Tara Rhine1, Amy Cassedy, Keith Owen Yeates, Hudson Gerry Taylor, Michael W Kirkwood, Shari L Wade. 1. Division of Pediatric Emergency Medicine, Department of Pediatrics (Dr Rhine), Division of Biostatistics and Epidemiology (Dr Cassedy), and Division of Physical Medicine and Rehabilitation (Dr Wade), Cincinnati Children's Hospital Medical Center, Ohio; University of Calgary, Alberta, Canada (Dr Yeates); Rainbow Babies & Children's Hospital, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio (Dr Taylor); and Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora (Dr Kirkwood).
Abstract
OBJECTIVE: To identify potentially modifiable individual and social-environmental correlates of posttraumatic stress symptoms (PTSS) among adolescents hospitalized for traumatic brain injury (TBI). SETTING: Four pediatric hospitals and 1 general hospital in the United States. PARTICIPANTS: Children ages 11 to 18 years, hospitalized for moderate-severe TBI within the past 18 months. DESIGN: Retrospective cross-sectional analysis. MAIN MEASURES: The University of California at Los Angeles (UCLA) Post-traumatic Stress Disorder (PTSD) Reaction Index and the Youth Self-Report (YSR) PTSD subscale. RESULTS: Of 147 adolescents enrolled, 65 (44%) had severe TBI, with an average time since injury of 5.8 ± 4 months. Of the 104 who completed the UCLA-PTSD Reaction Index, 22 (21%) reported PTSS and 9 (8%) met clinical criteria for PTSD. Of the 143 who completed the YSR-PTSD subscale, 23 (16%) reported PTSS and 6 (4%) met clinical criteria for PTSD. In multivariable analyses, having a negative approach to problem solving and depressive symptoms were both associated (P < .001) with higher levels of PTSS based on the UCLA-PTSD Reaction Index (β = 0.41 and β = 0.33, respectively) and the YSR-PTSD subscale (β = 0.33 and β = 0.40, respectively). CONCLUSION: Targeting negative aspects of problem solving in youths after brain injury may mitigate PTSS.
OBJECTIVE: To identify potentially modifiable individual and social-environmental correlates of posttraumatic stress symptoms (PTSS) among adolescents hospitalized for traumatic brain injury (TBI). SETTING: Four pediatric hospitals and 1 general hospital in the United States. PARTICIPANTS: Children ages 11 to 18 years, hospitalized for moderate-severe TBI within the past 18 months. DESIGN: Retrospective cross-sectional analysis. MAIN MEASURES: The University of California at Los Angeles (UCLA) Post-traumatic Stress Disorder (PTSD) Reaction Index and the Youth Self-Report (YSR) PTSD subscale. RESULTS: Of 147 adolescents enrolled, 65 (44%) had severe TBI, with an average time since injury of 5.8 ± 4 months. Of the 104 who completed the UCLA-PTSD Reaction Index, 22 (21%) reported PTSS and 9 (8%) met clinical criteria for PTSD. Of the 143 who completed the YSR-PTSD subscale, 23 (16%) reported PTSS and 6 (4%) met clinical criteria for PTSD. In multivariable analyses, having a negative approach to problem solving and depressive symptoms were both associated (P < .001) with higher levels of PTSS based on the UCLA-PTSD Reaction Index (β = 0.41 and β = 0.33, respectively) and the YSR-PTSD subscale (β = 0.33 and β = 0.40, respectively). CONCLUSION: Targeting negative aspects of problem solving in youths after brain injury may mitigate PTSS.
Authors: Brad G Kurowski; H Gerry Taylor; Kelly A McNally; Michael W Kirkwood; Amy Cassedy; Paul S Horn; Terry Stancin; Shari L Wade Journal: J Head Trauma Rehabil Date: 2020 May/Jun Impact factor: 3.117