A comparison of adult outcomes for males compared to females following pediatric traumatic brain injury.

Scott, Charis; McKinlay, Audrey; McLellan, Tracey; Britt, Eileen; Grace, Randolph C.; MacFarlane, Martin R.

doi:10.1037/neu0000074

Cited by 79 publications

(62 citation statements)

References 45 publications

(52 reference statements)

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“…Our finding of higher ratings on internalizing behaviour problems is consistent with previous research (Max et al, 2011;Scott et al, 2014). Individuals with TBI have been reported to show higher levels of withdrawal and internalizing problems (Liu and Li, 2013) and it has been suggested that behavioural difficulties may be related to a disruption to regulatory mechanisms in the brain.…”

Section: Discussionsupporting

confidence: 92%

“…First, the result that participants with a history of mTBI reported higher rates of behavioural problems of a predominantly internalizing nature is important as internalizing disorders are commonly underdiagnosed, likely because they are not as overt or disruptive as externalizing disorders (Scott et al, 2014). Further, the significant association between behaviour and sleep-related daytime dysfunction among those reporting mTBI has direct clinical implications as individuals with chronic poor sleep quality may be vulnerable to difficulties in mood regulation, impaired academic performance (Carskadon et al, 2004) and other adverse implications including substance abuse (Johnson and Breslau, 2001;Singleton and Wolfson, 2009), excessive caffeine intake (Orbeta et al, 2006) and smoking or drug use (Mednick et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

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Ongoing daytime behavioural problems in university students following childhood mild traumatic brain injury

Albicini

Lee²,

McKinlay

2016

International Journal of Rehabilitation Research

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Sleep is often disrupted in traumatic brain injury (TBI) and may be related to persistent behaviour problems; however, little is known about this relationship in young adults. This study explored associations between TBI, behavioural problems and sleep disturbances in 247 university students (197 non-TBI, 47 mild TBI, two moderate TBI, one severe TBI) aged 18-25 years, who completed validated measures for behaviour, sleep quality and history of TBI. Because of small group numbers, participants reporting moderate to severe TBI were excluded from the analyses. Results indicated that students with mild TBI reported higher levels of daytime dysfunction, somatic complaints, withdrawal, other behavioural complaints and internalizing behaviours compared with students with no TBI history. A correlational analysis indicated a moderate relationship between the above significant variables. Our results suggest that university students with a history of mild TBI are more likely to experience certain ongoing daytime behavioural problems, which are likely to negatively influence their academic functioning in tertiary education. This study highlights the importance of research on long-term problems following mild TBI in young adults aged 18-25 years--an age group often overlooked within the literature.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Ongoing daytime behavioural problems in university students following childhood mild traumatic brain injury

Albicini

Lee²,

McKinlay

2016

International Journal of Rehabilitation Research

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“…They were at elevated risk for externalizing disorders but had a reduced risk for internalizing disorders compared with women. 40 A criticism of studies of the association of individual ROIs and psychiatric symptoms has been that brain circuits, rather than individual regions, are likely most associated with psychiatric symptoms. 41 We agree with this viewpoint, but brain circuits are composed of individual regions, each of which likely contributes a unique component to psychiatric syndromes.…”

Section: Discussionmentioning

confidence: 99%

Brain Regions Associated With Internalizing and Externalizing Psychiatric Symptoms in Patients With Penetrating Traumatic Brain Injury

Huey¹,

Lee²,

Lieberman³

et al. 2016

JNP

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A factor structure underlying DSM-IV diagnoses has been previously reported in neurologically intact patients. The authors determined the brain regions associated with factors underlying DSM-IV diagnoses and compared the ability of DSM-IV diagnoses, factor scores, and self-report measures to account for the neuroanatomical findings in patients with penetrating brain injuries. This prospective cohort study included 254 Vietnam War veterans: 199 with penetrating brain injuries and 55 matched control participants. Measures include DSM-IV diagnoses (from a Structured Clinical Interview for DSM), self-report measures of depression and anxiety, and CT scans. Factors underlying DSM-IV diagnoses were determined using an exploratory factor analysis and correlated with percent of brain regions affected. The ability of the factor scores, DSM-IV diagnoses, and the self-report psychiatric measures to account for the anatomical variance was compared with multiple regressions. Internalizing and externalizing factors were identified in these brain-injured patients. Damage to the left amygdala and bilateral basal ganglia was associated with lower internalizing factor scores, and damage to the left medial orbitofrontal cortex (OFC) with higher, and bilateral hippocampi with lower, externalizing factor scores. Factor scores best predicted left amygdala and bilateral hippocampal involvement, whereas DSM-IV diagnoses best predicted bilateral basal ganglia and left OFC involvement. Damage to the limbic areas involved in the processing of emotional and reward information, including structures involved in the National Institute of Mental Health's Research Domain Criteria Negative Valence Domain, influences the development of internalizing and externalizing psychiatric symptoms. Self-report measures underperformed DSM-IV and factor scores in predicting neuroanatomical findings. DSM is a classification system of psychiatric disorders based on the clustering of psychiatric symptoms in patients as observed by clinicians.1 There is a growing body of evidence, however, that a factor structure underlies, and can cut across, DSM diagnoses. 2-4 It has been hypothesized, but not yet tested, that these factors underlying DSM diagnoses will be more closely associated with the neuroanatomical bases of psychiatric symptoms than DSM diagnosis. In the current study, we determined the factor structure of psychopathology underlying the DSM diagnoses of 199 Vietnam War veterans who suffered penetrating brain injuries and 55 matched control participants. We then determined which neuroanatomical structures, when damaged, were associated with higher or lower factor scores compared with participants without damage to that structure. We also compared the ability of DSM-IV categorical diagnoses, factors derived from DSM-IV diagnoses, and continuous self-report measures of depressive and anxiety symptoms to predict the neuroanatomical findings. This study had two goals: 1) to determine which specific brain regions are associated with core components of psychopa...

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“…While historically patients who appeared on the surface unimpaired after an ABI would have been discharged rapidly from services and left with a possible lifetime of neurocognitive difficulties from what appeared to be a ‘mild’ brain injury,6 there is now a greater understanding about the importance of long-term follow-up and specialist input as people who suffer a brain injury in childhood are at increased risk of offending behaviours7 and mental illness 8…”

Section: Introductionmentioning

confidence: 99%

Paediatric neurorehabilitation: finding and filling the gaps through the use of the Institute for Manufacturing strategic roadmapping method

et al. 2017

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IntroductionAcquired brain injury (ABI) is a major cause of morbidity and mortality in childhood. Specialist rehabilitation services are often situated far from families and local services may be non-standardised and fragmented. A strategic level of understanding is needed to improve patient care and outcomes. Roadmapping techniques are commonly used in industry settings to discover and present a systematic understanding of structures; however, they are rarely used in the healthcare setting. With continuing pressures on healthcare systems worldwide, they provide an effective method for examining services.MethodsThe Institute for Manufacturing (IfM) strategic roadmapping method was used to identify areas of difficulty and opportunities in paediatric neurorehabilitation. Participants included stakeholders from a wide range of professions and sectors who have input with children after ABI.ResultsDelegates identified a range of ‘layers’ covering trends, drivers, current experience and unmet needs. From these layers, four priorities were identified and further expanded.These included: ‘access to medical and therapy expertise close(r) to home’, ‘shared understanding across family, school and health’, ‘family and professional awareness of resources and support’ and ‘establishing a centre for rehabilitation technology evaluation, advice and co-ordination of services and research’.ConclusionThe IfM strategic roadmapping method identified and developed key areas for development in the field of paediatric neurological rehabilitation. Healthcare professionals looking at strategic level difficulties should strongly consider the use of such systematic tools when evaluating areas of practice.

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A comparison of adult outcomes for males compared to females following pediatric traumatic brain injury.

Abstract: Childhood TBI is associated with psychosocial problems in adulthood, regardless of injury severity. How deficits are expressed differs between the sexes, with important implications for interventions strategies.

Cited by 79 publications

References 45 publications

Ongoing daytime behavioural problems in university students following childhood mild traumatic brain injury

Ongoing daytime behavioural problems in university students following childhood mild traumatic brain injury

Brain Regions Associated With Internalizing and Externalizing Psychiatric Symptoms in Patients With Penetrating Traumatic Brain Injury

Paediatric neurorehabilitation: finding and filling the gaps through the use of the Institute for Manufacturing strategic roadmapping method

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