Marital Stability Over 10 Years Following Traumatic Brain Injury

Objective: To examine the stability of marriage from the time of traumatic brain injury (TBI) to 10 years postinjury. Design: Retrospective cohort. Setting: TBI Model Systems centers. Participants: In total, 1423 participants in the TBI Model Systems National Database who experienced TBI 10 years prior and were married at the time of injury. Interventions: Not applicable. Main Outcome Measure: Remaining married to the same partner from the time of injury to 10-year follow-up. Results: At 10 years, 66% (938) remained married to the same person. Significant associations were found with age at injury (P < .0001), sex (P = .0028), and preinjury problematic substance use (P = .0092). Marital stability over the 10-year period was higher for those who were older, were female, and had no problematic substance use history. Marital instability was greatest in the first year postinjury. Conclusions: Most married adults who received inpatient rehabilitation for TBI remained married to the same individual 10 years later. Those who were younger, were male, and had a history of problematic substance use were at a highest risk for relationship dissolution. Findings have implications for content, timing, and delivery of marital interventions. Substance use education and prevention appear to be important aspects of marital support.