguese sample2015.
60. Fann JR, Bombardier CH, Vannoy S, et al. Telephone and in-person cognitive behavioral therapy for major depression after traumatic brain injury: a randomized controlled trial. Journal of Neurotrauma. 2015;32(1):45-57.
61. Wood, R L, Alderman, N., Worthington, A. Neurobehavioural Rehabilitation. In: Agrawal, N., Faruqui, R. & Bodani, M. Oxford Textbook of Neuropsychiatry. Oxford University Press; 2020 Aug 25
62. Jackson, H.F., Hague, G., Daniels, L, Aguilar, R. Carr, D. & Kenyon, W. Structure to Self- Structuring: Infrastructures and Processes in Neurobehavioural Rehabilitation. Neurorehabilitation, 2014, 34, 681–694.