Relational dimension of irritability following traumatic brain injury: a qualitative analysis.
BACKGROUND
Irritability is a common long-term sequelae of traumatic brain injury (TBI). In a prior study on TBI irritability, relational interactions were one of four dimensions of irritability occurrence and precipitation. This present analysis examines these same data in greater detail.


METHODS
Fifty focus group transcripts from a study on irritability were re-analysed to examine: (1) irritability in spousal relationships following TBI, (2) retrospective accounts of spousal interactions contributing to irritability and (3) impact of irritability on marital relationships. Grounded Theory was used to develop themes, metacodes and theories.


RESULTS
Several theories emerged regarding irritability with respect to spousal relations, all based on the overarching theory that irritability in people with TBI has a strong relational component involved in triggering, experiencing and preventing irritability. Sub-theories supporting this include: (1) irritability breeds further irritability, (2) spousal responses can trigger irritability among persons with TBI and vice versa, (3) difficulties making emotional connections may incite negative interactions, (4) expectations of others may contribute to irritable behaviour, and (5) communication breakdowns may provoke irritability.


CONCLUSIONS
Irritability associated with TBI resides in the family system as well as the individual. In treating irritability one should include comprehensive assessment and assistance to improve interpersonal interactions.
Carolinas Rehabilitation, Carolinas Healthcare System , Charlotte, NC, USA. flora.hammond@rhin.com
Flora M
FM
Hammond
Christine S
CS
Davis
James R
JR
Cook
Peggy
P
Philbrick
Mark A
MA
Hirsch
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology*; D003142:Communication; D004644:Emotions; D005260:Female; D017144:Focus Groups; D006801:Humans; D007398:Interpersonal Relations; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D036301:Qualitative Research; D012720:Severity of Illness Index; D018454:Spouses / Q000523:psychology; D014481:United States; D055815:Young Adult