5.5 Impact of TBI on Social Integration

Case Study (continued)

At 6 month follow-up the patient and his spouse note that he has not yet returned to work. Although many friends dropped by to visit initially, they note that friends do not drop by as much. They do not go out as much, which they attribute in part to the patient’s fatigue near the end of the day. His wife notes that he is no longer able to maintain a conversation as he did before when he was “more interesting to talk to”. The patient complains he is not working and has nothing interesting to talk about. Several of their friends have noted that the patient is not himself and although they remain friends they call less often.

Describe how an ABI impacts on social integration.

  1. Fewer friends and social contacts;
  2. Greater degree of dissatisfaction with social networks;
  3. Negative reactions of peers;
  4. Reduced self-esteem.
  • Individuals with traumatic brain injury (TBI) often face isolation and a lack of social support 4.
  • Persons having experienced a brain injury reported having fewer friends and social contacts, and a greater degree of dissatisfaction with social networks than individuals without TBI 4.
  • Young people who have sustained a brain injury often recognize that the reaction of their peers is the most limiting factor predicting successful social integration.
  • Reduced self-esteem and a perceived decline in personal sex appeal have been reported as common personality changes following head injury 5;6.
  • Individuals who identified themselves as‘impaired’ or inadequate in some way did not perceive themselves as confident or attractiveand did not pursue or recognize safe opportunities for pair-bonding or sexual activity.
  • Although social integration is an area of great diversity and importance to brain injury survivors, there are few empirical studies describing the interventions intended to improve the lived experiences of these individuals.


For a more detailed discussion please see ERABI/Community Reintegration Post ABI.