Citation

Wade SL, Kaizar EE, Narad ME, Zang H, Kurowski BG, Miley AE, Moscato EL, Aguilar JM, Yeates KO, Taylor HG, Zhang N. J. Head Trauma Rehabil. 2020; ePub(ePub): ePub.

Affiliation

University of Cincinnati College of Medicine, Ohio (Drs Wade, Narad, and Zhang and Mr Zang); College of Arts and Science, University of Cincinnati, Ohio (Dr Wade and Ms Moscato); Divisions of Pediatric Rehabilitation Medicine (Drs Wade and Aguilar and Mss Miley and Moscato), Behavioral Medicine and Clinical Psychology (Dr Narad), Biostatics and Epidemiology (Mr Zang and Dr Zhang), and Physical Medicine and Rehabilitation (Dr Kurowski), Cincinnati Children's Hospital Medical Center, Ohio; Departments of Statistics (Dr Kaizar) and Pediatrics (Dr Taylor), The Ohio State University, Columbus; Departments of Pediatrics, Neurology and Rehabilitation Medicine, University of Cincinnati, Ohio (Dr Kurowski); Department of Psychology, Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, Calgary, Canada (Dr Yeates); and Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio (Dr Taylor).

Copyright

(Copyright © 2020, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000567

PMID

32108717

Abstract

OBJECTIVE: To examine the frequency of behavioral problems after childhood traumatic brain injury (TBI) and their associations with injury severity, sex, and social environmental factors. SETTING: Children's hospitals in the Midwestern/Western United States. PARTICIPANTS: 381 boys and 210 girls with moderate (n = 359) and severe (n = 227) TBI, with an average age at injury of 11.7 years (range 0.3-18) who were injured ≤3 years ago.

DESIGN: Secondary data analysis of a multistudy cohort. MAIN MEASURES: Child Behavior Checklist (CBCL) administered pretreatment.

RESULTS: Thirty-seven percent had borderline/clinical elevations on the CBCL Total Problem Scale, with comparable rates of Internalizing and Externalizing problems (33% and 31%, respectively). Less parental education was associated with higher rates of internalizing, externalizing, and total problems. Time since injury had a linear association with internalizing symptoms, with greater symptoms at longer postinjury intervals. Younger boys had significantly higher levels of oppositional defiant symptoms than girls, whereas older girls had significantly greater attention-deficit hyperactivity disorder symptoms than boys.

CONCLUSIONS: Pediatric TBI is associated with high rates of behavior problems, with lower socioeconomic status predicting substantially elevated risk. Associations of higher levels of internalizing symptoms with greater time since injury highlight the importance of tracking children over time.

Language: en