1. Coping Self-Efficacy as a Predictor of Cognitive Functioning Following Motor Vehicle Accident Trauma
Charles C. Benight, Ph.D., Lesley Johnson, B. A., Tina Markowski, Yvonne Sletta, M.S.W. Claire Thomas, B.A., Alex Harding, B.A., Nik Maslow, B.A.
Introduction. Many individuals who are exposed to a severe traumatic event will spend years attempting to cope with the aftermath. The emotional, social, and economic costs are staggering. The most severe trauma reaction is the diagnosis of Post Traumatic Stress Disorder (PTSD). Recent studies have shown that patients with PTSD demonstrate impaired cognitive function in a number of areas including abstract reasoning (Barrett et al., l996), short-term memory (Barrett et al., l996; Bremner et al., l993; Yehuda et al., l995), and information processing (McFarlane et al., l993; Thrasher et al., l994). It has been our goal in my laboratory to understand the psychosocial vulnerability factors that predispose someone to these cognitive difficulties following trauma and design innovative methods to intervene.
Method 50 individuals who suffered a motor vehicle accident (MVA) and were transported to the emergency room of a local hospital served as participants. Mean age was 37 (S.D. = 15). The sample was primarily Caucasian ( 81%). Median income range was $30,000-$35,000. Procedure. Participants were recruited within 4 days of their accident. Exclusion criteria include: Glasgow Coma Scale of <14, history of chronic drug or alcohol abuse, pregnant, chronic illnesses including coronary disease, diabetes, autoimmune disease, hypertension or chronic lung disease, <18 or >75 years old, history of psychotic psychiatric disorder, or alcohol use during accident. Participants complete the protocol at 4-7 days post accident, 1 month post-accident, and again at 3 months post-accident.
Results. Multiple Regression analyses were performed utilizing the enter method with age and IQ entered first, followed by CSE second to determine the independent contribution of CSE over and above these variables. Results, although preliminary, supported the importance of CSE as a predictor of several outcomes measured by the Wisconsin Card Sort Task and for Verbal Fluency (See Table 1).
Table 1: Regression Analyses with Age, IQ, and CSE predicting Cognitive Function
Cognitive Assessment
R2
CSE
F and Significance β
Verbal Fluency
.04
2.71, p = .053a
Age: -.06
IQ: **
CSE: .21*
WCST: Trials To Complete
.05
2.66, p = .053a
Age: .27*
IQ:
CSE: -.22*
WCST: % Persev Errors: Standard Score
2.90, p = .048a
Age: -.38**
IQ:
CSE: .23*
WCST: % Perseverative Responses Standard Score
2.52, p = .06 a
Age: ..35**
IQ:
CSE: .21*
WCST: Response Latency Following Negative Feedback for Ambiguous Error (Raw Score)
.20
11.89, p = .001
Age:
IQ:
CSE: -.44**
WCST: Response Latency Following Positive Feedback for Unambiguous Correct (Raw Score)
.06
3.06, p = .043 a
Age:
IQ:
CSE: -.24*
a 1-Tailed Tests (Directional Hypothesis); *p< .05; **p < .01
Discussion. Social cognitive theory provides a clinically relevant framework to identify those at most risk following a severe trauma (Benight et al., l997; Benight, Swift, et al., l999; Benight, Ironson, et al., l999; Benight & Harding, l999; Martinez, Tishiro, & Benight, l999; Benight, et al., in press). These data provide the first evidence suggesting that those with lower CSE following a significant trauma also demonstrate alterations in cognitive processing. Future research should intervene to increase CSE judgments and assess changes in cognitive processing. Recent research has found support for the use of virtual reality technology as an exposure technique in treating trauma survivors (Hodges et al., l999; Parent & Guy, l998; Rothbaum & Hodges, l999). Collaborative efforts are needed to design virtual reality treatments targeting CSE perceptions following trauma.
Age, IQ
30 Days
Cognitive Functioning: Abstract Reasoning & Verbal Fluency
30 Day
Coping Self-Efficacy
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