Abstract
Long-term psychological distress has been reported among significant others of patients who sustained a traumatic brain injury (TBI). This study examined the course and potential predictors of posttraumatic stress symptoms in a relative sample (N = 135) drawn from a national cohort study on severe TBI in Switzerland. Latent growth mixture model analyses revealed two main groups: Across 3, 6, and 12 months after the accident, 63% of the sample indicated fairly low symptom severity (“resilient” course), whereas 37% showed persistence of “higher distress” as indicated by elevated scores on the Impact of Event Scale–Revised. Group membership was significantly associated with self-reported dysfunctional disclosure style. Implications for research and practice are discussed.
Acknowledgments
We thank all of the participants who took part in this study. We appreciate the support that has been provided by the PEBITA research network and thank all local collaborators at the University Hospitals of Zurich and Basel; the Inselspital Berne; the Cantonal Hospitals of Graubünden, St. Gallen, Winterthur, Aarau, and Lucerne; and Patrizia Gallati, Chiara Haller, Désirée Piller, Marie My Lien Rebetez, and Rahel Schumacher for their contributions in data collection. This study was funded by Loterie Romande, Fondation Eagle, the Gottfried and Julia Bangerter Rhyner Foundation, the Swiss Insurance Association, the Swiss National Accident Insurance Fund, and Fragile Suisse.
Notes
Note. IES-R = Impact of Event Scale–Revised; GOS = Glasgow Outcome Scale.
a Not assessed in 33 proxies (24%) at 3 months, 6 (4%) at 6 months, and 10 (7%) at 12 months.
b Not assessed in 10 patients (7%) at 3 months, 12 (9%) at 6 months, and 1 (1%) at 12 months.
c Not assessed in 18 patients (13%) at 3 months and 13 (10%) at 6 months.
Note. T1 = 3 months; T2 = 6 months; T3 = 12 months. Fit indices for two-class growth mixture models were as follows: (a) intrusions, ssaBIC = 793.29, entropy =.91, LRT p < .01, BLRT p < .001; (b) avoidance, ssaBIC = 615.12, entropy =.97, LRT p = .14, BLRT p < .001 (not replicated in 14 out of 20 drawings); and (c) hyperarousal, ssaBIC = 706.02, entropy =.84, LRT p = .36, BLRT p < .001.
*p < .05; **p < .01 (indicates estimates significantly different from zero).
a Resilient group.
Note. Resilient group, n = 71; higher distress group, n = 34. GOSE 3 = Glasgow Outcome Scale Extended at 3 months; DTQ = Disclosure of Trauma Questionnaire total score. Step 1, R2 = .08 (Hosmer and Lemeshow), .09 (Cox and Snell), .13 (Nagelkerke); model χ2(4) = 9.98, p < .05. Step 2, R2 = .22 (Hosmer and Lemeshow), .24 (Cox and Snell), .33 (Nagelkerke); model χ2(5) = 28.55, p < .001.
a Reference category.
**p < .01.