Differential pathways of psychological distress in spouses vs. parents of people with severe traumatic brain injury (TBI): Multi-group analysis

Primary objective: A contemporary model of psychological stress based on an amalgamation of Conservation of Resources theory and the McMaster Model of Family Functioning was devised to compare the effects of neurobehavioural impairments on family functioning and psychological distress in spouses and parents caring for relatives with TBI. Method: Participants were 64 spouses and 58 parents. They completed the Neurobehavioral Problem Checklist, Family Assessment Device and the Brief Symptom Inventory. Structural equation modelling (SEM) was used to test the model for the combined (spouses and parents) sample. Multi-group analysis was then employed for examining differences in structural weights for spouses and parents. Main results: SEM supported the model for the combined sample. Multi-group analysis showed for spouses cognitive and behavioural impairments significantly disrupted family functioning, which in turn increased psychological distress. In contrast, cognitive and behavioural impairments did not significantly disrupt family functioning in parents. For parents, however, cognitive impairments increased psychological distress. Furthermore, parents who reported disrupted family functioning also experienced higher levels of psychological distress. The effect of cognitive impairments was statistically more influential on the level of distress in parents when compared to spouses. Conclusions: Understanding these differences can assist in better targeting family support interventions.