TY  - JOUR
PY  - 2022//
TI  - A prospective cohort study of the association between preinjury psychosocial function and postconcussive symptoms in pediatric mild traumatic brain injury: an A-CAP study
JO  - Journal of head trauma rehabilitation
A1  - Doan, Quynh
A1  - Chadwick, Leah
A1  - Tang, Ken
A1  - Brooks, Brian L.
A1  - Beauchamp, Miriam
A1  - Zemek, Roger
A1  - Craig, William
A1  - Gravel, Jocelyn
A1  - Yeates, Keith Owen
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVE: We evaluated the moderating effect of preinjury psychosocial function on postconcussion symptoms for children with mild traumatic brain injury (mTBI). DESIGN, SETTING, AND POPULATION: We conducted a prospective cohort study of children ages 8.0 to 16.9 years with mTBI (n = 633) or orthopedic injury (OI; n = 334), recruited from 5 pediatric emergency departments from September 2016 to December 2018. MAIN MEASURES: Participants completed baseline assessments within 48 hours of injury, and postconcussion symptoms assessments at 7 to 10 days, weekly to 3 months, and biweekly to 6 months post-injury. Preinjury psychosocial function was measured using parent ratings on the Pediatric Quality of Life Inventory (PedsQL) and the Strengths and Difficulties Questionnaire (SDQ), retrospectively evaluating their child's status prior to the injury. Parent and child ratings on the Health and Behavior Inventory (HBI) (cognitive and somatic subscales) and the Post-Concussion Symptom Interview (PCS-I) were used as measures of postconcussion symptoms. We fitted 6 longitudinal regression models, which included 747 to 764 participants, to evaluate potential interactions between preinjury psychosocial function and injury group as predictors of child- and parent-reported postconcussion symptoms. <br><br>RESULTS: Preinjury psychosocial function moderated group differences in postconcussion symptoms across the first 6 months post-injury. Higher emotional and conduct problems were significantly associated with more severe postconcussion symptoms among children with mTBI compared with OI. Wald's χ2 for interaction terms (injury group × SDQ subscales) ranged from 6.3 to 10.6 (P values <.001 to.043) across parent- and child-reported models. In contrast, larger group differences (mTBI > OI) in postconcussion symptoms were associated with milder hyperactivity (Wald's χ2: 15.3-43.0, all P <.001), milder peer problems (Wald's χ2: 11.51, P =.003), and higher social functioning (Wald's χ2: 12.435, P =.002). <br><br>CONCLUSIONS: Preinjury psychosocial function moderates postconcussion symptoms in pediatric mTBI, highlighting the importance of assessing preinjury psychosocial function in children with mTBI.<p />  <p>Language: en</p>
LA  - en
SN  - 0885-9701
UR  - http://dx.doi.org/10.1097/HTR.0000000000000853
ID  - ref1
ER  -