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Predictors of Caregiver and Family Functioning Following Traumatic Brain Injury: Social Support Moderates Caregiver Distress

Ergh, Tanya C. MA*; Rapport, Lisa J. PhD**; Coleman, Renee D. PhD; Hanks, Robin A. PhD

Journal of Head Trauma Rehabilitation: April 2002 - Volume 17 - Issue 2 - p 155–174
Original Article
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Objective: This study examined predictors of family dysfunction and caregiver distress among 60 pairs of persons who sustained a traumatic brain injury and their caregivers.

Design: A cross-sectional design that used hierarchical multiple regression analyses evaluated the relative influences of time since injury, awareness of deficit, and neurobehavioral and neuropsychological functioning of the person with injury, and caregiver perceived social support.

Results: The predictor model accounted for 52% of the variance in family dysfunction and 39% in caregiver psychological distress. Neurobehavioral disturbance in the person with injury was the strongest predictor of caregiver distress. Social support showed a direct and linear relationship to family functioning, and it was the strongest predictor of family functioning. Social support was a powerful moderator of caregiver psychological distress. In the absence of adequate social support, caregiver distress increased with longer time after injury, cognitive dysfunction, and unawareness of deficit in care recipients, whereas these characteristics were not associated with distress among caregivers with adequate social support.

Conclusions: Rehabilitation professionals should stress the importance of caregivers and families of persons with TBI seeking and obtaining adequate social support.

* Research Associate, Wayne State University Department of Psychology, Detroit, Michigan.

** Associate Professor, Wayne State University Department of Psychology, The Rehabilitation Institute of Michigan, Wayne State University School of Medicine, Department of Physical Medicine and Rehabilitation, Detroit, Michigan.

Neuropsychology Postdoctoral Research Fellow, Wayne State University Department of Psychology, Detroit, Michigan; University of California Department of Medicine, San Diego, California.

Chief of Rehabilitation Psychology, The Rehabilitation Institute of Michigan, Detroit, Michigan; Assistant Professor, Wayne State University School of Medicine, Department of Physical Medicine and Rehabilitation, Detroit, Michigan.

Address correspondence to: Tanya C. Ergh, Department of Psychology, 71 W. Warren, Wayne State University, Detroit, MI 48202. Telephone (313) 577-2800; Fax: (313) 577-7636. E-mail: tergh@sun.science.wayne.edu.

Requests for reprints to: Lisa J. Rapport, PhD, Department of Psychology, 71 W. Warren, Wayne State University, Detroit, MI 48202. Telephone (313) 577-7879; Fax: (313) 577-76536. E-mail: rapport@sun.science.wayne.edu.

This study was supported by grants from Wayne State University (Thesis Research Grant) and the US Department of Education—National Institute of Disability Research and Rehabilitation—The Traumatic Brain Injury Model Systems Project (H133A970021). The authors would like to thank Carole Koviak for her valuable assistance during data collection. Portions of these data were presented at the 2001 annual meetings of the International Neuropsychological Society, Chicago, Illinois, and American Psychological Association, San Francisco, California.

© 2002 Lippincott Williams & Wilkins, Inc.