This study utilizes a multivariate, correlational, expost facto research design to examine Parsons’ “sick role” as a dynamic, time-sensitive process of “sick role” and “recovery role” and the impact of this process on goal attainment (H1) and psychosocial distress (H2) of adult survivors of acquired brain injury. Measures used include the Brief Symptom Inventory-18, a Goal Attainment Scale, and an original instrument to measure sick role process. 60 survivors of ABI enrolled in community reentry rehabilitation participated. Stepwise regression analyses did not fully support the multivariate hypotheses. Two models emerged from the stepwise analyses. Goal attainment, gender, and postrehab responsibilities accounted for 40% of the shared variance of psychosocial distress. Anxiety and depression accounted for 22% of the shared variance of goal attainment with anxiety contributing to the majority of the explained variance. Bivariate analysis found sick role variables, anxiety, somatization, depression, gender, and goal attainment as significant. The study has implications for ABI rehabilitation in placing greater emphasis on sick role processes, anxiety, gender, and goal attainment in guiding program planning and future research with survivors of ABI. 1. Introduction Based on nonmilitary hospital, emergency room, and death records, an estimated 1.7 million Americans suffer a traumatic brain injury (TBI) each year [1]. Additional US military cases of TBI total over 20,000 annually [2]. Add to that number the additional annual 700,000 stroke victims [3], and the prevalence of people suffering any type of acquired brain injury (ABI) totals over 2.5 million Americans annually. For purposes of perspective, each year 12,000 people suffer a traumatic spinal cord injury [4], 50,000 are diagnosed with AIDS, and 176,000 are diagnosed with breast cancer [5]. Following medical treatment for acquired brain injury (ABI), many persons continue treatment in outpatient community reentry rehabilitation programs. Upon discharge, however, many survivors of ABI fail to demonstrate optimal goal attainment [6] and suffer heightened psychosocial distress as demonstrated by increased depression and anxiety [7–11]. Although there is not a consensus in the literature related to the prevalence of depression and anxiety, the number of brain injury survivors who suffer from depression can be as high as 77% and those who suffer from anxiety can be as high as 66% of the brain injury survivors studied [7–11]. Two recent studies emphasize the amount and longevity of depression in brain
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