Citation

Truss K, Godfrey C, Takagi M, Babl FE, Bressan S, Hearps SJ, Clarke C, Dunne K, Anderson V. J. Neurotrauma 2017; 34(14): 2272-2279.

Affiliation

Royal Childrens Hospital, Psychology Service, Melbourne, Victoria, Australia ; vicki.anderson@rch.org.au.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4842

PMID

28293983

Abstract

A substantial minority of children experience posttraumatic stress symptoms (PTSS) following injury. Research indicates variation in the trajectory of PTSS following pediatric injury, but investigation of PTSS following concussion has assumed homogeneity. This study aimed to identify differential trajectories of PTSS following pediatric concussion and to investigate risk-factors, including acute post-concussive symptoms (PCS), associated with these trajectories. 120 children aged 8-18 years reported PTSS for 3 months following concussion diagnosis using the Child PTSD Symptom Scale, with a score of 16 or above indicating probable PTSD diagnosis. Age, gender, injury mechanism, loss of consciousness, previous concussions, prior hospitalisation, prior diagnosis of depression or anxiety, and acute PCS were assessed as risk-factors. Data were analysed using group-based trajectory modelling.

RESULTS revealed 16% of children had clinically significant PTSS 2 weeks post-concussion, declining to 10% at 1 month and 6% at 3 months post-injury. Group-based trajectory modelling identified three trajectories of PTSS post-concussion: 'resilient' (70%); 'recovering' (25%), in which children experienced elevated acute symptoms that declined over time; and 'chronic symptomatology' (5%). Due to small size, the chronic group should be interpreted with caution. Higher acute PCS and prior diagnosis of depression or anxiety both significantly increased predicted probability of recovering trajectory group membership. These findings establish that most children are resilient to PTSS following concussion, but that PTSS do occur acutely in a substantial minority of children. The study indicates mental health factors, particularly PTSS, depression, and anxiety, should be considered integral to models of concussion management and treatment.

Language: en

Keywords

NEUROPSYCHOLOGY; PEDIATRIC BRAIN INJURY; TRAUMATIC BRAIN INJURY