To examine group differences among caregivers of service members or veterans (SMVs) and civilians with traumatic brain injury (TBI).
An observational research study examining the group differences between caregivers of SMVs and civilians with TBI. The data presented was collected as part of a larger study that calibrated and validated the Traumatic Brain Injury-Care Quality of Life (TBI-CareQOL) item banks.
Participants in this multicenter study completed an online survey via a study-specific website. Surveys were completed at the study site, at home, or via phone interview. Civilian caregivers were recruited from 4 rehabilitation hospitals and caregivers of SMVs were recruited through community outreach and collaboration with the Hearts of Valor.
Participants (N=473) consisted of 344 caregivers of civilians with TBI and 129 caregivers of SMVs with TBI.
Main Outcome Measures
Zarit Burden Interview Scale, TBI-CareQOL, and Mayo Portland Adaptability Inventory, 4th revision (MPAI-4).
Of the independent variables included in the logistic regression model that classified military-affiliated vs civilian caregivers, 5 were statistically significant: age, spousal status, time since injury, MPAI-4 Adjustment, and TBI-CareQOL Feeling Trapped.
The results indicate that caregivers of SMVs were more likely to report worse emotional and social adjustment among the individuals with TBI and caregivers of SMVs were more likely to report greater levels of feeling trapped by their caregiving duties.
List of abbreviations:MPAI-4 (Mayo Portland Adaptability Inventory, 4th revision), PTSD (post-traumatic stress disorder), SMV (service member or veteran), TBI (traumatic brain injury), TBI-CareQOL (Traumatic Brain Injury-Care Quality of Life), VA (Veterans Affairs)
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- The epidemiology of traumatic brain injury.J Head Trauma Rehabil. 2010; 25: 72-80
- A guide to US military casualty statistics: Operation New Dawn, Operation Iraqi Freedom, and Operation Enduring Freedom.Congressional Research Service, Washington, DC2014
- Traumatic brain injury among veterans.(Available at:)Accessed July 2, 2018)
- DoD worldwide numbers for TBI.(Available at:)Accessed July 2, 2018)
- Mild traumatic brain injury in U.S. soldiers returning from Iraq.N Engl J Med. 2008; 358: 453-463
- Posttraumatic stress disorder mediates the relationship between mild traumatic brain injury and health and psychosocial functioning in veterans of Operations Enduring Freedom and Iraqi Freedom.J Nerv Ment Dis. 2009; 197: 748-753
- Post-concussive disorder.in: Zasler N.D. Katz H.T. Zafonte R.D. Brain injury medicine: Principles and practice. Demos Medical Publishing, New York2007: 373-405
- Association of trauma exposure with psychiatric morbidity in military veterans who have served since September 11, 2001.J Psychiatr Res. 2009; 43: 830-836
- The invisible side of war: families caring for US service members with traumatic brain injuries and polytrauma.J Head Trauma Rehabil. 2012; 27: 3-13
- Traumatic brain injury caregivers: a qualitative analysis of spouse and parent perspectives on quality of life.Neuropsychol Rehabil. 2017; 27: 16-37
- Patient outcome in the year following severe head injury and relatives’ psychiatric and social functioning.J Neurol Neurosurg Psychiatry. 1985; 48: 876-881
- Caregivers’ well-being after traumatic brain injury: a multicenter prospective investigation.Arch Phys Med Rehabil. 2009; 90: 939-946
- Family functioning and emotional state two and five years after traumatic brain injury.J Int Neuropsychol Soc. 2010; 16: 306-317
- Caring for our wounded warriors: a qualitative examination of health-related quality of life in caregivers of individuals with military-related traumatic brain injury.J Rehabil Res Dev. 2016; 53: 669-680
- Stigma, perceived blame, self-blame, and depressive symptoms in men with colorectal cancer.Psychooncology. 2013; 22: 65-73
- The TBI-CareQOL measurement system: development and preliminary validation of health-related quality of life measures for caregivers of civilians and service members/veterans with traumatic brain injury.Arch Phys Med Rehabil. 2019; 100: S1-S12
- Traumatic Brain Injury Model Systems National Data and Statistical Center. Home page.(Available at:)https://www.tbindsc.orgDate accessed: December 18, 2017
- Further psychometric evaluation and revision of the Mayo-Portland Adaptability Inventory in a national sample.J Head Trauma Rehabil. 2003; 18: 479-492
- Refining a measure of brain injury sequelae to predict postacute rehabilitation outcome: rating scale analysis of the Mayo-Portland Adaptability Inventory.J Head Trauma Rehabil. 2000; 15: 670-682
- Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia.Can J Aging. 2000; 19: 494-507
- Relatives of the impaired elderly: correlates of feelings of burden.Gerontologist. 1980; 20: 649-655
- Health-related quality of life in caregivers of individuals with traumatic brain injury: development of a conceptual model.Arch Phys Med Rehabil. 2015; 96: 105-113
- Subjective burden of husbands and wives as caregivers: a longitudinal study.Gerontologist. 1986; 26: 260-266
- The development of a new computer adaptive test to evaluate feelings of being trapped in caregivers of individuals with traumatic brain injury: TBI-CareQOL Feeling Trapped Item Bank.Arch Phys Med Rehabil. 2019; 100: S43-S51
- The development of two new computer adaptive tests to evaluate feelings of loss in caregivers of individuals with traumatic brain injury: TBI-CareQOL Feelings of Loss-Self and Feelings of Loss-Person with Traumatic Brain Injury.Arch Phys Med Rehabil. 2019; 100: S31-S42
- The development of a new computer adaptive test to evaluate anxiety in caregivers of individuals with traumatic brain injury: TBI-CareQOL Caregiver-Specific Anxiety.Arch Phys Med Rehabil. 2019; 100: S22-S30
- The development of a new computer-adaptive test to evaluate strain in caregivers of individuals with TBI: TBI-CareQOL Caregiver Strain.Arch Phys Med Rehabil. 2019; 100: S13-S21
- Mild traumatic brain injury and posttraumatic stress disorder in returning veterans: perspectives from cognitive neuroscience.Clin Psychol Rev. 2009; 29: 674-684
- Psychological sequelae of combat violence: a review of the impact of PTSD on the veteran’s family and possible interventions.Aggress Violent Behav. 2004; 9: 477-501
- Psychological functioning of partners of Australian combat veterans: contribution of veterans’ PTSD symptoms and partners' caregiving distress.Aust Psychol. 2014; 49: 305-312
- Caregiver burden and psychological distress in partners of veterans with chronic posttraumatic stress disorder.J Trauma Stress. 2002; 15: 205-212
- Hidden heroes: America's military caregivers—executive summary.Rand Health Q. 2014; 4: 14
- Relationship of race/ethnicity to caregivers’ coping, appraisals, and distress after traumatic brain injury.NeuroRehabilitation. 2007; 22: 9-17
Published online: December 08, 2018
Supported by the National Institutes of Health (grant no. R01NR013658), the National Institute of Nursing Research, and the National Center for Advancing Translational Sciences (grant no. UL1TR000433).
© 2018 by the American Congress of Rehabilitation Medicine