Poster 24: Relationship of Perceived Attitudinal Barriers and Community Integration to Psychosocial Adjustment to Disability in Persons with Traumatic Brain Injury

Objective: To examine the relationship of perceived attitudinal barriers and community integration to disability adjustment. Design: Prospective survey study. Setting: General community. Participants: 167 persons (52 whites, 58 blacks, 57 Hispanics) with medically documented TBI (Mean best day 1 GCS score=12±3.7) consecutively admitted to the Neurosurgery Service at a Level I trauma center and assessed at 6 months after injury. Thirty-nine percent had annual household incomes of≤$20,000 per year. Mean years of education=11±3. Mean age=36±16. Interventions: Not applicable. Main Outcome Measures: Acceptance of disability scale-TBI version; Occupation and Social Integration subscales of the Craig Handicap Assessment and Reporting Technique–Short Form; Attitudes/Support subscale of the Craig Hospital Inventory of Environment–Short Form. Results: After controlling for demographic characteristics, perceived attitudinal barriers, occupation and social integration explained 22% of the variance in disability adjustment (F_12,126=6.19, P<.001). Fewer attitudinal barriers, greater productivity and social integration, and younger age were associated with greater disability adjustment. Conclusions: Adjustment to TBI is related to perceived negative attitudes from others and to decreased community integration. Interventions to improve these areas could lead to improved adjustment. Rehabilitation professionals should be sensitive to the needs of older clients who may experience greater adjustment difficulties.