Perceived Care Partner Burden at 1-Year Post-Injury and Associations With Emotional Awareness, Functioning, and Empathy After TBI: A TBI Model Systems Study

Authors

Daniel W Klyce
Kritzianel Merced
Alexander Erickson
Dawn M Neumann
Flora M Hammond
Angelle M Sander
Jennifer A Bogner
Tamara Bushnik
Joyce S Chung
Jacob A Finn

Publication Date

1-1-2023

Journal

NeuroRehabilitation

DOI

10.3233/NRE-220128

PMID

36617759

PMCID

PMC10325691

PubMedCentral® Posted Date

1-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Female, Empathy, Caregivers, Cross-Sectional Studies, Emotions, Brain Injuries, Traumatic, Traumatic brain injury, alexithymia, emotional awareness, caregiving

Abstract

BACKGROUND: People with traumatic brain injury (TBI) can lack awareness of their own emotions and often have problems with emotion dysregulation, affective disorders, and empathy deficits. These impairments are known to impact psychosocial behaviors and may contribute to the burden experienced by care partners of individuals with TBI.

OBJECTIVE: To examine the associations of emotional awareness, emotional functioning, and empathy among participants with TBI with care partner burden.

METHOD: This multisite, cross-sectional, observational study used data from 90 dyads (participants with TBI and their care partner) 1-year post-injury. Participants with TBI completed the Difficulty with Emotional Regulation Scale (DERS; Awareness, Clarity, Goals, Impulse, Nonacceptance, and Strategies subscales); PTSD Checklist-Civilian Version; NIH Toolbox Anger-Affect, Hostility and Aggression Subdomains; PHQ-9; GAD-7; and the Interpersonal Reactivity Index (empathic concern and perspective taking subscales). Care partners completed the Zarit Burden Inventory (ZBI) and provided demographic information.

RESULTS: Care partners were predominately female (77%), and most were either a spouse/partner (55.2%) or parent (34.4%). In an unadjusted model that included assessments of emotional awareness, emotional functioning, and empathy of the participant with TBI, the DERS-Awareness and NIH-Hostility subscales accounted for a significant amount of variance associated with care partner burden. These findings persisted after adjusting for care partner age, relationship, education, and the functional status of the participant with TBI (β= 0.493 and β= 0.328, respectively).

CONCLUSION: These findings suggest that high levels of hostility and low emotional self-awareness can significantly affect the burden felt by TBI care partners.