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Predictors of family functioning after traumatic brain injury in children and adolescents
J E Max1, C S Castillo, D A Robin
1Department of Psychiatry, University of Iowa, Iowa City, USA.
Insights
Pre-existing family issues and new psychiatric disorders in children significantly impact family functioning after traumatic brain injury (TBI). Early intervention for child psychopathology and family dysfunction can improve outcomes.
Area of Science:
- Pediatric neurology
- Child psychology
- Family studies
Background:
- Traumatic brain injury (TBI) in children can lead to long-term family challenges.
- Understanding factors influencing family outcome post-TBI is crucial for effective support.
Purpose of the Study:
- To identify predictors of family functioning in the two years following pediatric TBI.
- To inform clinical assessments and interventions for at-risk families.
Main Methods:
- Prospective follow-up of 6-14 year olds hospitalized with TBI.
- Assessment of pre-injury, injury, and post-injury factors using standardized clinical scales.
- Family functioning evaluated via interviews and caretaker questionnaires at 3, 6, 12, and 24 months post-TBI.
Main Results:
- Pre-injury family functioning, development of new psychiatric disorders in the child, and pre-injury life events were strongest predictors.
- These factors significantly influenced family functioning up to 24 months after TBI.
Conclusions:
- Families at risk for dysfunction after childhood TBI can be identified clinically.
- Early identification and treatment of child psychopathology and family dysfunction may reduce negative impacts.
Objective:
To assess factors predictive of family outcome in the first 2 years after traumatic brain injury (TBI) in children and adolescents.
Method:
Subjects were children aged 6 to 14 at the time they were hospitalized after TBI. The study used a prospective follow-up design. Assessments of preinjury factors (psychiatric family functioning, and family life events), injury factors (severity of injury), and postinjury factors (coping and development of a psychiatric disorder, never before present, i.e., "novel") were conducted using standard clinical scales. The outcome measure was family function as assessed with standardized family functioning interviews (at 12 and 24 months after TBI) and primary caretaker self-report questionnaires (at 3 and 6 months after TBI).
Results:
Fifty subjects enrolled, and the analyses focused on 37, 41, 43, and 42 subjects assessed at the 3-, 6-, 12-, and 24-month follow-up evaluations, respectively. The strongest influences on family functioning after childhood TBI are preinjury family functioning, the development of a "novel" psychiatric disorder in the child, and preinjury family life events or stressors.
Conclusions:
These data suggest that there are families, identifiable through clinical assessment, at increased risk for family dysfunction after a child's TBI. Early identification and treatment of the child's psychopathology and family dysfunction may attenuate the associated morbidity.