Problems and changes after traumatic brain injury: differing perceptions within and between families

This study is an attempt to characterize subgroups of families based on differing perceptions of problems and changes after traumatic brain injury. The Problem Checklist of the NYU Head Injury Family Interview was administered to 34 people with head injuries (PHI), and a significant other (SO) of each, between 1 and 3 years post-injury. Families were found to differ systematically in their responses and could be divided into three groups: High Agreement group (HAF), where there was high agreement between the PHI and the SO regarding problems and changes; High Disagreement--PHI endorsing more problems than the SO (HD-PHI); and High Disagreement--SO endorsing more problems than the PHI (HD-SO). No differences were found between these groups in age, sex, duration of coma, time since injury, educational achievement of the PHI, or the SO's relationship to the PHI. However, the HD-PHI group tended to have a higher return-to-work rate, the SOs in the HAF group reported the highest rates of subjective burden, and groups were found to differ in types of items endorsed by the PHI v. the SOs. Implications of findings are discussed regarding reliability of reporting problems, awareness issues in return to work and subjective burden of family members, and methodological and treatment issues.