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Caring for someone with an acquired brain injury: The role of psychological flexibility (Pages 151-164)

Journal of Contextual Behavioral Science (JCBS)

Volume 23, January 2022, Pages 151-164


Nils Rickardsson, Jennifer Scotland, Blanca Poveda, David Gillanders 



Caring for someone with an acquired brain injury (ABI) is associated with increased psychological distress and reduced satisfaction with life. Caregiver negative appraisals predict these poor outcomes, and social support and adaptive coping buffer these effects. Psychological flexibility is beneficial in dementia caregiving but has not been studied in ABI and never in comparison to known predictors of caregiver distress. This study examined known predictors and psychological flexibility in predicting depression, anxiety and life satisfaction in ABI caregiving.


A cross sectional online survey gathered responses of 145 ABI caregivers, recruited through social media, charities and National Health Services. Standardised measures of disability, appraisals, social support, coping, psychological flexibility, depression, anxiety and life satisfaction were analysed with correlation, regression and conditional process analysis.


Correlations were in theoretically specified directions, regression analysis showed that psychological flexibility was the strongest predictor of depression (β = −0.37, p < .001) and anxiety (β = −0.38, p < .001), whilst caregiver appraisals were strongest in life satisfaction (β = −0.34, p < .001). Furthermore, caregiver appraisals mediated the relation between care-recipients’ disability and caregiver outcomes. Psychological flexibility moderated this effect on depression, whilst problem-focused coping moderated this effect on life satisfaction.


These constructs could be potential targets for interventions, such as Acceptance and Commitment Therapy or traditional Cognitive Behavioural Therapy. Psychological flexibility plays an important role that adds to our understanding of caregiver distress in the specific context of ABI caregiving.

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