Spousal boundary ambiguity in acute neurological conditions v1.0
Research type
Research Study
Full title
Predictors and psychological outcomes associated with perceived boundary ambiguity in families affected by acute, non-progressive neurological conditions
IRAS ID
314109
Contact name
Mariann Kovacs
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
0 years, 8 months, 30 days
Research summary
Summary of Research
Sudden-onset, acute neurological events, such as traumatic brain injury (TBI) or stroke, are a major cause of disability which put considerable strain on the individual and their families as they navigate adjustment. Research suggests that a common experience following the acute event is ambiguous, unresolved loss which often manifests as boundary ambiguity (BA) in the family system. BA is defined by lack of clarity around family membership and the roles within the family system. It is associated with adverse outcomes both for family members and patients with neurological conditions, including psychological distress and family conflict.
The research project aims to increase our understanding of BA in the context of sudden-onset, acute neurological events. Spouses of individuals affected by a non-progressive neurological condition will be recruited with the help of clinicians working across Oxford University Hospital sites as well as via relevant UK-based charities and social media. Participants will be asked to fill in a set of questionnaires on two occasions with a 3-month interval in-between. These questionnaires will allow us to quantify BA and examine its predictors and how it is implicated in longer-term psychological and relational outcomes, as perceived by the partners of affected individuals. Results will contribute to our understanding of difficulties following sudden-onset, acute neurological events and could have clinical implications for the recommended treatments or the services offered.
Summary of Results
Acute-onset, non-progressive neurological events are often experienced as ambiguous, unresolved loss which gives rise to boundary ambiguity (BA) in the family system. BA is characterised by lack of clarity around family membership and the roles within the family system. BA has been shown to be linked to adverse outcomes, including increased psychological distress and family conflict. This research aimed to expand our understanding of BA as experienced by spouses in the context of acute-onset neurological conditions. Specifically, we wanted to examine 1) what makes someone more vulnerable to experiencing BA and 2) how BA is linked with psychological distress and relationship satisfaction. To address this aim, we invited partners of individuals affected by a non-progressive neurological condition to complete a set of questionnaires on two occasions, three months apart. Statistical analyses of the data revealed that spouses who had higher intolerance of uncertainty as well as those whose partenrs had more severe disability were more at risk of experiencing elevated BA. Furthermore, greater BA was associated with more severe symptoms of anxiety and depression in spouses, as well as with worse overall relationship quality. Longitudinally, BA at baseline was predictive of depression symptoms in spouses at the three-month follow-up. Overall, these findings contribute to a more comprehensive understanding of BA’s psychological underpinnings and how it is linked to spousal psychological and relational well-being.REC name
South East Scotland REC 01
REC reference
23/SS/0010
Date of REC Opinion
22 Mar 2023
REC opinion
Further Information Favourable Opinion