Fisher Allison P, Gies Lisa M, Narad Megan E, Austin Cynthia A, Yeates Keith Owen, Taylor H Gerry, Zhang Nanhua, Wade Shari L
Division of Physical Medicine and Rehabilitation, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH45229, USA.
Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
J Int Neuropsychol Soc. 2022 Feb;28(2):123-129. doi: 10.1017/S1355617721000308. Epub 2021 Apr 26.
We examined parent- and adolescent-reported executive functioning (EF) behaviors following pediatric traumatic brain injury (TBI) in the context of Online Family Problem-Solving Therapy (OFPST) and moderators of change in EF behaviors.
In total, 274 families were randomized to OFPST or an internet resource comparison group. Parents and adolescents completed the Behavior Rating Inventory of Executive Function at four time points. Mixed models were used to examine EF behaviors, assessing the effects of visit, treatment group, rater, TBI severity, age, socioeconomic status, and family functioning.
Parents rated their adolescents' EF as poorer (F(3,1156) = 220.15, p < .001; M = 58.11, SE = 0.73) than adolescents rated themselves (M = 51.81, SE = 0.73). Across raters, EF behaviors were poorer for adolescents whose parents had less education (F(3,1156) = 8.60, p = .003; M = 56.76, SE = 0.98) than for those with more education (M = 53.16, SE = 0.88). Age at baseline interacted with visit (F(3,1156) = 5.05, p = .002), such that families of older adolescents reported improvement in EF behaviors over time. Family functioning also interacted with visit (F(3, 1156) = 2.61, p = .049), indicating more improvement in EF behaviors over time in higher functioning families. There were no effects of treatment or TBI severity.
We identified a discrepancy between parent- and adolescent-reported EF, suggesting reduced awareness of deficits in adolescents with TBI. We also found that poorer family functioning and younger age were associated with poorer recovery after TBI, whereas adolescents of parents with less education were reported as having greater EF deficits across time points.
我们在在线家庭问题解决疗法（OFPST）的背景下，研究了儿科创伤性脑损伤（TBI）后家长和青少年报告的执行功能（EF）行为，以及EF行为变化的调节因素。
总共274个家庭被随机分配到OFPST组或互联网资源对照组。家长和青少年在四个时间点完成执行功能行为评定量表。使用混合模型来检查EF行为，评估就诊次数、治疗组、评分者、TBI严重程度、年龄、社会经济地位和家庭功能的影响。
家长对青少年EF的评分（F(3,1156) = 220.15，p <.001；M = 58.11，SE = 0.73）比青少年自评的分数（M = 51.81，SE = 0.73）更低。在所有评分者中，父母受教育程度较低的青少年的EF行为（F(3,1156) = 8.60，p =.003；M = 56.76，SE = 0.98）比受教育程度较高的青少年更差（M = 53.16，SE = 0.88）。基线年龄与就诊次数存在交互作用（F(3,1156) = 5.05，p =.002），即年龄较大青少年的家庭报告随着时间推移EF行为有所改善。家庭功能也与就诊次数存在交互作用（F(3, 1156) = 2.61，p =.049），表明功能较好的家庭中EF行为随时间改善更多。治疗或TBI严重程度没有影响。
我们发现家长和青少年报告的EF之间存在差异，这表明TBI青少年对自身缺陷的认识有所降低。我们还发现，家庭功能较差和年龄较小与TBI后的恢复较差有关，而父母受教育程度较低的青少年在各个时间点的EF缺陷都更大。
