title: Marital instability after brain injury: An exploratory analysis.
abstract: BACKGROUND
  Spousal caregivers have an important role in recovery after brain injury, and there is evidence that injury has an adverse impact on uninjured partners as well as survivors. Unfortunately, the impact of brain injury on coupled relationships has received limited attention from clinical researchers.
  
  
  OBJECTIVE
  To characterize marital stability after traumatic brain injury considering the perspectives of the patient and the uninjured partner. To identify predictors of marital stability.
  
  
  METHODS
  Forty-two couples with mild to severe injury completed the Marital Status Inventory, a measure of relationship stability, and the Revised Dyadic Adjustment Scale (RDAS), a measure of relationship quality.
  
  
  RESULTS
  Twenty-four percent (24%) of patients viewed their marriage as unstable as did 29% of partners. Most individuals (72%) agreed with their partner regarding the stability of their relationship. About half of patients (52%) and partners (50%) reported clinically significant levels of marital dissatisfaction. Multivariate logistic regression indicated that the RDAS was a salient predictor of marital stability. Findings indicate relatively high levels of marital stability despite high levels of marital distress.
  
  
  CONCLUSIONS
  Marital stability can be classified beyond labeling couples as married, separated, or divorced. Researchers have suggested that postinjury marital relationships are prone to instability and divorce in comparison to the general population. The present findings suggest otherwise.
authors.affiliation: Departments of Physical Medicine and Rehabilitation, Neurological Surgery and Psychiatry, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Kreutzer
authors.affiliation: Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Sima
authors.affiliation: Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Jennifer H
authors.initials: JH
authors.lastname: Marwitz
authors.affiliation: Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Herman R
authors.initials: HR
authors.lastname: Lukow Ii
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000523:psychology*; D005195:Family Relations / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008393:Marriage / Q000523:psychology*; D010549:Personal Satisfaction
keywords: Traumatic brain injury; marital quality; marital stability