Spousal relationship satisfaction following acquired brain injury: The role of insight and socio-emotional skill

Awareness through relationships in individuals undergoing rehabilitation following acquired brain injury

AIM

This cross-sectional study investigated the association between self-awareness and quality of therapeutic relationships following acquired brain injury (ABI) while controlling for the potential impact of cognitive problems. It also aimed to investigate attachment as a potential moderator.

METHOD

83 adults with ABI were recruited alongside a key member of their community neurorehabilitation team. The Scale to Assess Therapeutic Relationships (STAR) was used to measure therapeutic relationship quality and attachment was measured using the Experiences in Close Relationships - Relationship Structure (ECR-RS) questionnaire. Awareness was measured using the Patient Competency Rating Scale (PCRS) and the Mayo-Portland Adaptability Inventory (MPAI-4) provided a measure of cognitive problems. The MPAI-4 also provided an additional measure of awareness.

RESULTS

A significant association between self-awareness and therapeutic relationships was found in some regression models such that higher-quality relationships were associated with better awareness, after controlling for the impact of cognitive problems. Neither childhood parental attachment nor participants' attachment towards their rehabilitation staff were moderators.

CONCLUSION

The observed associations between awareness in clients and therapeutic relationships with rehabilitation staff may have importance for rehabilitation in this context. Results highlight the value of continuing to prioritize the therapeutic relational environment in ABI rehabilitation and research.

Self-awareness and quality of relationships after acquired brain injury: Systematic review without meta-analysis (SWiM)

BACKGROUND

Relational aspects of self-awareness following Acquired Brain Injury (ABI) are increasingly being recognized. However, research underpinning the nature of the association between self-awareness and quality of relationships has yet to be synthesized.

METHOD

Searches, which were completed between February 2022 and February 2023, consisted of combining terms related to ABI, self-awareness, and quality of relationships. Data were analyzed using the Synthesis Without Meta-Analysis (SWiM) approach.

RESULTS

Associations between self-awareness and relationship quality across eight studies identified for this review differed in direction and significance. A more consistent pattern emerged, however, when studies assessing the quality of specific types of relationships i.e., spousal (N = 1) and therapeutic (N = 3), were compared to studies assessing the quality of a person's broader network of relationships (N = 4). In particular, good awareness was positively associated with the quality of specific relationships (r = 0.66) whereas it was negatively associated with the quality of a person's broader network of relationships (r = -0.35).

CONCLUSION

Results are discussed with consideration given to measures assessing the quality of specific relationships. In particular, such measures may tap into important patterns of interaction between two individuals, such as those related to attunement or communication, which may be valuable preconditions for improving awareness.

Behavioral couples therapy for brain injury: single case methodology with bi-phasic design

OBJECTIVES

To explore the outcomes of Behavioral Couples Therapy (BCT) for couples with brain injury.

BACKGROUND

Brain injury can result in communication, emotional and behavioral disturbances, leading to higher levels of depression, anxiety and relationship distress. Currently, no study has explored the outcomes of BCT in couples impacted by brain injury.

METHOD

Four heterosexual couples living with brain injury were seen at a specialist outpatient service, and attended an average of 13 (range 8-25) BCT sessions. Participants with brain injury and their partners completed weekly measures of depression, anxiety, and couple satisfaction throughout baseline, assessment, intervention, and follow-up phases. Data were visually analyzed, and effects examined using reliable change analysis, and between-phase comparison conducted using Tau-U.

RESULTS

Tau-U analysis demonstrated that both the patient and partner groups experienced significant overall improvement in relationship satisfaction and anxiety. Partners also reported significant reduction in depression scores overall. Reliable change analysis indicated improvement for some individual patients and partners, with effects maintained at follow-up in some cases.

CONCLUSIONS

The results offer promising results regarding the use of BCT for brain injury in increasing relationship satisfaction and reducing psychological distress. Further investigation is warranted.

Factors related to the quality and stability of partner relationships after traumatic brain injury: A systematic literature review

OBJECTIVE

The latest literature review on partner relationships following traumatic brain injury (TBI), conducted a decade ago, discussed solely quantitative work and noted significant knowledge gaps. The current review updates and expands on this work by providing an overview of the current state of knowledge on factors related to relationship quality and stability following TBI.

DATA SOURCES

CINAHL, Embase, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycINFO, and PubMed were searched on April 23, 2020, for literature on factors associated with 1)relationship quality and 2)relationship stability following TBI.

STUDY SELECTION

English quantitative and qualitative studies investigating factors associated with relationship quality and/or stability following TBI were included. Two reviewers independently assessed eligibility. If consensus was not reached, a third reviewer's conclusion was decisive. Forty-three studies were included.

DATA EXTRACTION

Information regarding study objectives and characteristics, participant demographics, (in)dependent variables, and main findings was extracted. Study quality was rated using the JBI Checklist for Analytical Cross Sectional Studies and/or the CASP Checklist for Qualitative Research. Both were performed by the lead reviewer and checked by the second reviewer.

DATA SYNTHESIS

Thirty-eight factors related to relationship quality and/or stability were identified, covering injury characteristics (e.g., severity), body functions (e.g., personality changes), activities (e.g., communication), participation (e.g., social dependence), environment (e.g., children), and personal factors (e.g., coping strategies).

CONCLUSIONS

Relationship quality and stability following TBI are found to be related to a multitude of factors, including newly identified factors such as personality changes and dependence. Future research may wish to quantitatively investigate factors thus far only identified in qualitative research, explore possible positive effects of TBI on relationships, study the experiences of same-sex couples, and include the perspectives of both partners with and without the injury.

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

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.

Sexual activity and romantic relationships after burn injury: A Life Impact Burn Recovery Evaluation (LIBRE) study

BACKGROUND

Engaging in healthy sexual activity and romantic relationships are important but often neglected areas of post-burn rehabilitation. The degree to which persons with burn injuries engage in sexual activity and romantic relationships is not well understood. This study examined demographic and clinical characteristics predicting engagement in sexual activity and romantic relationships in a sample of adult burn survivors compared to a general United States sample.

METHODS

Data for the adult burn survivor sample were from 601 adult burn survivors who participated in field-testing for the calibration of the Life Impact Burn Recovery Evaluation (LIBRE) Profile, a burn-specific instrument assessing social participation on six scales including sexual activity and romantic relationships. Comparison data were obtained from a general population sample of 2000 adults through sample matching. Demographic predictors of sexual activity and romantic relationship status were examined in each sample using modified Poisson regression analyses. Clinical predictors of engaging in sexual activity and romantic relationships were also examined in the LIBRE sample.

RESULTS

Participants were slightly more likely to report being sexually active in the adult burn survivor sample than in the general sample (65% vs. 57%, p < 0.01). There was not a significant difference in romantic relationship status between the two samples (64% vs. 62%, p = 0.31). In multivariable regression analyses, men in both samples were more likely to report being in a sexual relationship (RR in LIBRE sample = 1.23, 95% CI 1.08-1.39; RR in general sample = 1.10, 95% CI 1.02-1.18). Participants in both samples who were not working were less likely to report being sexually active or in a romantic relationship (RRs ranging from 0.73 to 0.83, p < 0.05 for all estimates). In the adult burn survivor sample, respondents with hand burns were more likely to report being sexually active and in a romantic relationship (RR = 1.16, 95% CI 1.01-1.33). Time since burn injury, burn size, and burns to other critical areas were not significantly associated with either outcome in adjusted analyses.

CONCLUSIONS

The likelihood of engaging in sexual activity and romantic relationships is similar among adult burn survivors and the comparison group representing a general United States sample of adults. Further research addressing sexual activity and romantic relationships after burn injuries will help to foster better patient-clinician dialogue, pinpoint barriers, design interventions, and allocate appropriate resources.

The Psychosocial Impact of Neurobehavioral Disability

Neurobehavioral disability (NBD) comprises elements of executive and attentional dysfunction, poor insight, problems of awareness and social judgement, labile mood, altered emotional expression, and poor impulse control, any or all of which can have a serious impact upon a person's decision-making and capacity for social independence. The aim of this narrative review is to explore some of the more intrusive forms of NBD that act as obstacles to psychosocial outcome to act as a frame of reference for developing effective rehabilitation interventions. Special consideration is given to the psychosocial impact of three core forms of NBD: a failure of social cognition, aggressive behavior, and problems of drive/motivation. Consideration is also given to the developmental implications of sustaining a brain injury in childhood or adolescence, including its impact on maturational and social development and subsequent effects on long-term psychosocial behavior.

The computerized cognitive training alliance - A proposal for a therapeutic alliance model for home-based computerized cognitive training

Background

To increase the number of hours available for cognitive rehabilitation, it may be an option to use the spouse or paid assistants to assist with computerized home training. However, the delegation of training responsibilities may affect the normal roles of the therapist, the spouse and the training assistants.

Objective

This article suggests a new model for understanding the impact of computerized home training on the therapeutic alliance between the therapist, the patient and training assistants. Aspects of this knowledge are relevant also for the development and use of computerized training systems in clinical settings.

Method

Qualitative Interpretative Phenomenological Analysis (IPA) of semi-structured interviews was used to analyse the experience gained during home-based computerized cognitive training.

Results

Home-based computerized training enforces the delegation of aspects of the therapeutic alliance established between the therapist and the patient. The perceived authority of assistants and computer training systems may differ from the authority established through the patient/therapist alliance. Information may be lost in transition impacting skills and expertise long-term.

Conclusion

Roles and responsibilities between the therapist, the assistants and the computerized training system need to be clearly defined. A Cognitive Training Alliance model is being proposed which takes into consideration the challenges of delegating training responsibility to computer systems and non-professional assistants.

Does collaboration with an intimate partner support memory performance? An exploratory case series of people with epilepsy or acquired brain injury

BACKGROUND

Intimate couples can become cognitively interdependent over time. If one member of the couple has a neurological condition with associated cognitive impairments, their partner can support or 'scaffold' their cognitive functioning through collaboration.

OBJECTIVE

We explored the phenomenon of 'collaborative memory' in a case series of 9 couples in which one member had a neurological condition, specifically an acquired brain injury (ABI; n = 7) or epilepsy (n = 2).

METHODS

To investigate collaborative memory, we compared the performance of the patient when remembering alone versus their performance in collaboration with their partner on three memory tasks, assessing anterograde, semantic, and autobiographical memory.

RESULTS

We found that across all tasks and participants, collaboration typically increased overall memory performance (total score), but the patient's contribution to the task was typically lower when they collaborated compared with when they performed the task alone. We identified two distinct styles of collaboration which we termed 'survival scaffolding' (where the healthy partner 'takes over' memory recall) and 'stability scaffolding' (where the healthy partner cues and structures the patient's recall).

CONCLUSION

This exploratory case series contributes to the sparse literature on memory collaboration in people with neurological conditions. Our findings suggest that there are different styles of collaboration that can both help and hinder memory performance.

Investigating Relations between Traumatic Brain Injury and Relationship Functioning among OIF/OEF Veterans

Traumatic brain injury (TBI) is one of the most common injuries among Veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). TBI can negatively affect Veterans' close relationships, undermining an important source of support to aid recovery and rehabilitation. Given the complex symptom profile of TBI, the present research aimed to pinpoint key mediators of the link between TBI and marital functioning to help identify targets for intervention. Data from married OIF/OEF Veterans (N=188) were drawn from a larger sample. Mediation analyses simultaneously examined the potential roles of depressive, posttraumatic stress disorder (PTSD), and post-concussive symptoms in the association between TBI and Veterans' marital satisfaction. Results revealed associations between TBI and all three types of symptoms; however, only depressive symptoms independently mediated the association between TBI and marital satisfaction. These findings suggest depression as a mechanism by which TBI may interfere with healthy relationship functioning and highlight targets for intervention.

Evaluation of a Brief, Skill-Building, Supportive, and Educational Intervention for Couples After Brain Injury

OBJECTIVE

To examine the effectiveness of an intervention (Therapeutic Couples Intervention, TCI) designed to improve relationship quality for couples after acquired brain injury.

SETTING

Outpatient brain injury rehabilitation center.

PARTICIPANTS

Persons with brain injury (n = 75) and their intimate partners (n = 75).

DESIGN

Two-arm parallel, randomized, controlled trial with wait-listed control.

METHODS

Composed of 5 to 6 2-hour sessions, the TCI is a manualized, treatment program designed to enhance relationship quality by addressing issues and concerns most often identified by persons with brain injury and their partners.

MAIN MEASURE

Revised Dyadic Adjustment Scale completed by the persons with brain injury and their partners.

RESULTS

Persons with brain injury and their partners in the treatment group showed an improvement in relationship quality, both compared with their own baseline values and the control group.

CONCLUSIONS

Investigation provided evidence that a curriculum-based education, skill-building, and supportive intervention can benefit couples for up to 3 months after treatment. Additional research is needed to ascertain the long-term benefits of intervention and the efficacy of alternative delivery methods (eg, Internet, telephone, and group).

The long-term effects of childhood traumatic brain injury on adulthood relationship quality

PRIMARY OBJECTIVE

To investigated the long-term effect of childhood Traumatic Brain Injury (TBI) on adulthood Relationship Quality (RQ), examining injury severity, age of injury, and markers of prefrontal cortex (PFC) functioning, apathy, disinhibition, and executive dysfunction.

RESEARCH DESIGN

Longitudinal, between-subjects, cross-sectional design using retrospective and current data.

METHODS AND PROCEDURES

Participants (N = 169; 61 mild TBI (mTBI); 65 moderate to severe TBI (MSTBI); 43 orthopaedic injury (OI); Injury age: 1-17 years; Testing age: 18-31 years) completed a structured interview regarding their injury, demographic characteristics and RQ, the National Adults Reading Test, and Frontal Systems Behaviour Scale. Data were analyzed using IBM SPSS 25.

MAIN OUTCOMES AND RESULTS

Adults who had experienced childhood TBI had significantly poorer RQ than adults who had experienced childhood OI. Severity of TBI did not impact adulthood RQ. Earlier age of injury predicted reduced adulthood RQ in the MSTBI group. Greater PFC dysfunction predicted poorer RQ in adults with a history of childhood TBI. While elevated levels of apathy, disinhibition, and executive dysfunction were associated with poorer RQ, no individual marker had predictive value.

CONCLUSION

Experiencing a childhood TBI can have a long-term negative influence on adulthood RQ. Such RQ deficits can underpin reduced life satisfaction and increased health issues.

Relationship continuity and person-centred care: An exploratory mixed-methods investigation of spousal partners' responses to the challenging care needs of those with acquired brain injury

Some partners of people with an acquired brain injury experience the person with the injury and their relationship as continuous with the pre-injury person and relationship, but others experience the person and relationship as very different to what went before. Previous qualitative research has suggested that the experience of continuity may promote a more person-centred approach to how partners respond to challenging care needs. Given the value of triangulating evidence, this exploratory study used a mixed-methods design to investigate this suggestion. Twenty-six partners of people with an acquired brain injury completed the Birmingham Relationship Continuity Measure and a semi-structured interview about their response to challenging care needs. Interviews were coded and scored to provide a measure of the extent to which the participants' understanding, management and emotional responses showed a person-centred approach. The findings supported the hypothesis. Greater continuity was significantly correlated with a more person-centred approach. Associating relationship continuity and person-centred care is a novel approach to the issue of how family relationships may impact on care quality. Person-centred care can have important benefits for both the giver and receiver of care. Whether it can be promoted through fostering a sense of continuity in the relationship merits further investigation.

The Role of Emotional Intelligence in Community Integration and Return to Work After Acquired Brain Injury

OBJECTIVE

To investigate whether emotional intelligence (EI) skills measured via the Perceiving, Understanding, and Managing Emotions branches of the Mayer-Salovey-Caruso Emotional Intelligence Test V2.0 are associated with community integration (CI) and return to work (RTW) after moderate-to-severe acquired brain injury (ABI), after accounting for other established predictors.

DESIGN

Retrospective cohort study.

SETTING

Outpatient follow-up services within 2 specialist ABI rehabilitation centers in Melbourne, Australia.

PARTICIPANTS

Individuals (N=82) with moderate-to-severe ABI discharged from inpatient rehabilitation and living in the community (2mo to 7y postinjury).

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Community Integration Questionnaire scores for the total sample (N=82; age range 18-80) and RTW status (employed vs not employed) for the subset of participants employed prior to ABI (n=71; age range 19-66).

RESULTS

Hierarchical logistic and multiple regression analyses were used to examine the unique contribution of Perceiving, Understanding, and Managing Emotions scores to RTW and CI, after controlling for demographic, injury-related, psychological, and cognitive predictors. As a set, the 3 EI variables did not explain incremental variance in outcomes. However, individually, Understanding Emotions predicted RTW (adjusted odds ratio=3.10, P=.03), χ² (12)=35.52, P<.001, and Managing Emotions predicted CI (β=0.23, P=.036), F_12,69=5.14, P<.001.

CONCLUSION

Although the EI constructs in combination did not improve prediction beyond the effects of established variables, individual components of strategic EI may be important for specific participation outcomes after ABI.

Relationship Stability After Traumatic Brain Injury Among Veterans and Service Members: A VA TBI Model Systems Study

OBJECTIVE

To explore stability of relationships and predictors of change in relationship status 2 years following TBI/polytrauma.

SETTING

Five Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRCs).

PARTICIPANTS

A total of 357 active duty service members and Veterans enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers Traumatic Brain Injury Model Systems database with complete marital status information at 2 years postinjury.

DESIGN

Prospective, longitudinal, multisite.

MAIN MEASURES

Relationship status change was defined as change in marital status (single/never married; married; divorced/separated) at 2-year follow-up, compared with status at enrollment.

RESULTS

At the time of enrollment, 134 participants (38%) were single/never married; 151 (42%) were married, and 72 (20%) were divorced/separated. Of those married at enrollment, 78% remained married at year 2 while 22% underwent negative change. Multivariable analyses revealed that age and education at the time of injury and mental health utilization prior to injury were significant predictors of relationship change. Among those who were single/divorced/separated at the time of enrollment, 87% remained so at year 2 while 13% underwent positive change. Injury during deployment significantly predicted positive relationship change.

CONCLUSIONS

The unmalleable, preinjury characteristics identified may be used as potential triggers for education, prevention, surveillance, and couples therapy, if needed.

Factors influencing community case management and care hours for clients with traumatic brain injury living in the UK

OBJECTIVE

To investigate the relationship between deficits associated with traumatic brain injury (TBI) and case management (CM) and care/support (CS) in two UK community samples.

RESEARCH DESIGN

Prospective descriptive study.

METHOD

Case managers across the UK and from a single UK CM service contributed client profiles to two data sets (Groups 1 and 2, respectively). Data were entered on demographics, injury severity, functional skills, functional-cognition (including executive functions), behaviour and CM and CS hours. Relationships were explored between areas of disability and service provision.

RESULTS

Clients in Group 2 were more severely injured, longer post-injury and had less family support than clients in Group 1. There were few significant differences between Groups 1 and 2 on measures of Functionalskill, Functional-cognition and Behaviour disorder. Deficits in Functionalskills were associated with CS, but not CM. Deficits in measures of executive functions (impulsivity, predictability, response to direction) were related to CM, but not to CS. Insight was related to both CM and CS. Variables related to behaviour disorder were related to CM, but were less often correlated to CS.

CONCLUSIONS

The need for community support is related not only to Functionalskills (CS), but also to behaviour disorder, self-regulatory skills and impaired insight (CM).

How Partners Experience Personality Change After Traumatic Brain Injury – Its Impact on Their Emotions and their Relationship

Objective: The aim of this qualitative study was to explore how spouses/partners experience social, emotional and behavioural changes in persons following traumatic brain injury (TBI), with a particular focus on their emotional impact and the effect on the couple relationship.

Method: Interpretative phenomenological analysis (IPA) of interview data explored five women's experiences of these changes in their partners following TBI.

Results: Themes describe the direct emotional impact of living with the changes as well as the emotional impact of attempts to manage and make sense of the changes (identity change, managing the changes and making sense of the changes). The impact on the couple relationship is described under the themes of feeling love and receiving love. Changes led three of the participants to experience their partner as having been replaced by a new person; they actively disliked this new person; they felt unable to love the new person in the same way as the old person; and their love was defined in terms of a caring relationship, rather than a spousal relationship.

Conclusions: The study provides insight into why social, emotional and behavioural changes might be so consistently associated with reduced emotional wellbeing and lower levels of relationship quality and satisfaction.

Challenges Faced and Lessons Learned in the Development of a New Measure of Social Competence for Children and Adolescents With Acquired Brain Injury (ABI)

Recently, there has been a surge of interest and research in social functioning throughout childhood and adolescence, and how social development is affected by acquired brain injury (ABI). Despite ongoing research and theoretical advances, there remains a lack of specific, relevant and robust measurement tools that draw upon current clinical and social neuroscience knowledge, and which are developmental in nature, to assess social competence within the nonclinical and the ABI population. The aim of the current project was to develop a questionnaire to measure social competence and the quality of relationships of children and adolescents between the ages of 5 and 18 years. This questionnaire, the Developmental Assessment of Social Competence (DASC), also aimed to be sensitive to the specific social problems often associated with children who have suffered ABI. The current article outlines the process and challenges faced in developing such a measure up to the initial pilot stage. Participants included a pilot group of 40 parents who completed the pilot questionnaire, as well as an established questionnaire that assesses social functioning. Parents rated their own children who were aged between 6 and 14 years, and who were within the nonclinical population. Preliminary analyses found that the children generally scored highly on the DASC, and that a higher score on most scales of the DASC tended to be associated with a higher score on an established questionnaire measuring social skills. These data are promising, and provide important information for the following stages of development and evaluation of this new questionnaire.

Awareness of social and emotional functioning in people with early-stage dementia and implications for carers

OBJECTIVES

This study explores the extent to which awareness of social and emotional function is reduced in early-stage dementia and whether this relates to the quality of life of the person with dementia (PwD), the quality of the relationship between the PwD and carer and carer stress.

METHOD

Ninety-seven participants with a diagnosis of Alzheimer's, vascular or mixed dementia rated their social functioning using the Socio-Emotional Questionnaire (SEQ). Carers provided parallel ratings, allowing calculation of discrepancy scores used to index awareness. Neuropsychiatric symptoms, PwD quality of life, the perceived quality of the relationship for both partners and carer stress were also measured.

RESULTS

Factor analysis of the SEQ indicated three domains of social functioning: emotional recognition and empathy (ERE), social relationships (SR) and prosocial behaviour (PB). For PwD unawareness was related to cognitive dysfunction and psychiatric disturbance, but not to quality of life or quality of relationship. Lower awareness was associated with greater carer stress and poorer perceived quality of relationship.

CONCLUSION

Lack of awareness of social functioning had important implications for relationship quality and levels of carer stress.

The development of a new measure of social-emotional functioning for young adolescents

Social and emotional impairments are frequently reported following acquired brain injury, including an inability to adopt another's perspective, empathize, and display guilt, and inappropriate social conduct. Case studies suggest that these problems are particularly apparent when the injury is sustained in childhood, with deficits increasing with age and persisting throughout adulthood. In addition to these deficits, individuals may have limited insight into their cognitive or social-emotional deficits, which in turn may also affect social functioning and have implications for the success of rehabilitation. Despite the frequency of these problems, there is a dearth of suitable measures for detecting them in children or adolescents. The purpose of the current study was to develop one such measure from a measure initially intended for adults. Normative data were collected from 109 typically-developing 11- to 14-year-olds and their parent/guardian on the Social-Emotional Questionnaire for Children (SEQ-C). Factor and reliability analyses were conducted and the subscales were then explored in association with key demographic information. Social-emotional development showed a fluctuating course across early adolescence, alongside some gender differences. This measure, with its normative data, will be of value to neuropsychologists wishing to explore such functioning in their clinical practice.

The European Brain Injury Questionnaire (EBIQ) as a reliable outcome measure for use with people with brain injury

PRIMARY PURPOSE

There is a need to develop reliable outcome measures to determine well-being after brain injury. In 1997, Teasdale et al. published the European Brain Injury Questionnaire (EBIQ), a self-report and relative-report measure of the subjective experience of cognitive, emotional and social difficulties experienced by people with brain injury. It is now used in several rehabilitation centres as an outcome measure, but its test-re-test reliability has yet not been determined. The primary purpose of the present study is to establish this degree of reliability.

RESEARCH DESIGN

The EBIQ was administered twice within an approximately 1-month period to 50 people with brain injury, to 20 relatives of people with brain injury and to 51 normal controls.

RESULTS

The results showed significant and satisfactory test-re-test reliabilities for all three groups across all nine EBIQ scales (r = 0.55-0.90).

CONCLUSION

It is concluded that the EBIQ is a clinically reliable measure to determine the subjective well-being of people with brain injury and to assess change of subjective concerns over time.