Access Type

Open Access Thesis

Date of Award

January 2013

Degree Type


Degree Name




First Advisor

Lisa J. Rapport


Although research suggests that coping style affects recovery from traumatic brain injury (TBI), research on assessment of coping style after TBI is sparse. Prevalent theories in the general coping literature suggest a three-factor structure of coping style: task-, emotion-, and avoidance-oriented. However, this factor structure might not well characterize coping after TBI given the cognitive and emotional deficits associated with this population. Therefore, this study examined the psychometric properties of the Coping Inventory for Stressful Situations (CISS) among persons with moderate to severe TBI using approaches from Classical Test Theory (CTT) and Item Response Theory (IRT; Rasch analysis). This study also examined the relationship between coping style and TBI recovery, including subjective and objective well-being outcomes. Participants were 331 adults with moderate to severe TBI who were 1 to 15 years post injury. This was an archival study of a prospective data registry, examining cross-sectional assessments completed at 1, 2, 5, 10 and 15 years post injury. The primary measure of interest was the CISS. Outcomes included the Satisfaction with Life Scale (SWLS) and Disability Rating Scale (DRS). Predictors included demographic (age, education) and injury severity (Glasgow Coma Scale, DRS at discharge) characteristics, Positive (PA) and Negative (NA) Affectivity scales of the Positive Affective and Negative Affect Schedule (PANAS), and the CISS (Task, Emotion, Distraction, and Social Diversion scales). Analyses from CTT and IRT approaches supported the reliability of the CISS among individuals with TBI across short- and long-term adjustment to injury and at various disability levels (median coefficient alpha = .89). Both approaches also supported the three-factor structure of the CISS in persons with TBI. Rasch analysis provided good psychometric support for the use of the CISS with TBI and identified areas for improved item discrimination. Hierarchical multiple regression analyses found that coping style uniquely predicted disability and life satisfaction at follow-up after accounting for sociodemographic factors, injury severity, and affectivity. These findings extend psychometric support for the CISS to the moderate to severe TBI population and highlight the clinical utility of assessing coping style with TBI for predicting functional and subjective well-being.

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