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A Dyad Approach to Understanding Intimate Partner and Family Distress as Risk Factors for Poor Warfighter Brain
Tracey A Brickell1, Brian J Ivins, Megan M Wright
1Author Affiliations: Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Brickell, Ms Wright, Ms Sullivan, Ms Baschenis, Ms. Gillow, Dr French, and Dr Lange); National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, Maryland (Dr Brickell, Ms Wright, Ms Sullivan, Ms Baschenis,Ms Gillow, Dr French, and Dr Lange); F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Brickell, Dr French, Dr Lange); Contractor, General Dynamics Information Technology, Silver Spring, Maryland (Dr Brickell, Mr Ivins, Ms Gillow, Dr Lange); Contractor, CICONIX, Annapolis, Maryland (Ms Baschenis, Ms Wright, Ms Sullivan); and Traumatic Brain Injury Center of Excellence, Silver Spring, Maryland (Mr Ivins).
Family relationships significantly impact chronic neurobehavioral symptoms in service members and veterans (SMVs) after mild traumatic brain injury (MTBI). Negative family dynamics increase the likelihood of poor outcomes, highlighting the need for family-centered care in TBI treatment.
Area of Science:
- Neuroscience
- Military Health
- Psychology
Background:
- Mild traumatic brain injury (MTBI) is prevalent in military populations.
- Chronic neurobehavioral symptoms can persist after MTBI.
- Family dynamics may influence recovery and symptom severity.
Purpose of the Study:
- To investigate family risk factors associated with chronic neurobehavioral symptoms in service members and veterans (SMVs) post-MTBI.
- To utilize a dyadic approach involving SMVs and their intimate partners (IPs).
Main Methods:
- A prospective cohort study was conducted at a Military Treatment Facility.
- 122 SMV and 122 IP dyads participated.
- Neurobehavioral outcomes (SMVs) and health-related quality of life/family relationship factors (IPs and SMVs) were measured.
Main Results:
- SMVs with more severe neurobehavioral symptoms showed significantly higher scores on family risk factor measures.
- Negative family relationships were strongly associated with poor neurobehavioral outcomes.
- Effect sizes were largest for family relationship risk factors, with SMVs 4.2 to 13.0 times more likely to have poor outcomes with negative relationships.
Conclusions:
- Family environment risk factors are strongly linked to chronic neurobehavioral symptoms after MTBI in SMVs.
- Integrating family wellness programs into TBI treatment is crucial for holistic care.
- A family-centered approach supports warfighter brain health, return to duty, and family resilience.
