Associations of executive functioning, coping behaviour, psychiatric symptoms and depressive symptoms with treatment motivation in patients with acquired brain injury.

Abstract

Abstract Aim: Low motivation to engage in treatment is often seen in patients with acquired brain injury (ABI). The aim of the current study was to find factors that are associated with treatment motivation. Therefore, associations of executive functioning, coping behaviour, neuropsychiatric symptoms and depressive symptoms with treatment motivation were examined. Methods: In this cross-sectional study, patients with ABI and neuropsychiatric symptoms (N=92) were acquired from Dutch mental health institutions. Executive functioning was measured with the Trail Making Test and the Stroop test, coping styles were measured with the Utrechtse Coping List, neuropsychiatric symptoms were measured with the Neuropsychiatric Inventory Questionnaire, and depression was measured with the Patient Health Questionnaire. Treatment motivation was measured with the Motivation for Traumatic Brain Injury Rehabilitation Questionnaire. Regression analyses were used to examine associations. Results: After correction for age, gender, educational level and type of brain injury, significant associations were found between a lower cognitive flexibility (regression coefficient, B= -4.598, p=.007) and lower treatment motivation. In addition, greater use of a passive coping style (B= 1.112, p= .006) and more depressive symptoms (B= .614, p= .032) were associated with higher treatment motivation. No other associations with treatment motivation were found. Cognitive flexibility was the strongest predictor of the three significant predictors (standardised regression coefficient, β= -.271, p= .011). Conclusion: Current findings suggest that clinicians must be aware of a lower treatment motivation in patients with lower cognitive flexibility. For future research, a longitudinal study is suggested to examine causal relationships.