Psychological and behavioural difficulties following severe TBI in adolescence: a comparison with a sample of peers with brain lesions of other origin and with a control group

Pastore, Valentina; Galbiati, Susanna; Recla, Monica; Colombo, Katia; Beretta, Elena; Strazzer, Sandra

doi:10.1080/02699052.2018.1469041

Cited by 10 publications

(7 citation statements)

References 59 publications

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“…In a number of studies, TBI severity is associated with post-traumatic behavioral changes. Ratings completed by parents and/or children indicated greater internalizing and/or externalizing symptoms after moderate to severe TBI than in children with orthopedic injuries (OI) (5,12) or healthy children (13). Some studies identified greater problems following severe TBI than complicated/mild, moderate, and/or mild TBI for conduct, affective, anxiety, and ADHD problems (5,6,12), externalizing problems (14)(15)(16)(17)(18), and total behavior problems (19,20).…”

Section: Introductionmentioning

confidence: 99%

As Time Goes by: Understanding Child and Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury

et al. 2021

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Objective: To model pre-injury child and family factors associated with the trajectory of internalizing and externalizing behavior problems across the first 3 years in children with pediatric traumatic brain injury (TBI) relative to children with orthopedic injuries (OI). Parent-reported emotional symptoms and conduct problems were expected to have unique and shared predictors. We hypothesized that TBI, female sex, greater pre-injury executive dysfunction, adjustment problems, lower income, and family dysfunction would be associated with less favorable outcomes.Methods: In a prospective longitudinal cohort study, we examined the level of behavior problems at 12 months after injury and rate of change from pre-injury to 12 months and from 12 to 36 months in children ages 4–15 years with mild to severe TBI relative to children with OI. A structural equation model framework incorporated injury characteristics, child demographic variables, as well as pre-injury child reserve and family attributes. Internalizing and externalizing behavior problems were indexed using the parent-rated Emotional Symptoms and Conduct Problems scales from the Strengths and Difficulties questionnaire.Results: The analysis cohort of 534 children [64% boys, M (SD) 8.8 (4.3) years of age] included 395 with mild to severe TBI and 139 with OI. Behavior ratings were higher after TBI than OI but did not differ by TBI severity. TBI, higher pre-injury executive dysfunction, and lower income predicted the level and trajectory of both Emotional Symptoms and Conduct Problems at 12 months. Female sex and poorer family functioning were vulnerability factors associated with greater increase and change in Emotional Symptoms by 12 months after injury; unique predictors of Conduct Problems included younger age and prior emotional/behavioral problems. Across the long-term follow-up from 12 to 36 months, Emotional Symptoms increased significantly and Conduct Problems stabilized. TBI was not a significant predictor of change during the chronic stage of recovery.Conclusions: After TBI, Emotional Symptoms and Conduct Problem scores were elevated, had different trajectories of change, increased or stayed elevated from 12 to 36 months after TBI, and did not return to pre-injury levels across the 3 year follow-up. These findings highlight the importance of addressing behavioral problems after TBI across an extended time frame.

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Section: Introductionmentioning

confidence: 99%

As Time Goes by: Understanding Child and Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury

et al. 2021

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“…There is some preliminary evidence suggesting that psychological outcomes may differ according to etiology of ABI (Pastore et al, 2014;Pastore et al, 2018), although very few studies have specifically compared the outcomes of children with different causes of ABI (Pastore et al, 2013;Poggi et al, 2005). Most studies have focused on specific etiology groups to avoid the potentially confounding issue of different mechanisms of injury and pre-injury risk factors.…”

Section: Introductionmentioning

confidence: 99%

Investigation of children and adolescents’ mood and self-concept after acquired brain injury

Hendry

Ownsworth

Waters

et al. 2020

Child Neuropsychology

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Few studies have examined the self-reported mental health of children with an acquired brain injury (ABI). The current study aimed to: 1) identify levels of child-reported depressive and anxiety symptoms and poor self-concept, 2) investigate demographic and injury-related factors associated with children's mood and self-concept, and 3) examine associations between children's self-reported mental health and parents' reports of children's emotional and behavioral functioning in children specifically with traumatic brain injury (TBI). 122 children (66% male) aged 8-16 years with ABI of mixed etiology were consecutively recruited through an outpatient rehabilitation clinic. Children were administered the Beck Youth Inventories -Second Edition, and parents completed the Adaptive Behaviour Assessment System and the Child Behaviour Checklist (CBCL). Relative to the norms, 16.4% of children scored in the clinical range for the depression and anxiety scales, and 24.6% reported clinically low self-concept. Children with lower functional status had greater anxiety symptoms. Older children (13-16 years) reported significantly higher depressive and anxiety symptoms and lower self-concept than younger children (8-12 years). A significant interaction between age and sex indicated that older girls reported greater depressive and anxiety symptoms than younger girls whereas no age-based differences were found for boys.Parent-reported total emotional and behavioral problems were positively associated with children's self-reported depressive and anxiety symptoms and were negatively correlated with self-concept. These findings indicate that adolescents, particularly girls, may be at heightened risk of poor mental health following ABI. Further research investigating the reasons for these demographic differences may inform developmentally sensitive interventions.

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“…Impulsivity, attentional problems, reactive aggression and issues with behavioural or emotional regulation are common problems following TBI (Pastore et al, 2018;Williams et al, 2018). In cases of severe TBI, theory of mind (ToM) is often a ected (the ability to put oneself 'in another's shoes', and understand how others may think, feel and act in a manner di erent from our own experiences) (Hoskinson et al, 2019).…”

Section: Poverty and Educationmentioning

confidence: 99%

Identifying and supporting children with learning disabilities

Linzarini¹,

Bugden²,

Merkley³

et al. 2022

Reimagining Education: The International Science and Evidence Based Education Assessment

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T his chapter assesses ways to identify and support children with learning disabilities. Learning disabilities a ect many students and are seldom attributable to a single cause. They arise through complex interactions between biological and environmental factors within individual developmental trajectories. Early identi cation of children at risk for learning disabilities as well as adequate identi cation of children with learning disabilities are important for ensuring that children have access to the supports they need in order to reach their full potential. Here, we discuss identifying children's learning needs and providing educational support. Although many school systems recognize the need to provide inclusive education to support all learners, more work is needed to raise awareness and enable adequate evidence-based early identi cation of children with learning disabilities and support their learning trajectories and instructional needs inside and outside of the classroom. It is also fundamental to acknowledge the importance of research on diverse populations that could inform identi cation and support in various countries and socio-cultural contexts.

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Psychological and behavioural difficulties following severe TBI in adolescence: a comparison with a sample of peers with brain lesions of other origin and with a control group

Abstract: Adolescents with TBI are exposed at a very high risk to develop behavioural and psychological disturbances with the potential to severely affect their social re-entry. Further knowledge is needed to plan early and well-timed interventions.

Cited by 10 publications

References 59 publications

As Time Goes by: Understanding Child and Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury

As Time Goes by: Understanding Child and Family Factors Shaping Behavioral Outcomes After Traumatic Brain Injury

Investigation of children and adolescents’ mood and self-concept after acquired brain injury

Identifying and supporting children with learning disabilities

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