Diurnal cortisol and coping responses in close relatives of persons with acquired brain injury: a longitudinal mixed methods study

Brain Inj. 2010;24(6):893-903. doi: 10.3109/02699051003789211.

Abstract

Objective: To examine the impact of having a close relative experience a severe brain injury.

Design: Six-month longitudinal mixed methods concurrent embedded study. Quantitative data provided the primary database and qualitative data provided the secondary source.

Methods: Assessment included psychosocial factors of perceived stress, traumatic stress symptoms, coping and social support in addition to salivary cortisol as a biological marker of stress. Written accounts of the experience were provided in response to an open-ended question. Participants composed 15 close relatives of adults with severe brain injury admitted to a specialist rehabilitation facility (mean age 49.4 years; SD 11.79). Assessments were conducted on admission, at 6 weeks, 3 months and 6 months post-admission.

Results: Quantitative data revealed high traumatic stress at admission, with a non-significant decline at follow-up. Diurnal cortisol output declined significantly from baseline to all follow-up assessments. Coping sub-scales of acceptance and religion were repeated associated with cortisol indices at baseline, 6 weeks, 3 months and 6 months follow-up. Qualitative data revealed two themes; 'relational impact' and 'passage of time'.

Conclusions: Findings offer the potential for effective and timely intervention in family members of persons with severe brain injury.

MeSH terms

  • Adaptation, Psychological / physiology*
  • Adolescent
  • Adult
  • Brain Injuries / metabolism
  • Brain Injuries / psychology*
  • Brain Injuries / rehabilitation
  • Family / psychology*
  • Female
  • Humans
  • Hydrocortisone / metabolism*
  • Longitudinal Studies
  • Male
  • Mental Disorders / metabolism
  • Mental Disorders / psychology*
  • Mental Disorders / rehabilitation
  • Middle Aged
  • Psychometrics
  • Qualitative Research
  • Risk Factors
  • Social Support
  • Stress, Psychological / metabolism
  • Stress, Psychological / psychology*
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Hydrocortisone