Original research| Volume 99, ISSUE 11, P2222-2229, November 2018

The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers



      To assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration.


      A cross-sectional survey study of 564 informal caregivers of U.S. military service veterans of wars in Iraq and Afghanistan who experienced traumatic brain injuries or polytrauma (TBI/PT).


      Care settings of community-dwelling former inpatients of U.S. Department of Veterans Affairs Polytrauma Rehabilitation Centers.


      Caregivers of former inpatients (N=564), identified through next-of-kin records and subsequent nominations.


      Not applicable.

      Main Outcome Measures

      Caregiver strain, depression, anxiety, loneliness, and self-esteem; as well as care recipient community reintegration, a key aspect of TBI/PT rehabilitation.


      Family stigma was associated with strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. Caregiver stigma-by-association was associated with strain, depression, anxiety, loneliness, and lower self-esteem. Care recipient stigma was associated with caregiver strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration.


      Perceived stigma may be a substantial source of stress for caregivers of U.S. military veterans with TBI/PT, and may contribute to poor outcomes for the health of caregivers and for the community reintegration of the veterans for whom they provide care.


      List of abbreviations:

      ADLs (activities of daily living), IADLs (instrumental activities of daily living), PRC (Polytrauma Rehabilitation Center), PT (polytrauma), TBI (traumatic brain injuries), VA (Veterans Affairs)
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