Life goals after brain injury in the light of the dual process approach: empirical evidence and implications for neuropsychological rehabilitation

Sequelae of acquired brain injury endanger the realisation of important life-goals. Discrepancies arise between the importance attached to a goal and the success in realising it. This study investigates goal discrepancies and their influence on patients' subjective well-being (SWB) in different rehabilitation stages. Life-goals, SWB and daily functioning were assessed in 130 neurological inpatients and 42 outpatients by self-report questionnaires. Both patient groups reported greater discrepancies between importance and success of life-goals than a normative sample of healthy controls. In multiple regression modelling, goal discrepancy predicted SWB in the inpatient sample even when controlling for the influence of ABI-related functional limitations. Of significant influence were the discrepancies in the domains of intimacy and achievement. In the respective analysis of the outpatient sample, goal discrepancy was not a significant predictor of SWB when accounting for functional limitations. A post-hoc analysis examined the inter-relation between functional limitations and goal discrepancy. Functional limitations influenced the ratings of successful goal realisation, yet they had less impact on the importance attached to a goal. The findings highlight the importance of patients' life-goals for successful neuropsychological rehabilitation. They indicate a need for further research considering goal adjustment processes in the face of chronic functional impairment.