Health Outcomes in Children Living in Military Families Caring for a Service Member or Veteran with Traumatic Brain Injury

This study examined pediatric health-related quality of life (HRQOL) in families in which one parent was a service member or veteran (SMV) with traumatic brain injury (TBI) and the second parent was providing caregiving support to the SMV. Intimate partner caregivers (N = 168) of SMVs completed measures of HRQOL, SMV adjustment, and five parent proxy pediatric HRQOL measures for 350 children (M = 1.9 per caregiver). Caregivers were classified into four caregiver distress/SMV adjustment groups: [1] No Distress/Good Adjustment (n = 43, children = 79); [2] No Distress/Poor Adjustment (n = 19, children = 35); [3] High Distress/Good Adjustment (n = 18, children = 41); and [4] High Distress/Poor Adjustment (n = 88, children = 195). The High Distress/Good Adjustment and High Distress/Poor Adjustment groups reported worse scores on all pediatric HRQOL measures and a higher cumulative prevalence of clinically elevated scores (≥60 T) compared to the No Distress/Good Adjustment group; and on most comparisons compared to the No Distress/Poor Adjustment group. Fewer differences were found between the No Distress/Poor Adjustment and No Distress/Good Adjustment groups. There were no significant differences between the High Distress/Good Adjustment and High Distress/Poor Adjustment groups. Many caregivers reported clinically elevated scores on all five pediatric HRQOL measures in the total sample (23.1–53.7%) and in a 15 to 17-year-old subsample (23.6–61.1%). While poor SMV adjustment was associated with worse pediatric HRQOL, caregiver distress was associated with further impairment in pediatric HRQOL. Children of SMVs with neurobehavioral problems post-TBI and caregivers of SMVs experiencing high distress, may require intervention and long-term monitoring into adulthood.