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Relationship satisfaction among spouse caregivers of service members and veterans with comorbid mild traumatic brain injury and post-traumatic stress disorder

APA Citation:

Brickell, T. A., French, L. M., Varbedian, N. V., Sewell, J. M., Schiefelbein, F. C., Wright, M. M., & Lange, R. T. (2021). Relationship satisfaction among spouse caregivers of service members and veterans with comorbid mild traumatic brain injury and posttraumatic stress disorder. Family Process. Advance online publication. https://doi.org/10.1111/famp.12731

Abstract Created by REACH:

Caring for a Service member or Veteran (SM/V) with traumatic brain injury (TBI), even in cases that are considered “uncomplicated,” presents challenges that may spill over to impact marital satisfaction. 205 spouses caring for a SM/V diagnosed with comorbid TBI and posttraumatic stress disorder (PTSD) reported on 12 health-related quality of life measures (e.g., emotional support, vigilance, feeling trapped, anxiety, family disruption), SM/V functional adjustment, and marital satisfaction. Comparisons between spouses who were satisfied with their marital relationship and those who were dissatisfied were also explored to determine whether meaningful differences in quality of life emerged. In general, aspects of caregiving and poorer SM/V adjustment were negatively associated with caregivers’ marital satisfaction.

Focus:

Physical health
Couples
Veterans
Mental health

Branch of Service:

Army
Marine Corps
Navy
Air Force
Multiple branches

Military Affiliation:

Active Duty
Veteran

Subject Affiliation:

Spouse of service member or veteran

Population:

Adulthood (18 yrs & older)
Thirties (30 - 39 yrs)
Middle age (40 - 64 yrs)

Methodology:

Quantitative Study

Authors:

Brickell, Tracey A., French, Louis M., Varbedian, Nicole V., Sewell, Jessie M., Schiefelbein, Faith C., Wright, Megan M., Lange, Rael T.

Abstract:

This study examined relationship satisfaction and health-related quality of life (HRQOL) among spouse caregivers assisting service members and veterans (SMV) with comorbid uncomplicated mild traumatic brain injury (MTBI) and post-traumatic stress disorder (PTSD). Spouse caregivers (N = 205) completed the Couples Satisfaction Index (CSI), 12 HRQOL measures, and the Mayo-Portland Adaptability Inventory 4th Edition (MPAI-4). T-scores were classified as “clinically elevated” using a cutoff of ≥60T. The sample was also classified into “Satisfied” (≥13.5, n = 113, 55.0%) or “Dissatisfied” (<13.5, n = 92, 44.0%) relationship categories. Using stepwise regression analysis, Anxiety, Family Disruption, Vigilance, Emotional Support, Feeling Trapped, and MPAI-4 Adjustment were identified as the strongest predictors of CSI total scores (p < 0.001), accounting for 41.6% of the variance. Squared semi-partial correlations revealed that 18.1% of the variance was shared across all six measures, with 7.8% to 1.5% of unique variance accounted for by each measure separately. When comparing the number of clinically elevated measures simultaneously, the Dissatisfied group consistently had a higher number of clinically elevated scores compared to the Satisfied group (e.g., 3-or-more clinically elevated scores: Dissatisfied = 40.2%, Satisfied = 8.8%, OR = 6.93, H = 0.76). Caring for a SMV with comorbid TBI and PTSD can have a profound impact on the spouse caregiver's HRQOL, relationship satisfaction, and family functioning. The findings from the current study continue to support the need for family involvement in the SMV’s treatment plan, but more effort is needed to integrate behavioral health treatment that focuses on the family member's own issues into military TBI and PTSD systems of care.

Publisher/Sponsoring Organization:

John Wiley & Sons

Publication Type:

Article
REACH Publication

Author Affiliation:

Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, TB
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, LF
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, NV
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, JS
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, FS
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, MW
Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, RL

Keywords:

health-related quality of life, military spouse caregiver, post-traumatic stress disorder, relationship satisfaction, service member veteran, traumatic brain injury

View Research Summary:

REACH Publication Type:

Research Summary

Sponsors:

Traumatic Brain Injury Center of Excellence

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