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J Head Trauma Rehabil. 2016 Mar-Apr;31(2):E12-25. doi: 10.1097/HTR.0000000000000158.

The Impact of Traumatic Brain Injury on Self-Identity: A Systematic Review of the Evidence for Self-Concept Changes.

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School of Applied Psychology and Behavioural Basis of Health Program, Griffith Health Institute, Griffith University, Mt Gravatt, Queensland, Australia (Drs Beadle, Ownsworth, and Shum); School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Queensland, Australia (Dr Fleming); and Princess Alexandra Hospital, Woolloongabba, Queensland, Australia (Dr Fleming).



This review systematically appraised the evidence for changes to self-identity after traumatic brain injury (TBI) in adults and investigated associations between self-concept changes and neurocognitive and psychosocial functioning.


Systematic searches of 4 databases (PsycINFO, PubMed, CINAHL, and Cochrane Systematic Review Database) were undertaken from January 1983 to July 2014. Empirical studies were included if they used a quantitative measure of pre-/postinjury changes in self-concept after TBI or compared levels of self-concept between TBI and control participants.


Fifteen studies met the review criteria and, despite methodological differences, provided mostly evidence of negative changes to self-concept. However, stability in self-concept and positive changes to sense of self were also reported in some studies. Furthermore, levels of self-esteem and personality characteristics did not significantly differ between participants with TBI and orthopedic/trauma controls. Negative self-concept changes were associated with emotional distress in 3 studies.


People with TBI most commonly experience negative changes in self-identity; however, such changes are also reported after other traumatic events or injuries. Greater consistency in measurement of self-identity change and use of longitudinal designs is recommended to improve understanding of factors contributing to self-concept changes after TBI and to guide clinical interventions.

[Indexed for MEDLINE]

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