Using multiple views of family dynamics to predict the mental health of individuals with TBI and their caregivers in Mexico

Article type: Research Article

Authors: Stevens, Lillian F.^a | Perrin, Paul B.^b | Hubbard, Rebecca^b | Díaz Sosa, Dulce María^c | Espinosa Jove, Irma Guadalupe^d | Arango-Lasprilla, Juan Carlos^{e; *}

Affiliations: [a] Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA | [b] Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA | [c] Department of Psychology, Universidad Nacional Autónoma de México, México City, México | [d] Instituto Nacional de Rehabilitación de México, México City, México | [e] IKERBASQUE, Basque Foundation for Science, University of Deusto, Bilbao, Spain

Correspondence: [*] Address for correspondence: Juan Carlos Arango-Lasprilla, Ph.D, IKERBASQUE Research Professor, Department of Psychology, University of Deusto, IKERBASQUE, Basque Foundation for Science, Bilbao, Spain. Tel.: +34 608925426; E-mail: [email protected]

Abstract: Purpose:To examine differences in ratings of family dynamics between individuals with traumatic brain injury (TBI) and their family caregivers in Mexico, as well as differences in the prediction of caregiver and patient mental health outcomes from those ratings. Method:Forty-two patient-caregiver dyads (n = 84) from the National Institute of Rehabilitation in México City participated in a comprehensive evaluation of their family dynamics and mental health. Results:Patients' and caregivers' ratings of family dynamics were significantly correlated and did not differ across five of six types of family dynamics, but caregivers rated their family's level of empathy higher than patients, p < 0.001. Additionally, all patient and caregiver ratings of family dynamics were significantly correlated. Patients', caregivers', and combined (using structural equation modeling latent constructs) ratings of family dynamics robustly predicted four times as many caregiver mental health outcomes as patient mental health outcomes. Conclusions:Family dynamics influence both TBI patient and caregiver mental health but much more so in caregivers. Research on families of individuals with TBI in Mexico should incorporate both patient and caregiver perspectives to more comprehensively depict the environment in which TBI rehabilitation occurs.

Keywords: TBI, caregivers, family functioning, mental health outcomes

DOI: 10.3233/NRE-130955

Journal: NeuroRehabilitation, vol. 33, no. 2, pp. 273-283, 2013