探究青少年创伤性脑损伤与创伤后应激症状之间的联系。
Investigating the Connection Between Traumatic Brain Injury and Posttraumatic Stress Symptoms in Adolescents.
作者信息
Rhine Tara, Cassedy Amy, Yeates Keith Owen, Taylor Hudson Gerry, Kirkwood Michael W, Wade Shari L
机构信息
Division of Pediatric Emergency Medicine, Department of Pediatrics (Dr Rhine), Division of Biostatistics and Epidemiology (Dr Cassedy), and Division of Physical Medicine and Rehabilitation (Dr Wade), Cincinnati Children's Hospital Medical Center, Ohio; University of Calgary, Alberta, Canada (Dr Yeates); Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (Dr Taylor); and Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (Dr Kirkwood).
出版信息
J Head Trauma Rehabil. 2018 May/Jun;33(3):210-218. doi: 10.1097/HTR.0000000000000319.
OBJECTIVE
To identify potentially modifiable individual and social-environmental correlates of posttraumatic stress symptoms (PTSS) among adolescents hospitalized for traumatic brain injury (TBI).
SETTING
Four pediatric hospitals and 1 general hospital in the United States.
PARTICIPANTS
Children ages 11 to 18 years, hospitalized for moderate-severe TBI within the past 18 months.
DESIGN
Retrospective cross-sectional analysis.
MAIN MEASURES
The University of California at Los Angeles (UCLA) Post-traumatic Stress Disorder (PTSD) Reaction Index and the Youth Self-Report (YSR) PTSD subscale.
RESULTS
Of 147 adolescents enrolled, 65 (44%) had severe TBI, with an average time since injury of 5.8 ± 4 months. Of the 104 who completed the UCLA-PTSD Reaction Index, 22 (21%) reported PTSS and 9 (8%) met clinical criteria for PTSD. Of the 143 who completed the YSR-PTSD subscale, 23 (16%) reported PTSS and 6 (4%) met clinical criteria for PTSD. In multivariable analyses, having a negative approach to problem solving and depressive symptoms were both associated (P < .001) with higher levels of PTSS based on the UCLA-PTSD Reaction Index (β = 0.41 and β = 0.33, respectively) and the YSR-PTSD subscale (β = 0.33 and β = 0.40, respectively).
CONCLUSION
Targeting negative aspects of problem solving in youths after brain injury may mitigate PTSS.
目的
确定因创伤性脑损伤（TBI）住院的青少年中创伤后应激症状（PTSS）潜在的可改变个体及社会环境相关因素。
设置
美国四家儿科医院和一家综合医院。
参与者
年龄在11至18岁之间，在过去18个月内因中度至重度TBI住院的儿童。
设计
回顾性横断面分析。
主要测量指标
加利福尼亚大学洛杉矶分校（UCLA）创伤后应激障碍（PTSD）反应指数和青少年自我报告（YSR）PTSD分量表。
结果
在纳入研究的147名青少年中，65名（44%）患有重度TBI，受伤后的平均时间为5.8±4个月。在完成UCLA-PTSD反应指数的104名青少年中，22名（21%）报告有PTSS，9名（8%）符合PTSD临床标准。在完成YSR-PTSD分量表的143名青少年中，23名（16%）报告有PTSS，6名（4%）符合PTSD临床标准。在多变量分析中，基于UCLA-PTSD反应指数（β分别为0.41和0.33）和YSR-PTSD分量表（β分别为0.33和0.40），消极的问题解决方式和抑郁症状均与较高水平的PTSS相关（P<0.001）。
结论
针对脑损伤后青少年问题解决的消极方面可能会减轻PTSS。
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