Group Differences Among Caregivers of Civilians and Service Members or Veterans With Traumatic Brain Injury.

The service member or veteran caregivers and civilian caregivers were recruited through different mechanisms, so the groups were not equivalent. Service member or veteran caregivers were recruited through a caregiver support organization, which may have selected for caregivers already experiencing stress. Caregivers of service members or veterans could be caring for a person with TBI of any documented severity, while civilian caregivers had to be caring for a person with complicated mild, moderate, or severe TBI. Caregiver-reported injury severity was not reliable compared with Glasgow Coma Scale scores in the civilian sample. There were no data on medical or mental health comorbidities in the persons with TBI, so other conditions may have contributed to caregiver outcomes. Functional abilities and adjustment were subjective caregiver reports, so appraisal bias is possible. The study was cross-sectional, so it cannot show that any factor caused caregiver differences. The demographic differences may not represent all caregivers of service members or veterans.

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Do not conclude that caring for a service member or veteran with TBI causes more adjustment problems in the person with TBI or more feeling trapped in the caregiver. The groups were recruited differently, had different injury severity criteria, and the study was cross-sectional, so the associations may reflect selection bias or confounding.