OBJECTIVE: Paediatric severe traumatic brain injury (TBI) is associated with significant post-injury affective and behavioural problems. Few studies have examined the prevalence and characteristics of affective lability after paediatric TBI. METHODS: Ninety-seven children with severe TBI were evaluated 1 year post-injury for the presence of affective lability using the Children's Affective Lability Scale (CALS). Demographic, clinical and brain lesion characteristics were also assessed. RESULTS: Affective lability significantly increased after injury. Eighty-six children had a pre-injury CALS score of 1 SD or less from the group pre-injury mean (M = 8.11, SD = 9.31), of which 35 and 15 children had a 1 SD and 2 SD increase in their CALS score from pre- to post-injury, respectively. A variety of affective shifts manifested post-injury including anxiety, silliness, dysphoria and irritability. The most severe symptoms were irritability and unpredictable temper outbursts. Risk factors for affective lability included elevated pre-injury affective lability and psychosocial adversity as well as greater damage to the orbitofrontal cortex. Post-injury affective lability was most frequently associated with a post-injury diagnosis of attention-deficit hyperactivity disorder. CONCLUSIONS: Affective lability is common after paediatric TBI and frequently manifests as irritability and unpredictable outbursts. Early intervention is needed to improve psychiatric outcomes.
OBJECTIVE: Paediatric severe traumatic brain injury (TBI) is associated with significant post-injury affective and behavioural problems. Few studies have examined the prevalence and characteristics of affective lability after paediatric TBI. METHODS: Ninety-seven children with severe TBI were evaluated 1 year post-injury for the presence of affective lability using the Children's Affective Lability Scale (CALS). Demographic, clinical and brain lesion characteristics were also assessed. RESULTS: Affective lability significantly increased after injury. Eighty-six children had a pre-injury CALS score of 1 SD or less from the group pre-injury mean (M = 8.11, SD = 9.31), of which 35 and 15 children had a 1 SD and 2 SD increase in their CALS score from pre- to post-injury, respectively. A variety of affective shifts manifested post-injury including anxiety, silliness, dysphoria and irritability. The most severe symptoms were irritability and unpredictable temper outbursts. Risk factors for affective lability included elevated pre-injury affective lability and psychosocial adversity as well as greater damage to the orbitofrontal cortex. Post-injury affective lability was most frequently associated with a post-injury diagnosis of attention-deficit hyperactivity disorder. CONCLUSIONS: Affective lability is common after paediatric TBI and frequently manifests as irritability and unpredictable outbursts. Early intervention is needed to improve psychiatric outcomes.
Authors: Kevin N Ochsner; Rebecca D Ray; Jeffrey C Cooper; Elaine R Robertson; Sita Chopra; John D E Gabrieli; James J Gross Journal: Neuroimage Date: 2004-10 Impact factor: 6.556
Authors: J E Max; S L Koele; C C Castillo; S D Lindgren; S Arndt; H Bokura; D A Robin; W L Smith; Y Sato Journal: J Int Neuropsychol Soc Date: 2000-03 Impact factor: 2.892
Authors: Keith Owen Yeates; Kira Armstrong; Jennifer Janusz; H Gerry Taylor; Shari Wade; Terry Stancin; Dennis Drotar Journal: J Am Acad Child Adolesc Psychiatry Date: 2005-06 Impact factor: 8.829
Authors: Ellen Leibenluft; Patricia Cohen; Tristan Gorrindo; Judith S Brook; Daniel S Pine Journal: J Child Adolesc Psychopharmacol Date: 2006-08 Impact factor: 2.576
Authors: Nicole D Osier; James W Bales; Bunny Pugh; Samuel Shin; Julie Wyrobek; Ava M Puccio; David O Okonkwo; Dianxu Ren; Sheila Alexander; Yvette P Conley; C Edward Dixon Journal: J Neurotrauma Date: 2016-06-27 Impact factor: 5.269
Authors: Ole Kristian Drange; Arne Einar Vaaler; Gunnar Morken; Ole Andreas Andreassen; Ulrik Fredrik Malt; Per Ivar Finseth Journal: Int J Bipolar Disord Date: 2018-09-10