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Predictors of Emotional Distress in Family Caregivers of Persons with Traumatic Brain Injury: A Systematic Review

Published online by Cambridge University Press:  01 May 2013

Angelle M. Sander*
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, USA
Kacey Little Maestas
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, USA
Allison N. Clark
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, USA
Whitney N. Havins
Affiliation:
Department of Psychology, University of Houston, Houston, Texas, USA
*
Address for correspondence: Angelle M. Sander, 2323 S. Shepherd Drive, Ste. 907; Houston, Texas 77019, USA. E-mail: [email protected]
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Abstract

The purpose of the current paper was to conduct a systematic review of the literature on predictors of emotional distress in caregivers of persons with traumatic brain injury (TBI), and to provide evidence-based classification for prognostic variables to guide future research and clinical practice. A search was conducted using PubMed, CINAHL and PsycINFO databases. The citations of resulting articles were also reviewed. Twenty-eight articles met inclusion criteria and were retained for review. Reviews were conducted in accordance with the 2011 edition of the American Academy of Neurology (AAN) Guidelines for classifying evidence for prognostic studies. Data abstraction revealed one Class I study, four Class II studies, eight Class III studies, and 15 Class IV studies. Results of the review indicated that caregivers’ report of neurobehavioural problems in the person with injury is a probable predictor of emotional distress for caregivers of persons with complicated mild, moderate or severe TBI (Class B evidence). The level of participation in the person with injury, level of support needed by the person with injury, and family systems functioning are probably predictors of emotional distress for caregivers of persons with severe TBI (Class B evidence). Executive functioning impairment in the person with injury, pre-injury emotional distress in caregivers, caregiver age, caregivers’ use of emotion-focused coping, and social support may possibly be risk factors for caregivers’ emotional distress (Class C evidence). Recommendations for future research and implications for assessment and treatment of family caregivers are discussed.

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State of the Art Reviews
Creative Commons
This is a work of the U.S. Government and is not subject to copyright protection in the United States.
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013

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References

American Academy of Neurology. (2011). Clinical practice guideline process manual. St. Paul, MN: The American Academy of Neurology.Google Scholar
Anderson, M.I., Parmenter, T.R., & Mok, M. (2002). The relationship between neurobehavioural problems of severe traumatic brain injury (TBI), family functioning and the psychological well-being of the spouse/caregiver: path model analysis. Brain Injury, 16, 743757.CrossRefGoogle ScholarPubMed
Anderson, M.I., Simpson, G.K., Morey, P.J., Mok, M.M., Gosling, T.J., & Gillett, L.E. (2009). Differential pathways of psychological distress in spouses vs. parents of people with severe traumatic brain injury (TBI): multi-group analysis. Brain Injury, 23, 931943.CrossRefGoogle ScholarPubMed
Blankfeld, D.F., & Holahan, C.J. (1999). Social support, coping, and psychological adjustment among caregivers of head-injured patients. Psychology and Health, 14, 609624.CrossRefGoogle Scholar
Brooks, D.N. (1991). The head-injured family. Journal of Clinical and Experimental Neuropsychology, 13, 155188.CrossRefGoogle Scholar
Brooks, D.N., Campsie, L., Symington, C., Beattie, A., & McKinlay, W. (1987). The effects of severe head injury on patient and relative within seven years of injury. Journal of Head Trauma Rehabilitation, 2, 113.CrossRefGoogle Scholar
Brooks, N., Campsie, L., Symington, C., Beattie, A., & McKinlay, W. (1986). The five year outcome of severe blunt head injury: a relative's view. Journal of Neurology, Neurosurgery and Psychiatry, 49, 764770.CrossRefGoogle ScholarPubMed
Calvete, E., & de Arroyabe, E.L. (2012). Depression and grief in Spanish family caregivers of people with traumatic brain injury: the roles of social support and coping. Brain Injury, 26, 834843.CrossRefGoogle ScholarPubMed
Charles, N., Butera-Prinzi, F., & Perlesz, A. (2007). Families living with acquired brain injury: a multiple family group experience. NeuroRehabilitation, 22, 6176.CrossRefGoogle ScholarPubMed
Chwalisz, K. (1992). Perceived stress and caregiver burden after brain injury: A theoretical integration. Rehabilitation Psychology, 37, 189203.CrossRefGoogle Scholar
Davis, L.C., Sander, A.M., Struchen, M.A., Sherer, M., Nakase-Richardson, R., & Malec, J.F. (2009). Medical and psychosocial predictors of caregiver distress and perceived burden following traumatic brain injury. Journal of Head Trauma Rehabilitation, 24, 145154.CrossRefGoogle ScholarPubMed
Degeneffe, C.E., & Lynch, R.T. (2006). Correlates of depression in adult siblings of persons with traumatic brain injury. Rehabilitation Counseling Bulletin, 49, 130142.CrossRefGoogle Scholar
Douglas, J.M., & Spellacy, F.J. (2000). Correlates of depression in adults with severe traumatic brain injury and their carers. Brain Injury, 14, 7188.Google ScholarPubMed
Ergh, T.C., Rapport, L.J., Coleman, R.D., & Hanks, R.A. (2002). Predictors of caregiver and family functioning following traumatic brain injury: social support moderates caregiver distress. Journal of Head Trauma Rehabilitation, 17, 155174.CrossRefGoogle ScholarPubMed
First, M.B., Spitzer, R.L., Gibbon, M., & Williams, J.B.W. (2002). Structured clinical interview for DSM-IV-TR Axis I Disorders, research version, patient edition. (SCID-I/P). New York: Biometrics Research, New York State Psychiatric Institute.Google Scholar
Florian, V., Katz, S., & Lahav, V. (1989). Impact of traumatic brain damage on family dynamics and functioning: a review. Brain Injury, 3, 219233.CrossRefGoogle ScholarPubMed
Gillen, R., Tennen, H., Affleck, G., & Steinpreis, R. (1998). Distress, depressive symptoms, and depressive disorder among caregivers of patients with brain injury. Journal of Head Trauma Rehabilitation, 13, 3143.CrossRefGoogle ScholarPubMed
Groom, K.N., Shaw, T.G., O'Connor, M.E., Howard, N.I., & Pickens, A. (1998). Neurobehavioral symptoms and family functioning in traumatically brain-injured adults. Archives of Clinical Neuropsychology, 13, 695711.CrossRefGoogle ScholarPubMed
Hanks, R.A., Rapport, L.J., Wertheimer, J., & Koviak, C. (2012). Randomized controlled trial of peer mentoring for individuals with traumatic brain injury and their significant others. Archives of Physical Medicine and Rehabilitation, 93, 12971304.CrossRefGoogle ScholarPubMed
Hibbard, M.R., Cantor, J., Charatz, H., Rosenthal, R., Ashman, T., Gundersen, N., . . . Gartner, A. (2002). Peer support in the community: initial findings of a mentoring program for individuals with traumatic brain injury and their families. Journal of Head Trauma Rehabilitation, 17, 112131.CrossRefGoogle ScholarPubMed
Knight, R.G., Devereux, R., & Godfrey, H.P. (1998). Caring for a family member with a traumatic brain injury. Brain Injury, 12, 467481.CrossRefGoogle ScholarPubMed
Kreutzer, J.S., Gervasio, A.H., & Camplair, P.S. (1994). Patient correlates of caregivers’ distress and family functioning after traumatic brain injury. Brain Injury, 8, 211230.CrossRefGoogle ScholarPubMed
Kreutzer, J.S., Marwitz, J.H., & Kepler, K. (1992). Traumatic brain injury: family response and outcome. Archives of Physical Medicine and Rehabilitation, 73, 771778.Google ScholarPubMed
Kreutzer, J.S., Rapport, L.J., Marwitz, J.H., Harrison-Felix, C., Hart, T., Glenn, M., . . . Hammond, F. (2009). Caregivers’ well-being after traumatic brain injury: a multicenter prospective investigation. Archives of Physical Medicine and Rehabilitation, 90, 939946.CrossRefGoogle ScholarPubMed
Kreutzer, J.S., Stejskal, T.M., Godwin, E.E., Powell, V.D., & Arango-Lasprilla, J.C. (2010). A mixed methods evaluation of the Brain Injury Family Intervention. NeuroRehabilitation, 27, 1929.CrossRefGoogle ScholarPubMed
Livingston, M.G. (1987). Head injury: the relatives’ response. Brain Injury, 1, 3339.CrossRefGoogle ScholarPubMed
Livingston, M.G., Brooks, D.N., & Bond, M.R. (1985). Patient outcome in the year following severe head injury and relatives’ psychiatric and social functioning. Journal of Neurology, Neurosurgery and Psychiatry, 48, 876881.CrossRefGoogle ScholarPubMed
Marsh, N.V., Kersel, D.A., Havill, J.H., & Sleigh, J.W. (1998a). Caregiver burden at 1 year following severe traumatic brain injury. Brain Injury, 12, 10451059.CrossRefGoogle ScholarPubMed
Marsh, N.V., Kersel, D.A., Havill, J.H., & Sleigh, J.W. (1998b). Caregiver burden at 6 months following severe traumatic brain injury. Brain Injury, 12, 225238.CrossRefGoogle ScholarPubMed
Marsh, N.V., Kersel, D.A., Havill, J.A., & Sleigh, J.W. (2002). Caregiver burden during the year following severe traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 24, 434447.CrossRefGoogle ScholarPubMed
McKinlay, W., Brooks, D.N., Bond, M.R., Martinage, D.P., & Marshall, M.M. (1981). The short-term outcome of severe blunt head injury as reported by relatives of the injured persons. Journal of Neurology, Neurosurgery and Psychiatry, 44, 527533.CrossRefGoogle ScholarPubMed
Perlesz, A., Kinsella, G., & Crowe, S. (1999). The impact of traumatic brain injury on the family: a critical review. Rehabilitation Psychology, 44, 635.CrossRefGoogle Scholar
Ponsford, J., Olver, J., Ponsford, M., & Nelms, R. (2003). Long-term adjustment of families following traumatic brain injury where comprehensive rehabilitation has been provided. Brain Injury, 17, 453468.CrossRefGoogle ScholarPubMed
Ponsford, J., & Schonberger, M. (2010). Family functioning and emotional state two and five years after traumatic brain injury. Journal of the International Neuropsychological Society, 16, 306317.CrossRefGoogle ScholarPubMed
Riley, G.A. (2007). Stress and depression in family carers following traumatic brain injury: the influence of beliefs about difficult behaviours. Clinical Rehabilitation, 21, 8288.CrossRefGoogle ScholarPubMed
Rivera, P., Elliott, T.R., Berry, J.W., Grant, J.S., & Oswald, K. (2007). Predictors of caregiver depression among community-residing families living with traumatic brain injury. NeuroRehabilitation, 22, 38.CrossRefGoogle ScholarPubMed
Sander, A.M. (2002). Picking up the pieces after TBI. Retreived from http://www.tbicommunity.org/Google Scholar
Sander, A.M. (2005). Interventions for caregivers. In High, W., Sander, A.M., Struchen, M.A. & Hart, K.A. (Eds.), Rehabilitation interventions for traumatic brain injury (pp. 156175). New York: Oxford University Press.CrossRefGoogle Scholar
Sander, A.M. (2007). A cognitive-behavioral intervention for family members of persons with TBI. In Zasler, N.D., Katz, D.I. & Zafonte, R.D. (Eds.), Brain injury medicine. New York: Demos Publishing.Google Scholar
Sander, A.M., Clark, A.N., Atchison, T.B., & Rueda, M. (2009). A web-based videoconferencing approach to training caregivers in rural areas to compensate for problems related to traumatic brain injury. Journal of Head Trauma Rehabilitation, 24, 248261.CrossRefGoogle ScholarPubMed
Sander, A.M., Davis, L.C., Struchen, M.A., Atchison, T., Sherer, M., Malec, J.F., . . . Nakase-Richardson, R. (2007). Relationship of race/ethnicity to caregivers’ coping, appraisals, and distress after traumatic brain injury. NeuroRehabilitation, 22, 917.CrossRefGoogle Scholar
Sander, A.M., High, W.M. Jr, Hannay, H.J., & Sherer, M. (1997). Predictors of psychological health in caregivers of patients with closed head injury. Brain Injury, 11, 235249.CrossRefGoogle ScholarPubMed
Schonberger, M., Ponsford, J., Olver, J., & Ponsford, M. (2010). A longitudinal study of family functioning after TBI and relatives’ emotional status. Neuropsychological Rehabilitation, 20, 813829.CrossRefGoogle ScholarPubMed
Stebbins, P., & Pakenham, K.I. (2001). Irrational schematic beliefs and psychological distress in caregivers of people with traumatic brain injury. Rehabilitation Psychology, 46, 178194.CrossRefGoogle Scholar
Struchen, M.A., Atchison, T.B., Roebuck, T.M., Caroselli, J.S., & Sander, A.M. (2002). A multidimensional measure of caregiving appraisal: validation of the Caregiver Appraisal Scale in traumatic brain injury. Journal of Head Trauma Rehabilitation, 17, 132154.CrossRefGoogle ScholarPubMed
Wells, R., Dywan, J., & Dumas, J. (2005). Life satisfaction and distress in family caregivers as related to specific behavioural changes after traumatic brain injury. Brain Injury, 19, 11051115.CrossRefGoogle ScholarPubMed
Winstanley, J., Simpson, G., Tate, R., & Myles, B. (2006). Early indicators and contributors to psychological distress in relatives during rehabilitation following severe traumatic brain injury: findings from the Brain Injury Outcomes Study. Journal of Head Trauma Rehabilitation, 21, 453466.CrossRefGoogle ScholarPubMed