206912 How does stigma affect the mental health of family caregivers of veterans with traumatic brain injury?

Wednesday, November 11, 2009: 1:30 PM

Sean M. Phelan, MPH , School of Public Health, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
Joan M. Griffin, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Agnes Jensen , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Wendy Hellerstedt, MPH, PhD , School of Public Health, University of Minnesota, Minneapolis, MN
Nina A. Sayer , VA Medical Center, Center for Chronic Disease Outcomes Research, Minneapolis, MN
Diana Burgess, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Michelle Van Ryn, PhD , School of Medicine, University of Minnesota, Minneapolis, MN
Background. Families of individuals with stigmatized conditions can also experience illness-related stigmatization. Because individuals with traumatic brain injury (TBI) often have neurobehavioral problems that appear socially inappropriate, family caregivers may experience discrimination and stigma-by-association. This research aims to determine whether family caregivers of persons with TBI: 1) perceive discrimination toward their family member; 2) perceive discrimination toward themselves; 3) feel shame about their family member; and 4) experience depression, anxiety, and social isolation resulting from these perceptions.

Methods: Family caregivers of injured veterans who had been discharged from inpatient TBI rehabilitation for at least 3 months were eligible for this pilot study. Forty individuals completed a mailed survey with validated measures of stigma and discrimination.

Results: Forty-eight percent of family caregivers reported that they experienced discrimination and 68% reported that their injured relative experienced discrimination at least sometimes. In bivariate regression models, perceived discrimination of the veteran and family shame were significantly (p<.05) associated with greater social isolation. Perceptions of family discrimination were associated with depression, anxiety, and social isolation after controlling for other potential reasons for discrimination (age, sex, race, income).

Discussion: Our data suggest that family caregivers of individuals with TBI suffer discrimination and consequent mental health effects. They may be inclined to social isolation to avoid stigmatizing situations for themselves and the family member they provide care for. It is not clear how well such individuals are served by mental health professionals or whether counseling approaches may be enhanced by focusing on family context in these situations.

Learning Objectives:
1. Compare caregiver perceptions of discrimination of the individual with traumatic brain injury with perceived discrimination of family members. 2. Explain how experiences of discrimination and feelings of shame may lead to negative mental health outcomes among family members. 3. Discuss the potential role of intervention in this population reduce negative mental health outcomes

Keywords: Mental Health, Caregivers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a PhD candidate in epidemiology, and a predoctoral research fellow at the Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Veterans Mental Health
See more of: Mental Health