Relationship Stability After Traumatic Brain Injury Among Veterans and Service Members: A VA TBI Model Systems Study.
Lillian Flores Stevens, Yanna Lapis, Xinyu Tang and 6 others
PMID 28520674WHAT IT FOUND
Two years after TBI, 78% of Veterans and service members married at injury stayed married, while 22% were no longer married.
Younger age, less education, and prior mental health treatment were linked to relationship loss.
Key findings
01Among 151 Veterans and service members married at enrollment, 118 remained married and 33 had a negative relationship change at two years, meaning they were single, separated, or divorced.
02Among 206 Veterans and service members who were single, divorced, or separated at enrollment, 179 remained not in a relationship and 27 married by two years.
03Among those married at enrollment, multivariable analysis found age at injury, education, and prior mental health utilization were significantly associated with negative relationship change.
STILL TO COME
How it was doneWhat they found
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What it does not show
The final analytic sample was 357, and the relationship change groups were small: 33 negative changes among those married at enrollment and 27 positive changes among those not in a relationship at enrollment. The study included only Veterans and service members who completed inpatient rehabilitation at a VA Polytrauma Center, mostly with moderate to severe TBI, so it may not apply to civilians, mild TBI, or those who did not receive inpatient rehabilitation. Marital status was self-reported at enrollment and two-year follow-up, so some responses were inconsistent and changes within the two years may not have been captured. The database did not include variables such as age at marriage, years of marriage, partner demographics, relationship satisfaction, or behavioral dysfunction, which can affect relationship stability. The study did not examine relationship quality or satisfaction, and the labels positive and negative change do not show whether a change was beneficial or harmful for the participant.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the 22% negative change or the odds ratios as proof that TBI causes relationship loss or that couples counseling improves outcomes. This was a database follow-up study, not a treatment trial, and the positive and negative labels do not show whether changes were beneficial or harmful.