Megan E Narad1,2, Eloise E Kaizar3, Nanhua Zhang4, H Gerry Taylor5,6, Keith Owen Yeates7,8,9, Brad G Kurowski10,11, Shari L Wade2,9. 1. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 2. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH. 3. Department of Statistics, The Ohio State University, Columbus, OH. 4. Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine. 5. Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH. 6. Department of Pediatrics, the Ohio State University, Columbus, OH. 7. Department of Psychology, University of Calgary, Calgary, Alberta, Canada. 8. Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada. 9. Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada. 10. Division of Physical Medicine & Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; and. 11. Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH.
Abstract
OBJECTIVE: The objective of this study was to examine the impact of preinjury attention-deficit/hyperactivity disorder (PADHD) and secondary ADHD (SADHD) on outcomes after pediatric traumatic brain injury (TBI). METHODS: Two hundred eighty-four individuals aged 11 to 18 years hospitalized overnight for a moderate-to-severe TBI were included in this study. Parents completed measures of child behavior and functioning and their own functioning. Linear models examined the effect of ADHD status (PADHD vs SADHD vs no ADHD) on the child's executive functioning (EF), social competence, and functional impairment, and parental depression and distress. RESULTS: ADHD status had a significant effect on EF [F(2,269] = 9.19, p = 0.0001), social competence (F[2,263] = 32.28, p < 0.0001), functional impairment (F[2,269] = 16.82, p < 0.0001), parental depression (F[2,263] = 5.53, p = 0.005), and parental distress (F[2,259] = 3.57, p = 0.03). PADHD and SADHD groups had greater EF deficits, poorer social competence, and greater functional impairment than the no ADHD group. The SADHD group had greater levels of parental depression than the no ADHD and PADHD groups, and the SADHD group had higher parental distress than the no ADHD group. CONCLUSION: The results highlight the importance of early identification and management of ADHD symptoms after injury to mitigate downstream functional problems. Supporting parents managing new-onset ADHD symptoms may also be important.
OBJECTIVE: The objective of this study was to examine the impact of preinjury attention-deficit/hyperactivity disorder (PADHD) and secondary ADHD (SADHD) on outcomes after pediatric traumatic brain injury (TBI). METHODS: Two hundred eighty-four individuals aged 11 to 18 years hospitalized overnight for a moderate-to-severe TBI were included in this study. Parents completed measures of child behavior and functioning and their own functioning. Linear models examined the effect of ADHD status (PADHD vs SADHD vs no ADHD) on the child's executive functioning (EF), social competence, and functional impairment, and parental depression and distress. RESULTS: ADHD status had a significant effect on EF [F(2,269] = 9.19, p = 0.0001), social competence (F[2,263] = 32.28, p < 0.0001), functional impairment (F[2,269] = 16.82, p < 0.0001), parental depression (F[2,263] = 5.53, p = 0.005), and parental distress (F[2,259] = 3.57, p = 0.03). PADHD and SADHD groups had greater EF deficits, poorer social competence, and greater functional impairment than the no ADHD group. The SADHD group had greater levels of parental depression than the no ADHD and PADHD groups, and the SADHD group had higher parental distress than the no ADHD group. CONCLUSION: The results highlight the importance of early identification and management of ADHD symptoms after injury to mitigate downstream functional problems. Supporting parents managing new-onset ADHD symptoms may also be important.
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