Grief Experience among Family Caregivers following Traumatic Brain Injury: The Role of Survivor Personality Change, Perceived Social Support, and Meaning Reconstruction

Although multiple aspects of psychological adjustment among individuals who provide care for a relative with traumatic brain injury (TBI) have been extensively investigated, research activity with respect to potential loss and attendant grief experience in this population has been largely circumscribed. The current project aimed to address this lacuna by investigating both the extent and predictors of grief reaction in a cross-sectional sample of 123 TBI family caregivers. The influence on grief experience of three factors in particular – viz., caregiver perceived change in the personality of the TBI survivor, caregiver perceived social support, and family member meaning reconstruction following TBI-induced loss – was identified as a research focus. The relationships between carer grief experience and other indices of caregiver adjustment were also explored. Outcome measures included the Marwit-Meuser Caregiver Grief Inventory - Acquired Brain Injury Revised, Center for Epidemiologic Studies Depression Scale, Zarit Burden Interview - Short Form, and the Satisfaction with Life Scale. Results indicated that, after accounting for control variables, perceived TBI survivor personality change and perceived social support predicted caregiver grief. Only one form of meaning reconstruction, benefit-finding, emerged as a unique grief predictor. Time since survivor injury was not associated with grief scores. The impact of perceived survivor personality change on grief level was moderated by benefit-finding operating in interaction with perceived social support. Consistent with expectation, carer grief was observed to mediate the relationship between perceived personality change and both caregiver depressive symptoms and life satisfaction. These findings suggest that grief experience is likely a highly salient component of the adjustment process among many TBI family caregivers, and may operate as a factor that contributes to other key aspects of caregiver outcome. The results also highlight the potential role of benefit-finding and social support as protective factors with regard to grief among TBI family caregivers, and suggest the utility of the development and evaluation of grief-specific interventions for this population. With respect to the latter, services that aid family caregivers in finding something of meaningful benefit in their grief experience and promote supportive social networks may prove especially constructive.

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