Investigating the effects of acquired brain injuries on self-identity and adjustment in adolescence

Abstract

Section A
A systematic search and narrative review were conducted to explore how an adolescent’s self-concept changes after a brain injury, and to identify factors that aid their adjustment to life post-injury.

A systematic literature search was performed across various electronic databases, including PubMed, PsychINFO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), which covered studies published from 1999 to August 2024. In total, 12 studies that met the inclusion criteria were examined, focusing on changes in self-identity and self-concept among adolescents following an acquired brain injury (ABI).

The review identified three key aspects of an adolescent's self-concept that were impacted by an ABI: self-esteem, social identity, and self-awareness. The literature suggested that acceptance, social support, and various internal attributes, such as patience, significantly
facilitated adjustment after the injury. The findings were discussed in the context of existing research, and suggestions for future
research were explored.

Section B
Introduction: Individuals with acquired brain injury (ABI) often experience significant psychological adjustment difficulties. This current study aimed to validate a 22-item measure called the Self-Identity Adjustment Scale (SIAS), which has been designed to assess how adolescents perceive themselves and adjust to their lives following a brain injury.

Method: A total of 163 adolescents with a history of brain injury were recruited via UK-based charities. Participants completed the SIAS alongside additional self-report measures related to adjustment and wellbeing. An exploratory factor analysis (EFA) was conducted to evaluate the underlying structure of the SIAS and its construct validity.

Results: Exploratory factor analysis revealed an underlying two-factor structure, encompassing Adaptive Adjustment and Disrupted Adjustment. These distinct factors represent the nuanced positive and negative dimensions of identity adjustment that adolescents experience in the aftermath of a brain injury. Moreover, the Self-Identity Adjustment Scale (SIAS) exhibited robust construct validity when assessed alongside
established measurement tools.

Conclusion: The SIAS is a valuable tool for evaluating self-identity adjustment in adolescents post-brain injury. It provides researchers and clinicians with important insights into how young people adapt after a brain injury. Its application can help identify those having difficulty with post-injury identity, enabling targeted interventions and enhanced psychological support in clinical environments.

Date of Award	2025
Original language	English