Access Type

Open Access Dissertation

Date of Award

1-1-2011

Degree Type

Dissertation

Degree Name

Ph.D.

Department

Psychology

First Advisor

Lisa J. Rapport

Abstract

This study investigated the relationships between physiological/neuroendocrine reactivity to stress and long-term psychological outcomes among persons with TBI and their significant others. In addition, this study examined the potential moderating role of patient AOD in characterizing these relationships. The findings indicate that physiological stress reactivity predicts poor psychosocial functioning in survivors of TBI and their significant others. Chronic stress (reflected in high baseline values) and stress reactivity were generally adversely associated with psychological distress and life satisfaction. Among significant others of TBI survivors, this pattern was also observed for sense of caregiving mastery and burden. However, there were also some counterintuitive relationships that emerged as well. For instance, among TBI survivors, baseline systolic blood pressure was favourably associated with life satisfaction. Similarly, among significant others, baseline cortisol level was favourably associated with life satisfaction, psychological distress, and perceived caregiving burden. The construct of survivor awareness of deficits helped to elucidate this intriguing pattern of results. In general, and as predicted, stress responses were larger among survivors with intact awareness of their deficits and significant others of survivors with impaired awareness of their deficits than among survivors with impaired awareness and significant others of survivors with intact awareness of deficits. Moreover, counterintuitive findings were only observed among survivors with impaired awareness of deficits and their significant others.

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