Cusimano Michael D, Zhang Stanley, Mei Xin Y, Kennedy Dana, Saha Ashirbani, Carpino Melissa, Wolfe David
Injury Prevention Research Office, Division of Neurosurgery, Li Ka Shing Knowledge Institute and Trauma and Neurosurgery Program, St. Michael's Hospital, Toronto, Ontario, Canada.
Faculty of Medicine and the Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Neurotrauma Rep. 2021 Feb 17;2(1):94-102. doi: 10.1089/neur.2020.0030. eCollection 2021 Feb.
Youth and young adults who previously experienced foster care are prone to negative life events, such as physical injuries, and adverse childhood experiences (ACE), such as abuse, neglect, and household dysfunction. The purpose of the present study was to identify the prevalence of traumatic brain injury (TBI), ACE, and poor sustained attention and the associations of these events in this group of vulnerable persons. Participants completed standardized questionnaires on the prevalence of self-reported TBI (TBI) and ACE and performed the Sustained Attention to Response Task (SART) test to measure sustained attention. Chi-squared and Kruskal-Wallis rank-sum tests were used to assess demographic differences and associations between TBI and ACE. Sustained attention was assessed using analysis of variance and linear modeling. Seventy-one participants-46 youth and young adults who previously experienced foster care (vulnerable group) and 25 age-matched healthy controls-completed the standardized questionnaires. Analyses indicated that vulnerable participants reported markedly higher rates of TBI and ACE than healthy controls. Vulnerable persons with TBI reported significantly higher Total ACE scores ( = 0.02), were more likely to have a history of family dysfunction ( = 0.02), and were more likely to have lived with a mentally ill guardian ( = 0.01) than vulnerable persons with no TBI. TBI was significantly associated with Total Errors ( = 0.001 and = 0.02) and Omission Errors ( < 0.001 and = 0.01) in all participants and in vulnerable participants, respectively, after adjusting for education level.
曾经历寄养的青少年和青年容易遭遇负面生活事件，如身体受伤，以及童年不良经历（ACE），如虐待、忽视和家庭功能失调。本研究的目的是确定创伤性脑损伤（TBI）、ACE以及持续注意力不集中在这一弱势群体中的患病率，以及这些事件之间的关联。参与者完成了关于自我报告的TBI患病率和ACE的标准化问卷，并进行了持续注意力反应任务（SART）测试以测量持续注意力。使用卡方检验和克鲁斯卡尔-沃利斯秩和检验来评估人口统计学差异以及TBI和ACE之间的关联。使用方差分析和线性建模来评估持续注意力。71名参与者——46名曾经历寄养的青少年和青年（弱势群体）以及25名年龄匹配的健康对照者——完成了标准化问卷。分析表明，弱势群体报告的TBI和ACE发生率明显高于健康对照者。与没有TBI的弱势群体相比，患有TBI的弱势群体报告的ACE总分显著更高（=0.02），更有可能有家庭功能失调史（=0.02），并且更有可能与患有精神疾病的监护人一起生活（=0.01）。在调整教育水平后，TBI分别与所有参与者和弱势群体中的总错误数（=0.001和=0.02）以及遗漏错误数（<0.001和=0.01）显著相关。
