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Disruptive behaviour disorders and disruptive symptoms after severe paediatric traumatic brain injury

Joan P Gerring1, Marco A Grados, Beth Slomine

  • 1Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. jgerring@jhmi.edu

Brain Injury
|October 17, 2009
PubMed

Insights

Severe pediatric traumatic brain injury (TBI) can lead to new-onset oppositional defiant disorder (ODD) and conduct disorder (CD). Pre-existing conduct disorder and psychosocial adversity are key risk factors for these disruptive behaviors post-TBI.

Area of Science:

  • Neuroscience
  • Child Psychiatry
  • Developmental Psychology

Background:

  • Oppositional defiant disorder (ODD) and conduct disorder (CD) are disruptive behavioral disorders.
  • Severe pediatric traumatic brain injury (TBI) can impact neurodevelopment and behavior.
  • Understanding the trajectory of ODD and CD after TBI is crucial for intervention.

Purpose of the Study:

  • To determine the pre-injury prevalence and post-injury incidence of ODD and CD in children with severe TBI.
  • To assess the increase in disruptive symptoms following severe pediatric TBI.
  • To identify risk factors associated with the development of these behavioral disturbances.

Main Methods:

  • A cohort of 94 children with severe TBI was followed for one year post-injury.
  • Parental reports were used to assess psychiatric status pre-injury and at one year post-injury.
  • The primary outcome measure was the 1-year incidence of disruptive behavior disorders and symptoms.

Main Results:

  • Pre-injury prevalence of ODD and CD was 6% and 8%, respectively, with CD being higher than reference populations.
  • One-year post-injury incidence of new-onset ODD and CD was 9% and 8%, respectively, with CD incidence significantly higher than reference populations.
  • Significant increases in ODD symptoms and total disruptive symptoms were observed in the first year post-TBI. Higher pre-injury psychosocial adversity, delinquency, and affective lability were significant risk factors.

Conclusions:

  • Pre-injury conduct disorder is a significant predictor of post-injury disruptive behaviors.
  • New-onset CD and disruptive symptoms are direct consequences of TBI observed at one year post-injury.
  • Risk factors for these post-TBI behavioral disturbances are comparable to those in non-TBI populations.
Abstract

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