Dissertation

Psychosocial functioning in children with acquired brain injury and the impact on the family and caregiver functioning

Perleberg, Stephanie Hurst

1999

Overview

Although only a limited body of research addresses the impact of childhood acquired brain injury (ABI) upon family and caregivers, studies that do specifically address childhood ABI indicate that families experience increased stress, poorer family functioning, greater parenting stress, organizational difficulties, and changes in family socialization patterns. Emotional and behavioral changes in the child, those that effectively change the child's personality, are more difficult for families to accept than physical difficulties. These changes necessitate further exploration of the relation between specific changes in the child's psychosocial functioning and the impact on family and caregiver functioning. This study addresses the relation between a child's adaptive and maladaptive behaviors following ABI and later parental and family functioning in a sample with mixed etiology childhood ABI (children ages 5 to 14). It was predicted that lower levels of adaptive functioning and higher levels of maladaptive behavior in children would be related to (a) psychological symptomatology in parents, (b) family supportiveness, and (c) family conflict at a later point in time. Neither adaptive nor maladaptive child behaviors predicted parental symptomatology, but the level of parental psychological distress was directly related to broader levels of stress within the family. Higher levels of initial adaptive functioning were predictive of higher levels of family supportiveness at follow-up, but maladaptive behaviors did not account for variance beyond adaptive behavior. Adaptive behavior was predictive of family conflict, and maladaptive behavior strengthened the prediction, suggesting that both the behavioral deficits and behavior problems of a child with ABI contribute to conflict, disorganization, and lack of cohesion within a family. Family stress levels at the time of the follow-up evaluation reflect the impact of ABI and were better predictors of family conflict than initial stress levels. The present study demonstrates that behavioral functioning in children following ABI affects family outcomes and highlights the need to consider reciprocal effects between these children and their families. The findings provide an understanding that can be the basis for effective clinical interventions with families of children with ABI.

• Publisher: ProQuest Dissertations & Theses
• Subject: Clinical psychology / Families & family life / Individual & family studies / Personal relationships / Physical therapy / Psychotherapy / Rehabilitation / Sociology / Therapy
• ISBN: 9780599718449, 0599718447