Greenham Mardee, Hearps Stephen, Gomes Alison, Rinehart Nicole, Gonzalez Linda, Gordon Anne, Mackay Mark, Lo Warren, Yeates Keith, Anderson Vicki
a Clinical Sciences , Murdoch Childrens Research Institute , Melbourne , Australia.
b School of Psychological Sciences , University of Melbourne , Melbourne , Australia.
Dev Neuropsychol. 2015;40(6):348-62. doi: 10.1080/87565641.2015.1095191.
Mental health and social outcomes following acquired brain injury (ABI) in children are often considered to be due to brain insult, but other factors, such as environment, may also play a role. We assessed mental health and social function in children with chronic illness, with and without stroke (a form of ABI), and typically developing (TD) controls to examine environmental influences on these outcomes. We recruited 36 children diagnosed with stroke, 15 with chronic asthma, and 43 TD controls. Children and parents completed questionnaires rating child mental health and social function and distal and proximal environment. TD children had significantly less internalizing and social problems than stroke and asthma groups, and engaged in more social activities than children with stroke. Poorer parent mental health predicted more internalizing and social problems and lower social participation. Family dysfunction was associated with internalizing problems. Lower parent education contributed to children's social function. Children with chronic illness are at elevated risk of poorer mental health and social function. Addition of brain insult leads to poorer social participation. Quality of home environment contributes to children's outcomes, suggesting that supporting parent and family function provides an opportunity to optimize child mental health and social outcomes.
儿童获得性脑损伤（ABI）后的心理健康和社会结局通常被认为是由脑损伤所致，但其他因素，如环境，也可能起作用。我们评估了患有慢性病、有或无中风（一种ABI形式）的儿童以及正常发育（TD）对照组的心理健康和社会功能，以研究环境对这些结局的影响。我们招募了36名被诊断为中风的儿童、15名患有慢性哮喘的儿童和43名TD对照组儿童。儿童及其父母完成了对儿童心理健康、社会功能以及远端和近端环境进行评分的问卷。TD儿童的内化问题和社会问题明显少于中风组和哮喘组，且比中风儿童参与更多的社交活动。父母心理健康状况较差预示着更多的内化问题和社会问题以及更低的社会参与度。家庭功能障碍与内化问题相关。父母教育程度较低会影响儿童的社会功能。患有慢性病的儿童心理健康和社会功能较差的风险较高。加上脑损伤会导致社会参与度更低。家庭环境质量对儿童的结局有影响，这表明支持父母和家庭功能为优化儿童心理健康和社会结局提供了机会。
