Perrin Paul B, Norup Anne, Caracuel Alfonso, Bateman Andrew, Tjørnlund Morten, Arango-Lasprilla Juan Carlos
Virginia Commonwealth University.
A national study on young brain injury survivors, Department of Neurology, Rigshospitalet, Copenhagen University Hospital.
J Clin Psychol. 2017 Mar;73(3):279-293. doi: 10.1002/jclp.22324. Epub 2016 Jun 30.
The purpose of this study was to use actor-partner interdependence modeling (APIM) to examine the simultaneous effects of both acquired brain injury (ABI) patient and caregiver ratings of patient impairments on both patient and caregiver ratings of caregiver psychosocial dysfunction.
A sample of 968 individuals with ABI and their caregivers (n = 1,936) from 4 countries completed the European Brain Injury Questionnaire, a measure of ABI impairments and caregiver psychosocial functioning in the context of providing care for the person with ABI.
An APIM with all adequate or good fit indices found that patient ratings of their own impairments in the domains of social disadaptation and depression were uniquely and positively associated with patient ratings of caregiver psychosocial dysfunction, yet none of the patient ratings of their own impairments were uniquely associated with caregiver ratings of caregiver psychosocial dysfunction. Caregiver ratings of patient impairments across all 3 domains (cognition, social disadaptation, and depression) were uniquely and positively associated with caregiver ratings of caregiver psychosocial dysfunction. Yet only caregiver ratings of patient social disadaptation were uniquely and positively associated with patient ratings of caregiver psychosocial dysfunction.
These findings suggest that caregivers' views of ABI patients' impairments are likely much more associated with caregiver psychosocial functioning than are patients' views of their own impairments, pointing to caregivers' interpretations of their patients' impairments as a primary target for cognitive behavioral interventions.
本研究旨在运用行为者-伙伴相互依赖模型（APIM），检验后天性脑损伤（ABI）患者和照顾者对患者损伤的评定，对患者和照顾者对照顾者心理社会功能障碍评定的同时影响。
来自4个国家的968名ABI患者及其照顾者（n = 1936）完成了欧洲脑损伤问卷，该问卷用于测量在为ABI患者提供护理的背景下，ABI损伤及照顾者的心理社会功能。
一个具有所有适配指数良好或足够适配的APIM发现，患者对自身在社会适应不良和抑郁领域损伤的评定，与患者对照顾者心理社会功能障碍的评定存在独特的正相关，但患者对自身任何损伤的评定，与照顾者对照顾者心理社会功能障碍的评定均无独特关联。照顾者对患者在所有3个领域（认知、社会适应不良和抑郁）损伤的评定，与照顾者对照顾者心理社会功能障碍的评定存在独特的正相关。然而，只有照顾者对患者社会适应不良的评定，与患者对照顾者心理社会功能障碍的评定存在独特的正相关。
这些发现表明，与患者对自身损伤的看法相比，照顾者对ABI患者损伤的看法，可能与照顾者的心理社会功能有更强的关联，这表明照顾者对患者损伤的解读，是认知行为干预的主要目标。
