Khan Noor, Ryan Nicholas P, Crossley Louise, Hearps Stephen, Catroppa Cathy, Anderson Vicki
Brain and Mind Research, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Department of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
J Neurotrauma. 2023 Oct;40(19-20):2100-2109. doi: 10.1089/neu.2022.0420. Epub 2023 Aug 16.
Pediatric traumatic brain injury (TBI) can impact psycho-social functioning, including friendships and experiences of loneliness; however, few studies have explored associations between these factors and self-esteem. To address this gap, the objective of this study was to document inter-relationships between friendship quality, peer-related loneliness, and self-esteem 12 months post-injury. The sample in this prospective, longitudinal observational study consisted of 135 children, including 92 children with TBI (57 mild, 35 moderate-severe TBI) and 43 typically developing control (TDC) children. Children rated their friendship quality, loneliness, and self-esteem. Parents completed questionnaires measuring socioeconomic status and children's pre-injury functioning. At 12-month follow-up, ratings of friendship quality (perceived support and satisfaction with friendships), peer-related loneliness, and self-esteem were comparable between TBI and TDC participants. In mediation models, poorer quality friendships were associated with greater peer-related loneliness, and greater peer-related loneliness was related to reduced athletic and social self-esteem, at 12 months post-TBI. Loneliness with peers mediated the effects of both friendship support and friendship satisfaction on children's social self-esteem. Our preliminary findings suggest that regular monitoring of social interactions post-TBI might facilitate early identification of children who are likely to benefit from interventions targeting peer-related loneliness, which in turn may lower risk for poorer self-esteem.
儿童创伤性脑损伤 (TBI) 可影响心理社会功能,包括友谊和孤独感体验;然而,很少有研究探讨这些因素与自尊之间的关联。为了解决这一差距,本研究的目的是记录伤后 12 个月内友谊质量、与同伴相关的孤独感和自尊之间的相互关系。这项前瞻性、纵向观察研究的样本包括 135 名儿童,其中 92 名儿童患有 TBI(57 名轻度,35 名中重度 TBI),43 名正常发育对照(TDC)儿童。儿童对其友谊质量、孤独感和自尊进行了评分。家长完成了社会经济状况和儿童伤前功能的问卷。在 12 个月的随访中,TBI 和 TDC 参与者的友谊质量(感知支持和对友谊的满意度)、与同伴相关的孤独感和自尊评分相当。在中介模型中,较差的友谊质量与更大的与同伴相关的孤独感相关,而更大的与同伴相关的孤独感与运动和社会自尊降低相关,在 TBI 后 12 个月。与同伴的孤独感中介了友谊支持和友谊满意度对儿童社会自尊的影响。我们的初步发现表明,TBI 后定期监测社交互动可能有助于早期识别可能受益于针对与同伴相关的孤独感的干预措施的儿童,这反过来又可能降低自尊较低的风险。