Emily Anna Pearce, Psy.D., is a 2016 graduate of the Psy.D. Program in Clinical Psychology at Antioch University, New England

Dissertation Committee:

  • George Tremblay, Ph.D., Committee Chair
  • William Slammon, Ph.D., Committee Member
  • Nicholas Cioe, Ph.D., Committee Member


brain injury, rehabilitation, outcome, family stress, social support, friend support, physical function, Stress-Buffering, Mayo-Portland, MPAI-4

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Currently, 3.2-5.3 million Americans (1.1-1.7%) live with long-term disability resulting from acquired brain injury (ABI). Despite two to three million more being treated yearly for milder injuries and released without further services, those with enduring problems often require ongoing rehabilitation and support. The immediate and long-term costs of ABI are substantial, as are the burdens associated with lifelong sequelae. A clear understanding of prognostic indicators—only some of which have been identified—could assist in reducing these costs and burdens. Social support, which has been linked with physical health and function in populations across the world, is one likely indicator. Family stress, which may influence the availability of social support and which has been independently linked to functional outcomes in various populations, is another. Somewhat surprisingly, the relationship of either with functional outcomes in ABI has yet to be firmly established. Framed by the Stress-Buffering Model of social support, this study examined the extent to which family stress predicts physical function following ABI and whether and how social support moderates this relationship. Data for this study was obtained from a national brain injury database (OutcomeInfo). OutcomeInfo houses demographic, injury, medical, service, and administrative information, as well as ratings and scores from the Mayo-Portland Adaptability Inventory—Fourth Edition (MPAI-4). The MPAI-4 is a questionnaire designed for use in post-acute rehabilitation and support programs, intended to allow facilities to track outcomes and changes throughout treatment. Bivariate Pearson and partial correlation were used in this study to gather preliminary information about the Stress-Buffering Model’s applicability within these post-acute services. Bivariate Pearson correlations revealed no significant relationships between family stress or friend support and physical function. Partial correlations revealed no significant relationships when controlling for several personal and contextual variables both individually and concurrently. This study had several limitations, and results should not be generalized at this point. Despite the lack of significant results, this study presents a coherent conceptual framework within which to examine these relationships further and provides a research design upon which future investigators may build.


Emily Anna Pearce

ORCID Scholar ID# 0000-0002-1766-1193