{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T18:28:06Z","timestamp":1788028086482,"version":"build-2784847793"},"reference-count":58,"publisher":"SAGE Publications","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NRE"],"published-print":{"date-parts":[[2023,1,20]]},"abstract":"<jats:p>BACKGROUND: People with traumatic brain injury (TBI) can lack awareness of their own emotions and often have problems with emotion dysregulation, affective disorders, and empathy deficits. These impairments are known to impact psychosocial behaviors and may contribute to the burden experienced by care partners of individuals with TBI. OBJECTIVE: To examine the associations of emotional awareness, emotional functioning, and empathy among participants with TBI with care partner burden. METHOD: This multisite, cross-sectional, observational study used data from 90 dyads (participants with TBI and their care partner) 1-year post-injury. Participants with TBI completed the Difficulty with Emotional Regulation Scale (DERS; Awareness, Clarity, Goals, Impulse, Nonacceptance, and Strategies subscales); PTSD Checklist-Civilian Version; NIH Toolbox Anger-Affect, Hostility and Aggression Subdomains; PHQ-9; GAD-7; and the Interpersonal Reactivity Index (empathic concern and perspective taking subscales). Care partners completed the Zarit Burden Inventory (ZBI) and provided demographic information. RESULTS: Care partners were predominately female (77%), and most were either a spouse\/partner (55.2%) or parent (34.4%). In an unadjusted model that included assessments of emotional awareness, emotional functioning, and empathy of the participant with TBI, the DERS-Awareness and NIH-Hostility subscales accounted for a significant amount of variance associated with care partner burden. These findings persisted after adjusting for care partner age, relationship, education, and the functional status of the participant with TBI (\u03b2=\u200a0.493 and \u03b2=\u200a0.328, respectively). CONCLUSION: These findings suggest that high levels of hostility and low emotional self-awareness can significantly affect the burden felt by TBI care partners.<\/jats:p>","DOI":"10.3233\/nre-220128","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T12:21:47Z","timestamp":1673007707000},"page":"59-69","source":"Crossref","is-referenced-by-count":5,"title":["Perceived care partner burden at 1-year post-injury and associations with emotional awareness, functioning, and empathy after TBI: A TBI model systems study"],"prefix":"10.1177","volume":"52","author":[{"given":"Daniel W.","family":"Klyce","sequence":"first","affiliation":[{"name":"Central Virginia VA Health Care System, Richmond, VA, USA"},{"name":"Virginia Commonwealth University Health System, Richmond, VA, USA"},{"name":"Sheltering Arms Institute, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kritzianel","family":"Merced","sequence":"additional","affiliation":[{"name":"Central Virginia VA Health Care System, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Erickson","sequence":"additional","affiliation":[{"name":"Central Virginia VA Health Care System, Richmond, VA, USA"},{"name":"Palo Alto University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn M.","family":"Neumann","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"},{"name":"Rehabilitation Hospital of Indiana, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora M.","family":"Hammond","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"},{"name":"Rehabilitation Hospital of Indiana, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelle M.","family":"Sander","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine, Houston, TX, USA"},{"name":"TIRR Memorial Hermann, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Bogner","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Bushnik","sequence":"additional","affiliation":[{"name":"New York University Langone Health, New York, NY, USA"},{"name":"Rusk Rehabilitation Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce S.","family":"Chung","sequence":"additional","affiliation":[{"name":"VA Palo Alto Health Care System, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob A.","family":"Finn","sequence":"additional","affiliation":[{"name":"Minneapolis VA Health Care System, Minneapolis, MN, USA"},{"name":"University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"issue":"9","key":"10.3233\/NRE-220128_ref1","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1080\/02699050210128906","article-title":"The relationship between neurobehavioural problems of severe traumatic brain injury (TBI), family functioning and the psychological well-being of the spouse\/caregiver: Path model analysis","volume":"16","author":"Anderson,","year":"2002","journal-title":"Brain Injury"},{"issue":"5","key":"10.3233\/NRE-220128_ref2","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/geront\/41.5.652","article-title":"The Zarit Burden Interview: A new short version and screening version","volume":"41","author":"B\u00e9dard,","year":"2001","journal-title":"The Gerontologist"},{"issue":"3","key":"10.3233\/NRE-220128_ref3","first-page":"240","article-title":"Disorders of Affect Regulation: Alexithymia in Medical and Psychiatric Illness (Paperback edition 1999) Cambridge University Press. 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