Neuropsychological rehabilitation following acquired brain injury is increasingly recognized as essential with the advancements in research evidence of its effectiveness, particularly as current estimates of disability following the most common forms of brain injury (traumatic brain injury and cerebrovascular accident) are so high. Improvements in predictive capabilities of researchers and clinicians are paramount in designing effective interventions. As many variables associated with outcome following brain injury are not controllable (e.g. severity of the injury, age, education), it is essential that rehabilitation programs design interventions to target those variables that are susceptible to amelioration. While personality factors have been shown to affect outcome in other medical illnesses, only a few studies have examined the influence of personality on outcome following neurorehabilitation for acquired brain injury. The results of these studies have been mixed. This study used the Millon Behavioral Medicine Diagnostic (MBMD) to predict outcome as measured by the Mayo-Portland Adaptability Index (MPAI-4) following brain injury rehabilitation in a heterogeneous sample of persons with acquired brain injuries (N = 50). It was hypothesized that specific coping styles scales from the MBMD (Introversive, Dejected, Oppositional), which are based on Millon's personality system, would predict outcome. Results indicated that both the Introversive and Oppositional coping styles scales accounted for significant amounts of variance in outcome beyond that accounted for by the severity of the injury alone (p < .001). In both cases, individuals with mild/moderate-moderate/severe limitations following completion of the rehabilitation program had significantly higher scores on the Introversive and Oppositional coping compared to individuals with more successful outcomes. The hypothesis that a dejected coping style would predict outcome was not supported. Implications for rehabilitation are discussed in the context of Millon's personality system.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2015-12-01T20:35:38Z No. of bitstreams: 1 BrendaLuannaFernandesCortesDantas_DISSERT.pdf: 1225033 bytes, checksum: d7b5c4e41959453abcf8e2f488a3fd60 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2015-12-08T22:51:33Z (GMT) No. of bitstreams: 1 BrendaLuannaFernandesCortesDantas_DISSERT.pdf: 1225033 bytes, checksum: d7b5c4e41959453abcf8e2f488a3fd60 (MD5) / Made available in DSpace on 2015-12-08T22:51:33Z (GMT). No. of bitstreams: 1 BrendaLuannaFernandesCortesDantas_DISSERT.pdf: 1225033 bytes, checksum: d7b5c4e41959453abcf8e2f488a3fd60 (MD5) Previous issue date: 2014-08-13 / A Hipertens?o Arterial Sist?mica - HAS- ? definida como s?ndrome cuja caracter?stica principal ? a presen?a de n?veis tensionais elevados, associada a altera??es de n?veis funcionais ou estruturais nos ?rg?os aos quais atinge. Suas causas espec?ficas n?o s?o bem delimitadas e possui car?ter assintom?tico. Devido ? sua cronicidade exige ader?ncia ao plano de tratamento de forma permanente e sistem?tica, implicando em mudan?as no estilo de vida, combinadas ou n?o com uso de medicamentos. Os invent?rios de personalidade t?m sido largamente utilizados no delineamento de tra?os indicativos de dificuldades com ades?o ao tratamento. Nesse sentido, desenvolvido por Theodore Millon, o Millon Behavioral Medicine Diagnostic - MBMD ? um instrumento elaborado a partir do consenso entre profissionais de sa?de, visando identificar fatores psicol?gicos que venham a comprometer tratamentos m?dicos para que sejam conduzidos de modo a viabilizar uma melhor ades?o. Objetivos: avalia??o de evidencias de validade do Millon Behavioral Medicine Diagnostic - MBMD para p?blico de pacientes com hipertens?o, com vistas ? investiga??o de indicadores implicados na ades?o ou n?o ao tratamento anti-hipertensivo. M?todo: contou-se com amostra de 200 participantes, dos sexos masculino e feminino, com faixa et?ria entre 20 e 70 anos, recrutados presencialmente em um Hospital Universit?rio da cidade de Natal/RN. Foi administrado um protocolo de entrevista para obter informa??es sobre dados s?cio demogr?ficos, hist?ria cl?nica, h?bitos de cuidado e forma de conduzir o tratamento, e posteriormente segui-se a administra??o do pr?prio MBMD. Resultados: Por meio de An?lise Fatorial Confirmat?ria verificou-se que a organiza??o proposta pelos fatores ? favor?vel e se ajusta ? teoria, permitindo a visualiza??o de outros constructos subjecentes ?s escalas, com ?ndices de ajustes adequados e indicadores satisfat?rios de Alpha de Cronbach. Al?m disso, o MBMD revelou-se sens?vel ?s diferen?as intragrupais quanto as vari?veis sexo, idade, escolaridade, estado civil, profiss?o, renda, hist?rico de HAS, tempo de diagn?stico, uso de medica??o, presen?a de comorbidades, acompanhamento m?dico, uso de ?lcool e tabaco, dieta hiposs?dica, suporte social e crit?rios de ades?o. A utiliza??o de tal instrumento na avalia??o de ades?o ao tratamento anti-hipertensivo apresenta, portanto, indicadores de validade. / Systemic Arterial Hypertension ? SAH ? is defined as the syndrome which its main feature is the presence of high tensional levels, associated with alterations of functional or structural levels in the organs that it strikes. Its specific causes are not very well bounded and have an asymptomatic character. Due to its chronicity it requires adherence to the treatment plan in a systematic and permanent manner, implicating in lifestyle changes, combined or not with the use of medication. The personality inventories have been largely used in the lineation of indicative traits of difficulties with the adherence to the treatment. In this sense, developed by Theodore Millon, the Millon Behavioural Medicine Diagnostic ? MBMD is an instrument made from the consensus among healthcare professionals, aiming at identifying psychological factors that may compromise medical treatment so that they can be conducted in a way to enable a better adherence. Objective: evaluation of the evidence of validity of the Millon Behavioural Medicine Diagnostic ? MBMD for a public of patients with hypertension, aiming at investigating the indicators implicated in the adherence or not to the anti-hypertensive treatment. Method: there was a group of 200 participants in a university hospital in the city of Natal/RN, males and females, ranging from 20 to 70 years old. An interview protocol was administered in order to obtain information about socio-demographic data, clinical history, healthcare habits and way of conducting treatment, and after, the administration of the MBMD followed. Results: by means of Factor Analysis it was verified that the organization proposed by the factors is favorable and it adjusts to the theory, allowing the visualization of other underlying constructs to the scales, with adequate adjustment indexes and satisfactory Cronbach?s alpha indicators. Besides, the MBMD revealed itself sensitive to the intragroup differences relative to the sex, age, schooling, marital status, profession, income, SAH history, diagnostic time, medication use, comorbidity presence, hyposodic diet, social support and adherence criteria variables. The utilization of such instrument in the evaluation of the adherence to the anti-hypertensive treatment show, therefore, indicators of validity.