Perceived Stigma and Its Association With Participation Following Traumatic Brain Injury

Individuals with traumatic brain injury (TBI) may experience stigma in the form of negative attitudes or discriminatory behaviors, which are external actions directed toward the individual with the disability. Awareness of these negative attitudes, behaviors, and stereotypes related to one's condition is known as perceived stigma. Perceived stigma has been shown to be problematic in other populations because of its association with various negative mental and physical health outcomes. However, further research is needed on the factors related to perceived stigma in individuals with TBI as well as its association with community participation. The present study explored the associations of experiential and affective factors with perceived stigma in a sample of 504 individuals with TBI as well as the association of perceived stigma with community participation. Independent variables included experiential factors (preinjury years of education, preinjury occupation) and postinjury affective factors (depression, anxiety); demographic characteristics (age, gender, race/ethnicity) and injury severity served as covariates. Outcome variables included perceived stigma and community participation. Results of structural regression modeling revealed that affective factors were associated with perceived stigma, which was associated with community participation. Affective factors were associated with community participation only when perceived stigma was removed from the model. The findings of this research hold significant treatment implications for individuals with TBI such that modifying evidence-based practices to include consideration of perceived stigma may increase community participation for individuals with TBI.