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Cognitive outcome in children and adolescents following severe traumatic brain injury: Influence of psychosocial, psychiatric, and injury-related variables

Published online by Cambridge University Press:  01 January 1999

JEFFREY E. MAX
Affiliation:
Department of Psychiatry, University of Iowa, Iowa City, IA
MARY ANN ROBERTS
Affiliation:
Department of Pediatrics, University of Iowa, Iowa City, IA
SHARON L. KOELE
Affiliation:
Department of Psychiatry, University of Iowa, Iowa City, IA
SCOTT D. LINDGREN
Affiliation:
Department of Pediatrics, University of Iowa, Iowa City, IA
DONALD A. ROBIN
Affiliation:
Department of Speech Pathology and Audiology, University of Iowa, Iowa City, IA
STEPHAN ARNDT
Affiliation:
Department of Psychiatry, University of Iowa, Iowa City, IA
WILBUR L. SMITH
Affiliation:
Department of Radiology, University of Iowa, Iowa City, IA
YUTAKA SATO
Affiliation:
Department of Radiology, University of Iowa, Iowa City, IA

Abstract

Previous studies of childhood traumatic brain injury (TBI) have emphasized injury-related variables rather than psychiatric or psychosocial factors as correlates of cognitive outcomes. We addressed this concern by recruiting a consecutive series (N = 24) of children age 5 through 14 years who suffered a severe TBI, a matched group who sustained a mild TBI, and a second matched group who sustained an orthopedic injury. Standardized intellectual, memory, psychiatric, family functioning, family psychiatric history, neurological, and neuroimaging assessments were conducted at an average of 2 years following injury. Severe TBI, when compared to mild TBI and orthopedic injury, was associated with significant decrements in intellectual and memory function. A principal components analysis of independent variables that showed significant (p < .05) bivariate correlations with the outcome measures yielded a neuropsychiatric factor encompassing severity of TBI indices and postinjury psychiatric disorders and a psychosocial disadvantage factor. Both factors were independently and significantly related to intellectual and memory function outcome. Postinjury psychiatric disorders added significantly to severity indices and family functioning and family psychiatric history added significantly to socioeconomic status in explaining several specific cognitive outcomes. These results may help to define subgroups of children who will require more intensive services following their injuries. (JINS, 1999, 5, 58–68.)

Type
Research Article
Copyright
© 1999 The International Neuropsychological Society

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