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Published on: November 19, 2012
Family adaptation 18 months after traumatic brain injury in early childhood
Terry Stancin1, Shari L Wade, Nicolay C Walz
1Department of Psychiatry, Division of Pediatric Psychology, MetroHealth Medical Center, Cleveland, OH 44109, USA. tstancin@metrohealth.org
Insights
Young children with severe traumatic brain injury (TBI) experience significant family stress, which lessens over time and is influenced by social resources. This study compared TBI adaptation to orthopedic injuries.
Area of Science:
- Pediatric Neurotrauma
- Family Psychology
- Rehabilitation Medicine
Background:
- Traumatic brain injury (TBI) in young children presents unique challenges for families.
- Understanding family adaptation is crucial for effective support and intervention.
- Longitudinal studies are needed to track the impact of TBI on family functioning over time.
Purpose of the Study:
- To compare family adaptation to traumatic brain injury (TBI) in young children with adaptation to orthopedic injuries.
- To examine the trajectory of family functioning and parental distress during the first 18 months post-injury.
- To identify factors that moderate the impact of TBI on families.
Main Methods:
- A prospective, concurrent cohort study followed 99 children with TBI and 117 with orthopedic injuries (ages 3-6).
- Repeated assessments at baseline, 6, 12, and 18 months post-injury included standardized measures of family functioning, parental distress, coping, and injury burden.
- Mixed-effects models were used to analyze group differences in parental burden and distress, controlling for demographic factors.
Main Results:
- Moderate and severe TBI were associated with higher injury-related stress compared to orthopedic injuries, with stress decreasing over time.
- Severe TBI correlated with increased psychological distress but not necessarily depressive symptoms.
- Family functioning and social resources moderated the impact of TBI severity on burden and distress, respectively.
Conclusions:
- Severe TBI in young children leads to adverse family consequences in the initial 18 months post-injury.
- These consequences tend to diminish over time for many families.
- The impact of TBI on families is influenced by the availability of social resources.
Objective:
The purpose of this study was to examine family adaptation to a traumatic brain injury (TBI) in young children during the first 18-month postinjury, when compared with children who had an orthopedic injury.
Methods:
A concurrent cohort/prospective research design was used with repeated assessments of children aged 3 to 6 years with TBI or orthopedic injury requiring hospitalization and their families. Shortly after injury and at 6-, 12-, and 18-month postinjury, parents of 99 children with TBI (20 severe, 64 moderate, 15 mild) and 117 with orthopedic injury completed standardized assessments of family functioning, parental distress and coping, injury-related burden, and noninjury-related parent stressors and resources. Mixed models analyses examined group differences in parental burden and distress adjusted for race and social demographic factors.
Results:
Both moderate and severe TBI were associated with higher levels of injury-related stress than orthopedic injury, with stress levels diminishing over time in all groups. Severe TBI was also associated with greater psychological distress on the Brief Symptom Inventory but not with more depressive symptoms. Family functioning and social resources moderated the relationship of TBI severity to injury-related burden and caregiver distress, respectively. Lower child adaptive skills were associated with poorer family outcome but group differences remained even when controlling for this effect.
Conclusions:
Severe TBI in young children has adverse consequences for parents and families during the first 18-month postinjury. The consequences lessen over time for many families and vary as a function of social resources.
