Medical and Psychosocial Predictors of Caregiver Distress and Perceived Burden Following Traumatic Brain Injury

Objective: To determine whether caregivers' medical and psychiatric histories, coping style, and social support predict global distress and perceived burden. Design: Correlational, cohort study. Participants: A total of 114 caregivers of persons with moderate to severe traumatic brain injury, assessed 1 year postinjury. Measures: Ratings of caregivers' medical and psychiatric history; Disability Rating Scale; Ways of Coping Questionnaire; Multidimensional Scale of Perceived Social Support; Brief Symptom Inventory; and Modified Caregiver Appraisal Scale. Results: Caregivers' medical and psychiatric histories predicted global distress, after accounting for education, sex, income, and relationship, as well as disability of the person with injury. Increased use of escape-avoidance as a coping strategy was related to increased distress. Perceived burden was predicted by disability in the person with injury, use of escape-avoidance, and perceived social support. Conclusions: Caregivers' preinjury functioning is more predictive of global distress, whereas the functioning of the person with injury is more predictive of injury-related burden. Caregivers' medical and psychiatric histories are important considerations when targeting interventions; global stress management strategies may be as important as assisting with injury-related issues.