CENTRIPETAL AND CENTRIFUGAL FAMILY-LIFE CYCLE FACTORS IN LONG-TERM OUTCOME FOLLOWING TRAUMATIC BRAIN INJURY

The family life cycle model categorizes stresses on family systems in terms of their source and their effects on family members. Centripetal forces bring members together while centrifugal forces lead to loosened intrafamilial ties. This study examined the association of normative, developmental and centripetal illness-related family forces with patient outcome. Hypothesized centripetal and centrifugal forces acting on 65 families of married male TBI patients were used as independent variables in stepwise multiple regressions with criterion measures of quality of life outcome used as dependent measures. Centripetal variables included measures of family coping, marital adjustment, and number of years married. Centrifugal variables included number of children, age of oldest child, and amount of perceived financial strain. Regression equations obtained had multiple R's ranging from 0.623 to 0.407 (p values <0.017). Results suggest that families normatively dealing with the developmental stage of the family with young children may face unique challenges when a husband sustains a TBI, particularly when financial strain exists. Stages in family development involving conflict between centripetal and centrifugal forces may be most problematic for families to resolve, and potentially the most effective periods for intervention.