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Psychosocial status after pediatric traumatic brain injury: A subtype analysis using the Child Behavior Checklist

Published online by Cambridge University Press:  27 August 2003

Susan E. Hayman-Abello*
Affiliation:
Department of Psychology, University of Windsor, Windsor, Ontario, Canada
Byron P. Rourke
Affiliation:
Department of Psychology, University of Windsor, Windsor, Ontario, Canada Yale University, New Haven, Connecticut
Darren R. Fuerst
Affiliation:
Department of Psychology, University of Windsor, Windsor, Ontario, Canada Wayne State University School of Medicine, Detroit, Michigan
*
Reprint requests to: Susan E. Hayman-Abello, Department of Psychology, University of Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4 Canada. E-mail: hayman2@uwindsor.ca

Abstract

This study identified subtypes of psychosocial functioning in children who had sustained traumatic brain injury (TBI). Child Behavior Checklist (CBCL) profiles for 92 participants, aged 12 to 18 years, who had sustained a mild, moderate, or severe TBI were subjected to Q-Factor analysis. Sixty-four of the participants (75%) were classified into a four-category psychosocial typology labelled Normal (n = 32), Attention (n = 14), Delinquent (n = 10), and Withdrawn–Somatic (n = 8). This typology was found to overlap in part with previous TBI psychosocial typology (Butler et al., 1997), and with three of the clinical profile types derived by Achenbach (1993) for the CBCL. The majority of participants, including those who sustained severe TBI, were assigned to the Normal subtype and the overall level of psychosocial deviance was relatively mild in the other three subtypes. The results of this study support previous typology efforts and confirm the heterogeneous presentation of social and emotional functioning following TBI. (JINS, 2003, 9, 887–898.)

Type
Research Article
Copyright
Copyright © The International Neuropsychological Society 2003

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References

Achenbach, T.M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington, Vermont: University of Vermont, Department of Psychiatry.Google Scholar
Achenbach, T.M. (1993). Empirically Based Taxonomy: How to Use Syndromes and Profile Types Derived from the CBCL/4-18, TRF, and YSR. Burlington, Vermont: University of Vermont, Department of Psychiatry.Google Scholar
Achenbach, T.M. & Edelbrock, C.S. (1983). Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington, Vermont: University of Vermont, Department of Psychiatry.Google Scholar
American Congress of Rehabilitation Medicine. (1993). Definition of mild TBI. Journal of Head Trauma Rehabilitation, 8 (30), 8687.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association Press.Google Scholar
Asarnow, R.F., Satz, P., Light, R., Lewis, R., & Neumann, E. (1991). Behavior problems and adaptive functioning in children with mild and severe closed head injury. Journal of Pediatric Psychology, 16, 543555.CrossRefGoogle ScholarPubMed
Barry, C.T., Taylor, H.G., Klein, S., & Yeates, K.O. (1996). Validity of neurobehavioral symptoms reported in children with TBI. Child Neuropsychology, 2, 213226.CrossRefGoogle Scholar
Bloom, D.R., Levin, H.S., Ewing-Cobbs, L., Saunders, A.E., Song, J., Fletcher, J.M., & Kowatch, R.A. (2001). Lifetime and novel psychiatric disorders after pediatric traumatic brain injury. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 572579.10.1097/00004583-200105000-00017CrossRefGoogle ScholarPubMed
Brown, G., Chadwick, O., Shaffer, D., Rutter, M., & Traub, M. (1981). A prospective study of children with head injuries: III. Psychiatric sequelae. Psychological Medicine, 11, 6378.CrossRefGoogle ScholarPubMed
Butler, K., Rourke, B.P., Fuerst, D.R., & Fisk, J.L (1997). A typology of psychosocial functioning in pediatric closed-head injury. Child Neuropsychology, 3, 98133.10.1080/09297049708401371CrossRefGoogle Scholar
Donders, J. (1992). Premorbid behavioral and psychosocial adjustment of children with TBI. Journal of Abnormal Child Psychology, 20, 233246.10.1007/BF00916690CrossRefGoogle Scholar
Drotar, D., Stein, R.E.K., & Perrin, E.C. (1995). Methodological issues in using the child behavior checklist and its related instruments in clinical child psychology research. Journal of Clinical and Consulting Psychology, 24, 184192.Google Scholar
Ewing-Cobbs, L., Fletcher, J.M., & Levin, H.S. (1995). TBI. In Rourke, B.P. (Ed.), Syndrome of nonverbal learning disabilities: Neurodevelopmental manifestations (pp. 433459). New York: Guilford Press.Google Scholar
Filley, C.M., Cranberg, L.D., Alexander, M.P., & Hart, E.J. (1987). Neurobehavioral outcome after closed head injury in childhood and adolescence. Archives of Neurology, 44, 194198.10.1001/archneur.1987.00520140058018CrossRefGoogle ScholarPubMed
Fletcher, J.M. & Taylor, H.G. (1997). Children with brain injury. In Mash, E.J. & Terdal, L.G. (Eds.), Assessment of childhood disorders (3rd ed.) (pp. 453480). New York: Guilford Press.Google Scholar
Fletcher, J.M., Ewing-Cobbs, L., Miner, M.E., Levin, H.S., & Eisenberg, H.M. (1990). Behavioral changes after closed head injury in children. Journal of Consulting and Clinical Psychology, 58, 9398.10.1037/0022-006X.58.1.93CrossRefGoogle ScholarPubMed
Fletcher, J.M., Ewing-Cobbs, L., Francis, D.J., & Levin, H. (1995). Variability in outcomes after TBI in children: A developmental perspective. In Broman, S.H. & Michel, M.E. (Eds.) Traumatic head injury in children (pp. 321). New York: Oxford University Press.Google Scholar
Fuerst, D.R. (1991). Psychosocial functioning of children with learning disabilities: The relations between psychosocial subtypes and neuropsychological functioning at three age levels. Unpublished doctoral dissertation, University of Windsor, Ontario.Google Scholar
Fuerst, D.R., Fisk, J.L., & Rourke, B.P. (1990). Psychosocial functioning of learning-disabled children: Relations between WISC Verbal IQ-Performance discrepancies and personality subtypes. Journal of Consulting and Clinical Psychology, 58, 657660.10.1037/0022-006X.58.5.657CrossRefGoogle ScholarPubMed
Gerring, J.P., Brady, K.D., Chen, A., Vasa, R., Grados, M., Bandeen-Roche, K.J., Bryan, R.N., & Denckla, M. (1998). Premorbid prevalence of ADHD and development of secondary ADHD after closed head injury. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 647654.10.1097/00004583-199806000-00015CrossRefGoogle ScholarPubMed
Green, M.L., Foster, M.A., Morris, M.K., Muir, J.J., & Morris, R.D. (1998). Parent assessment of psychological and behavioral functioning following pediatric acquired brain injury. Journal of Pediatric Psychology, 23, 289299.CrossRefGoogle ScholarPubMed
Knights, R.M., Ivan, L.P., Ventureyra, E.C.G., Bentivoglio, C., Stoddart, C., Winogron, W., & Bawden, H.N. (1991). The effects of head injury in children on neuropsychological and behavioral functioning. Brain Injury, 5, 339351.10.3109/02699059109008107CrossRefGoogle Scholar
Kraus, J.F. (1995). Epidemiological features of brain injury in children: Occurrence, children at risk, causes and manner of injury, severity, and outcomes. In Broman, S.H. & Michel, M.E. (Eds.), Traumatic head injury in children (pp. 2239). New York: Oxford University Press.Google Scholar
Light, R., Asarnow, R., Satz, P., Zaucha, K., McCleary, C., & Lewis, R. (1998). Mild closed-head injury in children and adolescents: Behavior problems and academic outcomes. Journal of Consulting and Clinical Psychology, 66, 10231029.10.1037/0022-006X.66.6.1023CrossRefGoogle ScholarPubMed
Max, J.E., Lindgren, S.D., Knutson, C., Pearson, C.S., Ihrig, D., & Welborn, A. (1997a). Child and adolescent traumatic brain injury: Psychiatric findings from a pediatric outpatient specialty clinic. Brain Injury, 11, 699711.Google Scholar
Max, J.E., Robin, D., Lindgren, S.D., Smith, W.L., Sato, U., Mattheis, P.J., Stierwalt, J.A.G., & Castillo, C. (1997b). Traumatic brain injury in children and adolescents: Psychiatric disorders at two years. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 12781285.CrossRefGoogle Scholar
Max, J.E., Koele, S.L., Castillo, C.C., Lindgren, S.D., Arndt, S., Bokura, H., Robin, D., Smith, W.L., & Sato, Y. (2000). Personality change disorder in children and adolescents following traumatic brain injury. Journal of the International Neuropsychological Society, 6, 279289.CrossRefGoogle ScholarPubMed
Michaud, L.J., Rivara, F.P., Jaffe, K.M., Gay, G., & Dailey, J.L. (1993). TBI as a risk factor for behavioral disorders in children. Archives of Physical Medicine and Rehabilitation, 74, 368374.Google Scholar
Pelco, L., Sawyer, M., Duffield, G., Prior, M., & Kinsella, G. (1992). Premorbid emotional and behavioral adjustment in children with mild head injuries. Brain Injury, 6, 2937.10.3109/02699059209008119CrossRefGoogle ScholarPubMed
Porter, J.E. & Rourke, B.P. (1985). Personality and socioemotional dimensions of learning disabilities in children. In Rourke, B.P. (Ed.), Neuropsychology of learning disabilities: Essentials of subtype analysis (pp. 257280). New York: Guilford Press.Google Scholar
Rivara, J.B., Jaffe, K.M., Polissar, N.L., Fay, G.C., Martin, K.M., Shurtleff, H.A., & Liao, S. (1994). Family functioning and children's academic performance and behavior problems in the year following traumatic brain injury. Archives of Physical and Rehabilitation Medicine, 75, 369379.CrossRefGoogle ScholarPubMed
Rourke, B.P. & Fuerst, D.R. (1991). Learning disabilities and psychosocial functioning: A neuropsychological perspective. New York: Guilford Press.Google Scholar
Satz, P., Zaucha, K., McCleary, C., Light, R., Asarnow, R., & Becker, D. (1997). Mild head injury in children and adolescents: A review of studies (1970–1995). Psychological Bulletin, 122, 107131.CrossRefGoogle ScholarPubMed
Shaffer, D. (1995). Behavioral sequelae of head injury: The British studies. In Broman, S.H. & Michel, M.E. (Eds.), Traumatic head injury in children (pp. 5569). New York: Oxford University Press.Google Scholar
Shaffer, D., Chadwick, O., & Rutter, M. (1975). Psychiatric outcome of localized head injury in children. Outcome of severe damage to the CNS: Ciba Foundation Symposium (new series), 191210.CrossRefGoogle Scholar
Taylor, H.G., Yeates, K.O., Wade, S.L., Drotar, D., Stancin, T., & Minich, N. (2002). A prospective study of short- and long-term outcomes after traumatic brain injury in children: Behavior and achievement. Neuropsychology, 16, 1527.10.1037/0894-4105.16.1.15CrossRefGoogle Scholar
Tsatsanis, K.D., Fuerst, D.R., & Rourke, B.P. (1997). Psychosocial dimensions of learning disabilities: External validation and relationship with age and academic functioning. Journal of Learning Disabilities, 30, 490502.10.1177/002221949703000505CrossRefGoogle ScholarPubMed
Winogran, H.W., Knights, R.M., & Bawden, H.N. (1984). Neuropsychological deficits following head injury in children. Journal of Clinical Neuropsychology, 6, 269286.CrossRefGoogle Scholar
Yeates, K.O., Taylor, H.G., Barry, C.T., Drotar, D., Wade, S.L., & Stancin, T. (2001). Neurobehavioral symptoms in childhood closed-head injuries: Changes in prevalence and correlates during the first year postinjury. Journal of Pediatric Psychology, 26, 7991.CrossRefGoogle ScholarPubMed