Caregiver depression following traumatic brain injury (TBI): a consequence of adverse effects on family members?

Many studies have demonstrated that the behaviour of individuals with traumatic brain injury (TBI) predicts the emotional adjustment of their caregivers. The primary objective of the present study was to obtain an understanding of potential moderating and mediating variables between carer depression and analogous stressors. Seven sets of predictor variables (demographic variables, concurrent stressful life events, behavioural problems, social role problems, extent of adverse effects on family members, appraisal, and support) and the criterion variable of depression in caregivers were examined. Fifty-eight carers participated in the study at 6 months, 1 year, 2 years, or 3 years following injury. The number of adverse effects on family members (other than the informant) was the only stressor significantly related to carer depression. However, carer appraisal of adverse family effects was found to mediate the relationship between stressor and depression, and carer perception of support effectiveness was found to moderate the effect of adverse family effects on depression. Forty-six per cent of the variance in caregiver depression was accounted for by carers appraisal of adverse family effects and the interaction of adverse family effects and support effectiveness. These findings highlight the importance of supporting families as a whole in the rehabilitation of persons with TBI.