Social factors predictive of social integration for adults with brain injury.

INTRODUCTION: Individuals with acquired brain injury (ABI) may not only struggle with physical and cognitive impairments, but may also face challenges reintegrating into the community socially. Research has demonstrated that following ABI, individuals' social networks tend to dwindle, support may decline, and isolation increases. This study examined factors impacting social integration in a community-based sample of 102 individuals with ABI.

METHODS: Potential predictors included emotional support, instrumental support, problem solving confidence, and approach-avoidance style (AAS) of problem solving, while controlling for age, gender, education, and time since injury. Hierarchical regression was used to analyze whether these factors were predictive of social integration.

RESULTS: The final model accounted for 33% of the variance in social integration outcomes. Results demonstrated that emotional support was initially a significant predictor; however, when controlling for emotional support the variance in social integration was better accounted for by social problem solving - specifically, AAS. A follow-up mediation analysis indicated that the relationship between social problem solving (specifically, AAS) and social integration was partially mediated by emotional support.

CONCLUSIONS: This suggests that for individuals with ABI, a tendency to approach rather than avoid social problem solving issues is a significant predictor for social integration both directly and indirectly through its association with emotional social support. Implications for Rehabilitation Both instrumental and emotional social support should be assessed in patients with acquired brain injury (ABI), ensuring that emotional needs are met in addition to the more obvious instrumental needs. Barriers to problem solving for people with ABI may limit optimal social integration; thus, assessment and intervention aimed at increasing AAS are recommended. To enhance the social integration outcomes of people with brain injury, strength-based psychosocial rehabilitation should optimally balance an individual's abilities with areas requiring compensation, focusing on how to approach rather than avoid problems as well as strategies to cultivate emotional social support.