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The effect of behavioral, personality, and emotional changes after brain injury on caregiver relationships
Dissertation   Open access

The effect of behavioral, personality, and emotional changes after brain injury on caregiver relationships

William H. Gardner
Doctor of Philosophy (Ph.D.), Drexel University
Jun 1999
DOI:
https://doi.org/10.17918/00000767
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Abstract

This study investigated how the nature and pattern of behavioral problems, personality changes, emotional dysfunction, and gender of the caregiver corresponded to the change of the primary caregiver. A representative sample of 100 individuals with moderate to very severe brain injuries was selected from a state-wide database. Problem behaviors were divided into four clinically relevant categories: (1) loss of self-control (e.g., aggression, impulsivity, sexual disinhibition), (2) emotional dysfunction (e.g., depression, anxiety, mood swings), (3) adynamia (e.g., apathy, lack of motivation), and (4) personality problems (e.g., childishness, stubbornness). Loss of self-control was related most strongly (p = .03) to experiencing any change in caregiver. Post-injury substance use related to experiencing any change in caregiver (p = .04) and to changes away from having a parent or partner as caregiver. Personality problems and post-injury substance use related most strongly (p < .001) to instability in living situation. A noteworthy finding is that higher levels of functional independence at discharge from acute care and at last report related to the change of caregiver away from a spouse ( p < .05) and from a friend or non-parent relative (p = .04). This is interpreted from a clinical perspective as reflecting the level of activity and behavior on the part of the subject. Severity of injury, as measured by the Glasgow Coma Scale did not relate to change in caregiver. Length of coma only related to the change of caregiver away from a friend or non-parent relative within the first month post-injury (p = .01). The results emphasize the importance of assisting clients with learning to better control their behavior in order to maintain stability in the caregiving relationship.

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