Children's Learning Institute and Department of Pediatrics, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Department of Pediatric Surgery, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA.
J Neurotrauma. 2021 Sep 15;38(18):2600-2609. doi: 10.1089/neu.2020.7541. Epub 2021 Jun 23.
Following pediatric traumatic brain injury (TBI), post-concussion symptoms (PCS) and post-traumatic stress symptoms (PTSS) occur commonly; however, it is unknown to what degree they overlap. The study examined PCS and PTSS persisting 7 weeks after injury in children and adolescents ages 8-15 years with TBI ( = 89) or extracranial injury (EI; = 40) after vehicle collisions. TBI was divided into mild, complicated-mild/moderate, and severe groups. Parents retrospectively rated children's pre-injury symptoms and behavior problems, and children completed self-report measures after injury. PCS and PTSS total scores were significantly correlated in TBI and EI groups, respectively, for child ( = 0.75; = 0.44), and adolescent ( = 0.61; = 0.67) cohorts. Generalized linear models examined whether injury type and severity, age, sex, and pre-injury symptom ratings predicted PCS and PTSS total scores and factor scores. Specific PCS and PTSS factor scores were elevated in different TBI severity groups, with most frequent problems following mild or severe TBI. PCS did not differ by age; however, girls had more emotional symptoms than boys. Only PTSS were predicted by pre-injury externalizing behavior. Significant age by sex interactions indicated that adolescent girls had more total, avoidance, and hyperarousal PTSS symptoms than younger girls or all boys. PCS and PTSS significantly overlapped in both TBI and EI groups, highlighting shared persistent symptoms after injury. Shared vulnerability factors included female sex, milder TBI, and poorer pre-injury adjustment. Older age was a unique vulnerability factor for PTSS. Psychological health interventions after injury should be customized to address comorbid symptoms.
儿童创伤性脑损伤（TBI）后常出现脑震荡后症状（PCS）和创伤后应激症状（PTSS）；然而，尚不清楚它们的重叠程度。本研究调查了 8-15 岁因车辆碰撞致 TBI（n=89）或颅脑外损伤（EI；n=40）的儿童和青少年在损伤后 7 周时 PCS 和 PTSS 的持续性。TBI 分为轻度、复杂轻度/中度和重度。父母对孩子受伤前的症状和行为问题进行了回顾性评估，孩子在受伤后完成了自我报告的测量。TBI 和 EI 组的儿童和青少年 PCS 和 PTSS 总分均显著相关（ = 0.75； = 0.44）。一般线性模型检查了损伤类型和严重程度、年龄、性别和受伤前症状评分是否能预测 PCS 和 PTSS 总分和因子分。特定的 PCS 和 PTSS 因子分在不同的 TBI 严重程度组中升高，轻度或重度 TBI 后最常见的问题。PCS 与年龄无关；然而，女孩的情绪症状比男孩多。只有 PTSS 受到外部化行为的预测。年龄和性别之间的显著相互作用表明，青春期女孩的总、回避和过度唤醒 PTSS 症状比年轻女孩或所有男孩都多。TBI 和 EI 组中 PCS 和 PTSS 均显著重叠，突出了受伤后共同存在的持续性症状。共同的脆弱性因素包括女性、较轻的 TBI 和较差的受伤前调整。年龄较大是 PTSS 的独特脆弱性因素。受伤后应根据共同症状来定制心理健康干预措施。
