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Behavioural Neurology
Volume 2015, Article ID 185941, 13 pages
Research Article

The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma

1Hunter Holmes McGuire VAMC, Psychology Section (116B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA
2Departments of Psychology, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
3Departments of Psychology, Psychiatry, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
4Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, 1 Veterans Drive (152/Building 9), Minneapolis, MN 55417, USA
5Center for Health Services Research in Primary Care, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA
6Humphrey School of Public Affairs, University of Minnesota, 267 Humphrey Center, 301 19th Avenue S., Minneapolis, MN 55455, USA
7Mayo Clinic, Department of Health Sciences Research, Division of Health Care Policy and Research, Kern Center for the Science of Health Care Delivery, 200 First Street SW, Rochester, MN 55905, USA

Received 7 July 2015; Revised 23 October 2015; Accepted 27 October 2015

Academic Editor: Alison Godbolt

Copyright © 2015 Lillian Flores Stevens et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received inpatient rehabilitation care in a Veterans Affairs’ Polytrauma Rehabilitation Center from 2001 to 2009 completed a retrospective, self-report survey. Embedded in the survey were measures of caregiver mental health, including the National Institutes of Health’s Patient Reported Outcome Measurement Information System (PROMIS) Anxiety and Depression Short Forms, the Rosenberg Self-Esteem scale, and the Zarit Burden Short Form. Though no groups endorsed clinical levels, mental health symptoms varied by caregiver training category (Trained, Not Trained, and Did Not Need Training). Caregivers who did not receive training on how to navigate healthcare systems endorsed higher depression and burden and lower self-esteem than those who did. Caregivers who did not receive training in supporting their care recipients’ emotions endorsed higher anxiety, depression, and burden and lower self-esteem than those who did. Analyses also suggested a different association between training and mental health based on caregivers’ relationship to the care recipient and the intensity of care recipient needs. Potential hypotheses for testing in future studies raised by these findings are discussed.