In line with the mission of the National Institute of Child Health and Human Development and the National Center for Medical Rehabilitation Research, the purpose of this proposal is to foster advancement of research for the benefit of individuals with chronic disability and functional impairment due to traumatic brain injury (TBI) and their family caregivers. Research investigating the impact of TBI on family caregivers from a multidimensional perspective is an important and under-researched area in the brain injury and disability field. Based on the TBI literature, we know that informal family caregivers experience psychological distress and emotional dysfunction. Yet identifying prevalence of severe psychological distress and psychiatric disorders in this population has received scant attention by researchers. This career development award proposal capitalizes on the applicant's clinical expertise working with survivors following TBI and their families while providing advanced research training with an expert mentor and accomplished team of advisors to examine the impact of brain injury on families and patients. The training portion of this grant has several key components including mentorship in the conduct of clinical research in a rehabilitation setting, didactics and research training (M.S. in Clinical Research and Biostatistics), and research activities. The research component of this proposal includes a longitudinal study of 120 family caregivers in the first year following a relative's TBI in comparison with a demographically-matched control group.
The specific aims of the proposal are to 1) determine the interaction of caregiving with history of previous psychiatric illness in the severity of depressive symptoms among family members providing care to persons with TBI, 2) determine whether caregivers and non-caregivers have different incidence of Major Depressive Disorder based on DSM-IV-TR criteria, 3) elucidate the relationship between family caregivers' mental health and survivors' neurobehavioral functioning and recovery following TBI, and 4) identify the role of biopsychosocial factors impacting the psychiatric functioning of informal family caregivers. ? ? Relevance: Informal caregivers are at risk for developing psychiatric disorders after a family member has a brain injury. Mental health problems often diminish family members' ability to care for themselves and for survivors, thereby increasing the risk of patients' rehospitalization and institutionalization. This proposal is relevant for the community integration of persons with functional impairment following TBI and their family caregivers. By filling a substantial gap in the scientific literature on psychiatric consequences of brain injury for family caregivers, the proposed research offers an opportunity to address the mental health needs of family members as well as to develop preventive approaches which may ultimately improve the quality of life for family caregivers and survivors. ? ? ?