Document Type

Thesis

Degree

Master of Arts

Major

Psychology

Date of Defense

4-21-2025

Graduate Advisor

Carissa Philippi, Ph.D.

Committee

Carissa Philippi, Ph.D.

Sandra Langeslag, Ph.D.

Hannah White, Ph.D.

Abstract

Mild traumatic brain injury (mTBI) often leads to cognitive impairments, which can significantly affect recovery outcomes. Although there are many different interventions available for individuals with mTBI, evidence-based research has indicated that cognitive rehabilitation programs can lead to significant improvement in psychological symptoms as well as psychosocial and vocational functioning in mTBI. Additionally, clinical research has identified a construct, self-efficacy, or the belief in one's capacity to achieve goals, that may play a critical role in further improving cognitive rehabilitation outcomes. Current research examining self-efficacy and cognitive rehabilitation in mTBI has found that higher self-efficacy is associated with greater treatment engagement and predicts positive outcomes, such as more positive coping skills and reduced symptom severity. However, to our knowledge, no studies have investigated the neural underpinnings of self-efficacy following cognitive rehabilitation in mTBI. Using neuroimaging data for 37 individuals collected as a part of a larger study (SCORE), the present study had two aims: (i) to investigate the relationship between self-efficacy and resting-state connectivity of self-related brain regions before and after cognitive rehabilitation in mTBI and, (ii) to examine whether resting state functional connectivity (rsFC) after cognitive rehabilitation mediates the relationship between self-efficacy at baseline and treatment response following cognitive rehabilitation in mTBI. Results indicated that there was significant relationship between self-efficacy and rsFC between the ACC-anterior medial prefrontal cortex. In addition, cognitive rehabilitation was associated with increased rsFC between the mPFC and supramarginal gyrus, and between the precuneus and premotor cortex, dorsal precuneus, and inferior parietal lobule. These regions lie within motor, attention, and default mode networks, potentially reflecting improvements in cognitive or behavioral functioning in individuals with mTBI. Future research should consider incorporating self-efficacy-enhancing strategies into rehabilitation programs to further support recovery and optimize outcomes.

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