The Essential Role of Psychosocial Risk and Protective Factors in Pediatric Traumatic Brain Injury Research

Abstract

This article builds upon Traumatic Brain Injury Common Data Elements (TBI CDE) version 1.0 and the pediatric CDE Initiative by emphasizing the essential role of psychosocial risk and protective factors in pediatric TBI research. The goals are to provide a compelling rationale for including psychosocial risk and protective factors in addition to socioeconomic status (SES), age, and sex in the study design and analyses of pediatric TBI research and to describe recommendations for core common data elements in this domain. Risk and protective factor research is based on the ecological theory of child development in which children develop through a series of interactions with their immediate and more distant environments. Home, school, religious, and social influences are conceptualized as risk and/or protective factors. Child development and TBI researchers have interpreted risk and protective variables as main effects or as interactions and have used cumulative risk indices and moderation models to describe the relationship among these variables and outcomes that have to do with development and with recovery from TBI. It is likely that the number, type, and interaction among risk and protective factors each contribute unique variance to study outcomes. Longitudinal designs in TBI research will be essential to understanding the reciprocal relationships between risk/protective factors and the recovery/outcome made by the child. The search for effective interventions to hasten TBI recovery mandates the need to target modifiable risks and to promote protective factors in the child's environment.

Social competence following pediatric stroke: Contributions of brain insult and family environment

“…We found a strong relationship between family function and all measures of children's social adjustment. While we had predicted this association, such a strong link is a relatively novel finding within the child brain insult literature (Gerring & Wade, 2012) and emphasizes the critical importance of the child-family relationship in the development of social competence in the context of early brain insult. Given that family function is a potentially modifiable risk factor, this finding indicates that attention to family stress and burden may enhance the quality of the child's environment with secondary benefits to the child.…”

“…Few studies to date have explored the relative contributions of brain insult and chronic illness factors in the context of pediatric stroke. In addition to child-based chronic illness factors, home environment has been linked to social outcomes following acquired brain injury (Anderson et al, 2009;Beauchamp & Anderson, 2010;Gerring & Wade, 2012;Yeates et al, 2007). In particular, more proximal factors, such as parent mental health and family function, have been found to predict social outcomes in both healthy and brain-injured groups (Beauchamp & Anderson, 2010;Gerring & Wade, 2012;Rubin, Chen, Mcdougall, Bowker, & Mckinnon, 1995).…”

“…In addition to child-based chronic illness factors, home environment has been linked to social outcomes following acquired brain injury (Anderson et al, 2009;Beauchamp & Anderson, 2010;Gerring & Wade, 2012;Yeates et al, 2007). In particular, more proximal factors, such as parent mental health and family function, have been found to predict social outcomes in both healthy and brain-injured groups (Beauchamp & Anderson, 2010;Gerring & Wade, 2012;Rubin, Chen, Mcdougall, Bowker, & Mckinnon, 1995). This study aimed to compare the social competence of children with a history of pediatric stroke, children with a chronic illness (asthma) and healthy controls, in order to explore the relative contribution of stroke-specific factors and chronic illness within this domain.…”

Prospective study of myelin water fraction changes after mild traumatic brain injury in collegiate contact sports

“…Family-level factors are critical social-environmental influences on outcomes for children following a TBI (Gerring and Wade, 2012). Family-level factors can include caregiver distress or depression, and deteriorating family functioning (Aitken et al, 2009;Wade, Carey, and Wolfe, 2006a).…”

Progress in Developing Common Data Elements for Traumatic Brain Injury Research: Version Two – The End of the Beginning

“…[1][2][3][4][5][6][7] One year later, the CDEs were modified to make them more compatible with the needs of pediatric TBI research. [8][9][10][11][12][13][14] From the inception of this project, the CDEs were expected to require regular updating to ensure their continued feasibility and utility. The first version of the CDEs (v.1) was a major advance toward standardization of TBI research, but there were also limitations that needed to be addressed.…”