Psychological and marital adjustment in couples following a traumatic brain injury (TBI): a critical review.

Department of Psychology, Université du Québec à Trois-Riviéres, Québec, Canada.
Brain Injury (Impact Factor: 1.86). 01/2006; 19(14):1223-35. DOI: 10.1080/02699050500309387
Source: PubMed

ABSTRACT The first part of this paper examines current data describing the psychological and marital adjustment of couples following a traumatic brain injury (TBI). Although these findings reveal some discrepancies, they highlight that adjustment following a TBI represents a genuine challenge for those involved in the process. The second part moves toward the examination of factors associated with psychological and marital adjustment in both couple partners. Here again, there exists a large diversity in empirical data and theoretical models informing this emerging area of interest. Nevertheless, cognitive variables such as coping skills are commonly seen as critical variables to explain the adjustment level in people with TBI and their spouse/caregivers. Concurrently with the discussion of the methodological issues and pitfalls encountered in this area of research, the conclusion provides suggestions of further steps to undertake in this endeavour toward a better understanding of the adjustment process following TBI.

  • [Show abstract] [Hide abstract]
    ABSTRACT: OVERVIEW: Mild traumatic brain injury (mTBI) can have a profoundly negative effect on the injured person's quality of life, producing cognitive, physical, and psychological symptoms; impeding postinjury family reintegration; creating psychological distress among family members; and often having deleterious effects on spousal and parental relationships. This article reviews the most commonly reported signs and symptoms of mTBI, explores the condition's effects on both patient and family, and provides direction for developing nursing interventions that promote patient and family adjustment.
    The American Journal of Nursing 10/2014; 114(11). DOI:10.1097/01.NAJ.0000456426.79527.9b · 1.32 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Background: While study on the emotional effects of traumatic brain injury (TBI) for individuals and caregivers has increased dramatically over the years, insufficient research has been performed on TBI's impact on the coupled relationship or the healing process successful couples go through following injury. As such, couples are left on their own to adjust to the complex challenges that TBI brings. Methods: This qualitative study aims to develop a framework for conceptualizing and assessing couples after TBI. Additionally, it purposes to establish a foundation built upon the practises of successful couples that have subsisted TBI from which methods of treatment can be drawn. Existing personal narratives written by survivors of TBI and their caregivers were analysed. Data triangulation with clinician-authored literature was performed. Constant comparative analysis of the data was then performed through an involving substantive and theoretical coding. Results: Five primary themes emerged: Ambiguous Losses, Identity Reformations, Tenuous Stability, Non Omnes Moriar and The New Us. From these, two grounded theories were developed: Relational Coring and Relational Recycling. Conclusions: These theories will allow researchers and practitioners to grasp the impact of TBI on the coupled relationship, familiarize themselves with the process by which relational experiences following TBI interact and understand the ways in which couples respond to these interacting experiences to work toward relational healing.
    Brain Injury 01/2014; DOI:10.3109/02699052.2014.880514 · 1.86 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Acquired brain injury (ABI) affects social relationships; however, the ways social and support networks change and evolve as a result of brain injury is not well understood. This study explored ways in which survivors of ABI and members of their support networks perceive relationship changes as recovery extends into the long-term stage. Two survivors of ABI and members of their respective support networks participated in this case study integrating information from interviews, field notes, and artifacts. Inductive data analysis revealed themes of adjustment to impairments and compensations, connection changes with other people, feelings of protectiveness toward the survivor, emotional intensity, and the influence of personality traits on the recovery process. Application of these themes to intervention suggests health care professionals might benefit from shifting their focus from the survivor alone to the survivor functioning within a social support network. Acquired brain injury (ABI) is a general term describing damage to the brain that happens after birth and does not relate to congenital disorder, developmental disability, or a progressive disease (Toronto Acquired Brain Injury Network, n.d.). Psychosocial adjustment is one of several long-term issues confronting survivors of ABI. Because psychosocial adjustment following ABI is a slow and multifaceted process, and because progress toward achieving adjustment goals is difficult to measure and document, rehabilitation professionals may choose to target psychosocial goals less frequently than goals addressing functional limitations relating to everyday activities. Regardless of this reluctance—or perhaps because of it—psychosocial struggles often emerge as substantial contributors to long-term challenges experienced by survivors attempting community re-integration (Khan, Baguley, & Cameron, 2003; Miller, Burnett, & McElliott, 2003; Ownsworth & Fleming, 2005). Hence, attention to psychosocial issues is an important element of long-term ABI rehabilitation. Psychosocial struggles relate directly to roles survivors play in social and support networks. Before injury, survivors participate as members of social networks comprised of relatives, friends, and community members. All individuals within such networks function within established, yet fluctuating interpersonal roles (e.g., confidant, bill payer, disciplinarian) and relationships (e.g., father, banker, coach). These roles and relationships allow for expression of unique characteristics, strengths, and challenges held by network members, as well as forming the basis for long-term maintenance of the network.


Available from
Dec 22, 2014