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Relationship Stability After Traumatic Brain Injury Among Veterans and Service Members: A VA TBI Model Systems Study
Lillian Flores Stevens1, Yanna Lapis, Xinyu Tang
1Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Drs Stevens and Lapis); Departments of Psychology (Dr Stevens) and Physical Medicine and Rehabilitation (Drs Stevens, Lapis, and Kreutzer), Virginia Commonwealth University, Richmond; Defense and Veterans Brain Injury Center (DVBIC), Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Dr Stevens); Biostatistics Program, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock (Dr Tang); Department of Physical Medicine & Rehabilitation & Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, and Department of Psychiatry, Baylor College of Medicine & Harris Health System, Houston, Texas (Dr Sander); Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas (Dr Sander); Departments of Physical Medicine and Rehabilitation & Ophthalmology, The University of Alabama at Birmingham (Dr Dreer); Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis (Dr Hammond); Spaulding Rehabilitation Hospital Department of Physical Medicine & Rehabilitation and Northeastern University Department of Communication Sciences and Disorders, Boston, Massachusetts (Dr O'Neil-Pirozzi); MHBS, James A. Haley Veterans Hospital, Tampa, Florida (Dr Nakase-Richardson); VA HSR&D Center of Innovation in Disability Rehabilitation and Research (CINDRR), James A. Haley Veterans Hospital, Tampa, Florida (Dr Nakase-Richardson); Defense and Veterans Brain Injury Center (DVBIC), James A. Haley Veterans Hospital, Tampa, Florida (Dr Nakase-Richardson); and Department of Internal Medicine, University of South Florida, Tampa (Dr Nakase-Richardson).
Objective:
To explore stability of relationships and predictors of change in relationship status 2 years following TBI/polytrauma.
Setting:
Five Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRCs).
Participants:
A total of 357 active duty service members and Veterans enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers Traumatic Brain Injury Model Systems database with complete marital status information at 2 years postinjury.
Design:
Prospective, longitudinal, multisite.
Main Measures:
Relationship status change was defined as change in marital status (single/never married; married; divorced/separated) at 2-year follow-up, compared with status at enrollment.
Results:
At the time of enrollment, 134 participants (38%) were single/never married; 151 (42%) were married, and 72 (20%) were divorced/separated. Of those married at enrollment, 78% remained married at year 2 while 22% underwent negative change. Multivariable analyses revealed that age and education at the time of injury and mental health utilization prior to injury were significant predictors of relationship change. Among those who were single/divorced/separated at the time of enrollment, 87% remained so at year 2 while 13% underwent positive change. Injury during deployment significantly predicted positive relationship change.
Conclusions:
The unmalleable, preinjury characteristics identified may be used as potential triggers for education, prevention, surveillance, and couples therapy, if needed.
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