INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #60 Loneliness and depression improve after a grief-based treatment in TBI caregivers Denise Krch, Kessler Foundation, East Hanover, United States Lisa Spielman, Icahn School of Medicine at Mount Sinai, New York, United States Nancy Chiaravalloti, Kessler Foundation, East Hanover, United States Jeanne Zanca, Kessler Foundation, West Orange, United States Jean Lengenfelder, Kessler Foundation, East Hanover, United States Ekaterina Dobryakova, Kessler Foundation, East Hanover, United States Christina Rasmussen, Life Reentry Institute, Austin, United States Category: Emotional and Social Processes Keyword 1: caregiver burden Keyword 2: traumatic brain injury Objective: Although grief is traditionally associated with bereavement, it can also be experienced as ambiguous loss by caregivers whose loved one survives a TBI. The current research examined the efficacy of Life Reentry (LR), a group-based grief treatment in partner caregivers of individuals with traumatic brain injury (TBI). We hypothesized that LR would primarily decrease grief and fear as measured by approach and avoidance, and secondarily decrease loneliness and depression. Participants and Methods: This double-blind, randomized controlled trial included 96 partner (spouses or significant others) caregivers who were assigned to participate in either LR or an active control group. LR treatment provided participants with strategies to help process grief associated with feelings of ambiguous loss after their loved one suffered a TBI. Active control comprised an education series about health and function after TBI (TBIEd). Both treatment and control sessions involved six, weekly 75-minute teleconference sessions as well as independent homework assignments discussed in closed social media forums. Pre- and post-treatment, caregivers completed a battery of self-report questionnaires, including BIS/BAS (Behavioral Inhibition System/ Behavioral Approach System), PROMIS loneliness, and PHQ-8. Participants were predominantly female (83.3%), white (90.3%), not Hispanic (94.4%), middle-aged (51.6±13.2, range 25-79), and had served as their partner’s caregiver for an average of 5.5 years (±5.0, range 0.5-28). There were no significant differences between the groups on sex, race/ethnicity, age, or time caregiving. The primary analysis was a 2 (Group: LR vs. TBIEd) by 2 (Time: baseline vs. post-treatment) mixed effects model on the BIS/BAS total and subscale scores. Secondary outcomes of PROMIS loneliness and PHQ-8 were also examined using the mixed effects model approach. Results: The primary outcome measures BIS and BAS Total scores and the BAS subscale scores Drive, Fun-Seeking, and Reward Responsiveness did not show any significant effects of treatment group, time, or treatment group by time for the baseline-post models. There were significant treatment group by time effects on the PROMIS Loneliness scale (F (1,59.71)=5.19, p=0.026) and the PHQ-8 (F(1,57.38)=5.68, p=0.02). Scores on loneliness and depression both decreased significantly after treatment for the LR group (Loneliness: Baseline=15.77±5.42; Post=13.40±4.35. PHQ-8: Baseline=8.60±5.78; Post=6.05±5.31) but not the TBIEd group (Loneliness: Baseline=14.08±5.24; Post=13.81±4.65. PHQ-8: Baseline=6.38±5.55; Post=5.90±5.32). Conclusions: LR had a significant positive impact on loneliness and depression for partner caregivers. Although the treatment did not significantly improve caregivers’ avoidance of worrisome situations or their willingness to approach goals, it may take longer for the benefits of LR to effect behavioral changes. These findings provide preliminary evidence that extend LR as an appropriate treatment for caregivers working through the emotions associated with ambiguous loss. Such a treatment program may complement the support-based offerings in rehabilitation centers for family members of persons sustaining traumatic injury.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #60

Loneliness and depression improve after a grief-based treatment in TBI caregivers

Denise Krch, Kessler Foundation, East Hanover, United States
Lisa Spielman, Icahn School of Medicine at Mount Sinai, New York, United States
Nancy Chiaravalloti, Kessler Foundation, East Hanover, United States
Jeanne Zanca, Kessler Foundation, West Orange, United States
Jean Lengenfelder, Kessler Foundation, East Hanover, United States
Ekaterina Dobryakova, Kessler Foundation, East Hanover, United States
Christina Rasmussen, Life Reentry Institute, Austin, United States

Category: Emotional and Social Processes

Keyword 1: caregiver burden
Keyword 2: traumatic brain injury

Objective:

Although grief is traditionally associated with bereavement, it can also be experienced as ambiguous loss by caregivers whose loved one survives a TBI. The current research examined the efficacy of Life Reentry (LR), a group-based grief treatment in partner caregivers of individuals with traumatic brain injury (TBI). We hypothesized that LR would primarily decrease grief and fear as measured by approach and avoidance, and secondarily decrease loneliness and depression.

Participants and Methods:

This double-blind, randomized controlled trial included 96 partner (spouses or significant others) caregivers who were assigned to participate in either LR or an active control group. LR treatment provided participants with strategies to help process grief associated with feelings of ambiguous loss after their loved one suffered a TBI. Active control comprised an education series about health and function after TBI (TBIEd). Both treatment and control sessions involved six, weekly 75-minute teleconference sessions as well as independent homework assignments discussed in closed social media forums. Pre- and post-treatment, caregivers completed a battery of self-report questionnaires, including BIS/BAS (Behavioral Inhibition System/ Behavioral Approach System), PROMIS loneliness, and PHQ-8. Participants were predominantly female (83.3%), white (90.3%), not Hispanic (94.4%), middle-aged (51.6±13.2, range 25-79), and had served as their partner’s caregiver for an average of 5.5 years (±5.0, range 0.5-28). There were no significant differences between the groups on sex, race/ethnicity, age, or time caregiving. The primary analysis was a 2 (Group: LR vs. TBIEd) by 2 (Time: baseline vs. post-treatment) mixed effects model on the BIS/BAS total and subscale scores. Secondary outcomes of PROMIS loneliness and PHQ-8 were also examined using the mixed effects model approach.

Results:

The primary outcome measures BIS and BAS Total scores and the BAS subscale scores Drive, Fun-Seeking, and Reward Responsiveness did not show any significant effects of treatment group, time, or treatment group by time for the baseline-post models. There were significant treatment group by time effects on the PROMIS Loneliness scale (F (1,59.71)=5.19, p=0.026) and the PHQ-8 (F(1,57.38)=5.68, p=0.02). Scores on loneliness and depression both decreased significantly after treatment for the LR group (Loneliness: Baseline=15.77±5.42; Post=13.40±4.35. PHQ-8: Baseline=8.60±5.78; Post=6.05±5.31) but not the TBIEd group (Loneliness: Baseline=14.08±5.24; Post=13.81±4.65. PHQ-8: Baseline=6.38±5.55; Post=5.90±5.32).

Conclusions:

LR had a significant positive impact on loneliness and depression for partner caregivers. Although the treatment did not significantly improve caregivers’ avoidance of worrisome situations or their willingness to approach goals, it may take longer for the benefits of LR to effect behavioral changes. These findings provide preliminary evidence that extend LR as an appropriate treatment for caregivers working through the emotions associated with ambiguous loss. Such a treatment program may complement the support-based offerings in rehabilitation centers for family members of persons sustaining traumatic injury.