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Spouse caregivers (<jats:italic>N<\/jats:italic>\u00a0=\u00a0205) completed the Couples Satisfaction Index (CSI), 12 HRQOL measures, and the Mayo\u2010Portland Adaptability Inventory 4<jats:sup>th<\/jats:sup> Edition (MPAI\u20104). T\u2010scores were classified as \u201cclinically elevated\u201d using a cutoff of \u226560T. The sample was also classified into \u201cSatisfied\u201d (\u226513.5, <jats:italic>n<\/jats:italic>\u00a0=\u00a0113, 55.0%) or \u201cDissatisfied\u201d (&lt;13.5, <jats:italic>n<\/jats:italic>\u00a0=\u00a092, 44.0%) relationship categories. Using stepwise regression analysis, Anxiety, Family Disruption, Vigilance, Emotional Support, Feeling Trapped, and MPAI\u20104 Adjustment were identified as the strongest predictors of CSI total scores (<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001), accounting for 41.6% of the variance. Squared semi\u2010partial correlations revealed that 18.1% of the variance was shared across all six measures, with 7.8% to 1.5% of unique variance accounted for by each measure separately. When comparing the number of clinically elevated measures simultaneously, the Dissatisfied group consistently had a higher number of clinically elevated scores compared to the Satisfied group (e.g., 3\u2010or\u2010more clinically elevated scores: Dissatisfied\u00a0=\u00a040.2%, Satisfied\u00a0=\u00a08.8%, OR\u00a0=\u00a06.93, H\u00a0=\u00a00.76). Caring for a SMV with comorbid TBI and PTSD can have a profound impact on the spouse caregiver's HRQOL, relationship satisfaction, and family functioning. The findings from the current study continue to support the need for family involvement in the SMV\u2019s treatment plan, but more effort is needed to integrate behavioral health treatment that focuses on the family member's own issues into military TBI and PTSD systems of care.<\/jats:p>","DOI":"10.1111\/famp.12731","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T04:58:27Z","timestamp":1638507507000},"page":"1525-1540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Relationship satisfaction among spouse caregivers of service members and veterans with comorbid mild traumatic brain injury and post\u2010traumatic stress disorder"],"prefix":"10.1111","volume":"61","author":[{"given":"Tracey A.","family":"Brickell","sequence":"first","affiliation":[{"name":"Traumatic Brain Injury Center of Excellence Walter Reed National Military Medical Center  Bethesda Maryland 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