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Evolution and factors associated with pediatric post-traumatic stress disorder 1 year after mild traumatic brain
Sharon Barak1,2, Maya Miriam Gerner2, Ety Berant3
1Department of Nursing, Faculty of Health Science, Ariel University, Ariel.
Insights
Mild traumatic brain injury (mTBI) can cause long-term post-traumatic stress disorder (PTSD) or symptoms (PTSS). One year after mTBI, 20% of youth still had PTSD, highlighting the need for ongoing monitoring.
Area of Science:
- Neuroscience
- Pediatrics
- Psychology
Background:
- Mild traumatic brain injury (mTBI) can result in persistent adverse outcomes, including post-traumatic stress disorder (PTSD) and post-traumatic stress symptoms (PTSS).
- Understanding the long-term evolution of PTSD and PTSS after pediatric mTBI is crucial for effective management.
Purpose of the Study:
- To investigate the occurrence and long-term trajectory of PTSD and PTSS in youth following mTBI.
- To identify factors associated with the development and persistence of PTSD and PTSS.
Main Methods:
- A cohort of 85 youth (median age 10) and their mothers were assessed shortly after mTBI (T1) and 1 year later (T2).
- Assessments included PTSS/PTSD, postconcussion symptoms, loss of consciousness, child anxiety, and maternal mental health.
- Statistical analyses included Wilcoxon test, correlations, partial correlations, and calculation of PTSD recovery trajectories (chronic, delayed, recovery, resilience).
Main Results:
- PTSS and PTSD rates significantly decreased from T1 (34%) to T2 (21%).
- PTSS at T2 was significantly correlated with PTSS and postconcussion symptoms at T1 (r=0.60, 0.32, 0.37).
- Most youth exhibited 'resilient' (40%) or 'recovery' (35%) trajectories; only 6% showed 'delayed' recovery. 20% still experienced PTSD at T2.
Conclusions:
- A significant proportion of youth continue to experience enduring PTSD or PTSS one year after mTBI.
- Early PTSS and postconcussion symptoms are predictive of later PTSS.
- Long-term monitoring of youth following mTBI is essential to address persistent psychological sequelae.
Abstract:
Mild traumatic brain injury (mTBI) can lead to lasting adverse outcomes, including post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS). This study examined whether PTSD and PTSS can occur even after mTBI and tracked the evolution of PTSD in the long term. A total of 85 youth post-mTBI (median age: 10.00, 25-75th percentile: 8.50-2.62; 24% girls) and their mothers participated in this study. Assessments included PTSS/PTSD, postconcussion symptoms, loss of consciousness status, child's anxiety, and maternal mental health, both shortly after mTBI (T1) and 1 year later (T2). Changes in PTSS scores from T1 to T2 were evaluated using the Wilcoxon test. T2 PTSS evolution was evaluated using correlations and partial correlations. To evaluate PTSD recovery trajectories, the percentage of youth in four recovery trajectories (chronic, delayed, recovery, and resilience) was calculated. Results showed a significant decrease in PTSS and PTSD rates from T1 (34%) to T2 (21%). PTSS at T2 was associated with PTSS and postconcussion symptoms at T1. After accounting for the child's sociodemographic and clinical characteristics, the child's self-reported PTSS at T1, along with self-reported postconcussion symptoms and symptom intensity, showed significant correlations with PTSS at T2 ( r = 0.60, 0.32, and 0.37, respectively; P < 0.05). Most youth fell into the 'resilient' (40%) or 'recovery' (35%) groups, with only 6% showing 'delayed' recovery. One year after mTBI, 20% of the youth still experienced PTSD. In conclusion, this study highlights the need for long-term monitoring of youth after mTBI, as a notable proportion continue to experience enduring PTSD or PTSS.
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