Marital Stability and Quality of Couple Relationships after Acquired Brain Injury: A Two-Year Follow-Up Clinical Study

Abstract

Couple relationships after acquired brain injury (ABI) could be vulnerable to emotional distress. Previous evidence has demonstrated significant marital dissatisfaction in the first period after a traumatic event, while long-term evaluations are lacking. In this study, we evaluated the impact of a series of demographic and clinical factors on marital stability after two years from the injury. Thirty-five patients (29% female) with mild/moderate ABI (57% vascular, 43% traumatic) and their partners were enrolled. The couples completed a series of psychological questionnaires assessing marital adjustment (Dyadic Adjustment Scale, DAS) and family functioning (Family Relationship Index, FRI) at discharge from the intensive rehabilitation unit and after 2 years. Demographics (i.e., educational level, job employment and religion commitment) and clinical variables (i.e., the Barthel index, aetiology and brain lesion localization) were considered as predictive factors. Regression analyses revealed that the DAS and FRI values are differently influenced by demographic and clinical factors in patients and caregivers. Indeed, the highest educational level corresponds to better DAS and FRI values for patients. In the spouses, the variability of the DAS values was explained by aetiology (the spouses of traumatic ABI patients had worse DAS values), whereas the variability in the FRI values was explained by religious commitment (spending much time on religious activities was associated with better FRI values). Our data suggest that some clinical and demographic variables might be important for protecting against marital dissatisfaction after an ABI.

Association between family functioning, resilience, and psychosocial burden among family members of patients in the intensive care unit: A cross-sectional study

“…The FRI is a scale derived from the short form of the FES (Moos & Moos, 1975) that measures the perceptions of family members regarding family functioning. The FRI has been used for members of families such as those of patients with advanced cancer, head injuries, and somatization disorder and those of patients with cancer receiving palliative care (Kissane & Blosh, 2002;Laratta et al, 2021;Nissen et al, 2016;Obimakinde, Ladipo, & Irabor, 2015). It is composed of 12 dichotomous (true/false) items categorized into the following three subscales (four items per subscale): cohesion, which captures the overall sense of family togetherness and the willingness toward family time; expressiveness, which measures the capacity of family members to express their feelings to each other; and conflict resolution, which measures the ability of the family to resolve disagreements among one another.…”

Comment on Laratta et al. Marital Stability and Quality of Couple Relationships after Acquired Brain Injury: A Two-Year Follow-Up Clinical Study. Healthcare 2021, 9, 283

“…We read with great interest the recent article by Laratta et al [1] entitled 'Marital Stability and Quality of Couple Relationships after Acquired Brain Injury: A Two-Year Follow-Up Clinical Study'. The authors identify several demographic and clinical factors that are related to the quality of couple relationships following acquired brain injury (ABI).…”

“…Although it was probably not an option for Laratta et al [1], given their limited sample size and their focus on the demographic and clinical variables, we do recommend that future studies on relationships after ABI also consider the potential role of social cognition impairments. Those with social cognition impairments experience problems in understanding the mental states of others and using this information to guide their own social behavior [7].…”

“…Additionally, while the sample sizes in these studies were small (n = 9 and n = 20, respectively) and more research is needed, their results indicated that social cognition impairments may indeed play an important role in couple relationships following ABI. In addition, it is conceivable that social cognition impairments may function as a confounding variable in some of the relations investigated by Laratta et al [1] as they have also been found to be related to, for instance, educational level [8] and religious practices [11].…”

“…In conclusion, Laratta et al [1] address a highly relevant and understudied topic by investigating which demographic and clinical factors influence the quality of partner relationships following ABI. The study's merit is, however, somewhat limited by the small sample size.…”