Self-focused processing after severe traumatic brain injury: Relationship to neurocognitive functioning and mood symptoms

Objective To investigate the impact of neurocognitive functioning on the self-focused processing styles of rumination and reflection, and the relationship to mood symptoms after severe traumatic brain injury (TBI). Design A cross-sectional design with a between-group component comparing self-focused processing styles and mood symptoms of adults with TBI and age- and gender-matched controls. Method Fifty-two participants with severe TBI (75% male, M age = 36.56, SD = 12.39) completed cognitive tests of attention, memory, executive functioning and the Awareness Questionnaire, Reflection and Rumination Questionnaire (RRQ), and Depression, Anxiety, and Stress Scales (DASS - 21). Fifty age- and gender-matched controls completed the RRQ and DASS-21. Results TBI participants reported significantly greater mood symptoms than controls (p < .05); however, levels of rumination and reflection did not significantly differ. TBI participants high on both reflection and rumination had significantly greater mood symptoms than those with high reflection and low rumination (p < .001). Higher levels of rumination and reflection were associated with better working memory and immediate and delayed verbal memory (r = .36-.43, p < .01). Higher levels of rumination were also associated with greater verbal fluency, self-awareness, and mood symptoms (r = .36-.70, p < .01). Conclusions Individuals with better memory functioning may be more likely to engage in self-focused processing after severe TBI. Reflection without ruminative tendencies is more adaptive for mental health than reflection with rumination.