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Sixty-nine primary caregivers of people with a severe traumatic brain injury (TBI) were assessed at 6 months post injury. Caregivers completed questionnaires on the physical, cognitive, emotional, beha vioural, and social functioning of the person with the TBI. Caregiver psychosocial functioning and levels of subjective and objective burden were also assessed. Clinically significant levels of anxiety, depression, and impairment in social adjustment were evident in over a third of the caregivers. The frequency with which various changes in the person with the TBI and types of objective burden were reported had little relationship to the degree of distress caused by these changes. The person with TBI s social isolation and negative emotional behaviours caused the greatest degree of stress for caregivers. Caregivers were also most distressed by the impact that caregiving had on their personal health and free time. The …