scholarly journals Psychological Outcome in Young Survivors of Severe TBI: A Cross-Informant Comparison

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Karoline Doser ◽  
Ingrid Poulsen ◽  
Anne Norup

Objective. To investigate the psychological outcome and the agreement between self-ratings and proxy-ratings in young individuals after severe traumatic brain injury (TBI).Methods. Twenty pairs of former patients who sustained a severe TBI in their adolescence or early adulthood and their significant others (SOs) were contacted around 66 months after injury to complete a measure of psychological and behavioral problems. The Adult Self-Report 18–59 and the Adult Behavior Checklist 18–59 were used.Results. Results showed significant differences compared to the normative sample in the domains withdrawal, attention, and intrusive and internalizing problems. Good or excellent levels of agreement were found between the self-rating and the proxy-rating in overt areas such as somatic complaints and aggressive and intrusive behavior. Fair or poor levels of agreement were found in nonovert areas such as anxiety and depression, withdrawal, thought and attention problems, and personal strength.Conclusion. The findings show that young patients experience psychological dysfunction. Our study suggests that the use of either a self-rating or a proxy-rating would be appropriate for evaluating overt domains, regarding the good to excellent levels of agreement. However, in nonovert domains, such as withdrawal and attention, an additional proxy-rating from a SO could provide supplementary information and build a more complete objective assessment.

2018 ◽  
Vol 6 (10) ◽  
pp. 35 ◽  
Author(s):  
Ihab Zubeidat ◽  
Waleed Dallasheh ◽  
Antonio Fernández-Parra ◽  
Juan Carlos Sierra ◽  
José María Salinas

The Youth Self-Report (YSR/11-18) is a widely used child-report measure that assesses problem behaviors along two “broadband scales”: internalizing and externalizing. It also scores eight empirically based syndromes and DSM-oriented scales and provides a summary of total problems. Although the YSR was designed for youths ages 11-18, no studies have systematically evaluated whether youths under the age of 11 can make valid reports using the YSR broad-band, syndrome and DSM-oriented scales. It is a parallel form to the caretaker-completed Child Behavior Checklist (CBCL) and teacher-completed Teacher Report Form (TRF). Few studies related to YSR/11-18 (Achenbach, & Rescorla, 2000, 2001) factor structure were carried out in Spanish children and adolescent population. This study analyses the factor structure of this assessment tool, in 961 Spanish adolescents attending school from 13 to 18 years old. A principal components method was used to extract the factors followed by a Varimax rotation. According to current research, each sex was treated separately, and only items referred to misbehavior (105 out of 119) were included. Seven first-order common factors were found in both, boys and girls: Anxious/Depressed, Somatic Complaints, Delinquent Behavior, Aggressive Behavior, Attention Problems, Thought Problems and Relational Problems. Factoring of these seven syndromes led to a single second-order factor in younger males. Older males and females showed labeled internalize and externalize symptoms. These results resembled that obtained in former studies with Spanish population.


2013 ◽  
Vol 19 (7) ◽  
pp. 829-834 ◽  
Author(s):  
Ruth E. Sumpter ◽  
Liam Dorris ◽  
Thomas Kelly ◽  
Thomas M. McMillan

AbstractThe objective of this study is to systematically investigate sleep following moderate–severe pediatric traumatic brain injury (TBI). School-aged children with moderate–severe TBI identified via hospital records were invited to participate, along with a school-age sibling. Subjective reports and objective actigraphy correlates of sleep were recorded: Children's Sleep Habits Questionnaire (CSHQ), Sleep Self-Report questionnaire (SSR), and 5-night actigraphy. TBI participants (n= 15) and their siblings (n= 15) participated. Significantly more sleep problems were parent-reported (CSHQ:p= 0.003;d= 1.57), self-reported (SSR:p= 0.003;d= 1.40), and actigraph-recorded in the TBI group (sleep efficiency:p= 0.003;d= 1.23; sleep latency:p= 0.018;d= 0.94). There was no evidence of circadian rhythm disorders, and daytime napping was not prevalent. Moderate–severe pediatric TBI was associated with sleep inefficiency in the form of sleep onset and maintenance problems. This preliminary study indicates that clinicians should be aware of sleep difficulties following pediatric TBI, and their potential associations with cognitive and behavioral problems in a group already at educational and psychosocial risk. (JINS, 2013,19, 1–6)


2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Sarvani

The present study is to find out the influence of organizational care and support on emotional and behavioral problems of sheltered street children. The sample consist 444 respondents. 176 are from government shelters, and 268 are from non¬ government shelters. For this purpose of investigation Revised Youth Self Report (RYSR), which is a revised form of Youth Self Report (YSR) is an English form of age 11-18 years, devised by Achenbach and Rescorla (2001) and Organizational care and support developed by researcher were used. The data obtained were analyzed through t- test to know the mean difference between the government and non government groups. The street children in government shelters have more behavioral problems such as anxiety, withdrawal, somatic problems, social problems, thought problems, attention problems, rule breaking behavior and aggression than non government sheltered street children. Government sheltered street children have more health problems, and less social support than non government sheltered street children.


2019 ◽  
Author(s):  
Emily L. Dennis ◽  
Karen Caeyenberghs ◽  
Robert F. Asarnow ◽  
Talin Babikian ◽  
Brenda Bartnik-Olson ◽  
...  

Traumatic brain injury (TBI) is a major cause of death and disability in children in both developed and developing nations. Children and adolescents suffer from TBI at a higher rate than the general population; however, research in this population lags behind research in adults. This may be due, in part, to the smaller number of investigators engaged in research with this population and may also be related to changes in safety laws and clinical practice that have altered length of hospital stays, treatment, and access to this population. Specific developmental issues also warrant attention in studies of children, and the ever-changing context of childhood and adolescence may require larger sample sizes than are commonly available to adequately address remaining questions related to TBI. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric Moderate-Severe TBI (msTBI) group aims to advance research in this area through global collaborative meta-analysis. In this paper we discuss important challenges in pediatric TBI research and opportunities that we believe the ENIGMA Pediatric msTBI group can provide to address them. We conclude with recommendations for future research in this field of study.


Author(s):  
Ascensión Fumero ◽  
Rosario J. Marrero ◽  
Alicia Pérez-Albéniz ◽  
Eduardo Fonseca-Pedrero

Bipolar disorder is usually accompanied by a high suicide risk. The main aim was to identify the risk and protective factors involved in suicide risk in adolescents with bipolar experiences. Of a total of 1506 adolescents, 467 (31%) were included in the group reporting bipolar experiences or symptoms, 214 males (45.8%) and 253 (54.2%) females. The mean age was 16.22 (SD = 1.36), with the age range between 14 and 19. Suicide risk, behavioral and emotional difficulties, prosocial capacities, well-being, and bipolar experiences were assessed through self-report. Mediation analyses, taking gender as a moderator and controlling age as a covariate, were applied to estimate suicide risk. The results indicated that the effect of bipolar experiences on suicide risk is mediated by behavioral and emotional difficulties rather than by prosocial behavior and subjective well-being. Specifically, emotional problems, problems with peers, behavior problems, and difficulties associated with hyperactivity were the most important variables. This relationship was not modulated by gender. However, the indirect effects of some mediators varied according to gender. These results support the development of suicide risk prevention strategies focused on reducing emotional difficulties, behavioral problems, and difficulties in relationships with others.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 5541-5541
Author(s):  
Ainhoa Madariaga ◽  
Sandra A. Mitchell ◽  
Tyler Pittman ◽  
Lisa Wang ◽  
Valerie Bowering ◽  
...  

5541 Background: A 4 month improvement in OS was demonstrated when Wee1 inhibitor adavosertib (Ad) and gemcitabine (G; arm A) was compared to G and placebo (P; arm B) in a phase 2 trial in recurrent ovarian cancer (NCT02151292). The patient reported outcome version of the CTCAE (PRO-CTCAE) was used to capture self-report of the frequency, severity and/or interference (scored 0-4; higher scores indicating worse symptomatic adverse events [syAEs]). Methods: Ad/P was given orally on D1-2, D8-9, D15-16 with G D1, D8, D15 in a 28-day cycle. English speaking pts in 2 centres completed PRO-CTCAE items electronically in clinic at baseline, D1 and D15 of each cycle and off treatment. An exploratory objective was to characterize syAEs in the first 3 months of therapy. We calculated 12-week area under the curve (AUC12w) as a measure of syAE over time and incremental AUC12w (iAUC12w) for adjustment to baseline syAEs and compared arms A and B using an independent samples t-test. We assessed proportion of scores 3-4 at 6 time-points and compared them using Fisher’s Exact Test at each survey. Results: 51 pts were enrolled and completed ≥1 survey, 47 were evaluable for primary outcome (arm A: 28, B: 19). ECOG status was ≤1 in 44/47 pts. Median number of cycles of therapy were 5 (1-16) in arm A, and 2 (1-16) in B. Survey completion rates were high (arm A 93%, B 95%). Mean AUC12w fatigue severity (A 152 [standard error 9] vs B 112 [10]; p = 0.005) and interference (A 144 [11] vs 98 [15]; p = 0.018), diarrhea frequency (A 70 [12] vs B 33 [9]; p = 0.014), mucositis (A 23 [6] vs B 6 [3]; p = 0.012) and difficulty swallowing severity (A 10 [3] vs B 2 [2]; p = 0.023) were higher in arm A (any grade). There were no statistically significant between-arm differences in abdominal pain, bloating, nausea, vomiting and anxiety. The iAUC12w was significantly higher in arm A vs B for difficulty swallowing severity (A 10.1 [3] vs B -2.7 [4.7]; p = 0.02), mucositis severity (A 19.9 [6.6] vs B -3.1 [6.9]; p = 0.02) and fatigue severity (A 35.2 [8.2] vs B -3.1 [9.8]; p = 0.005). Proportions with high scores (3-4) were only significantly higher at C1D15 for fatigue severity in arm A (A 55% vs B 19%, p = 0.044). No significant differences were seen in other 3-4 scores per survey time. Conclusions: This is the first study evaluating pts self-reported toxicity with adavosertib in a randomized setting, allowing pts self-evaluation of toxicity in the context of improved PFS and OS. Greater fatigue, diarrhea, mucositis and difficulty swallowing were experienced by pts receiving adavosertib and gemcitabine, but score 3-4 reached significance on C1D15 fatigue only. No significant differences were detected in syAE profile for nausea, vomiting, abdominal pain, bloating and anxiety. This approach allows objective assessment of pts perception of toxicity with complex therapy. Clinical trial information: NCT02151292.


2016 ◽  
Vol 73 (5) ◽  
pp. 429-434 ◽  
Author(s):  
Jelena Kostic ◽  
Milkica Nesic ◽  
Miodrag Stankovic ◽  
Olivera Zikic ◽  
Jasminka Markovic

Background/Aim. According to currently available data, there is no research dealing with evaluating empathy in adolescents with conduct disorders in our region. The aim of the research was to examine the differences in the severity of cognitive and affective empathy in adolescents with and with no conduct disorder, as well as to examine the relationship between cognitive and affective empathy and the level of externalization in adolescents with conduct disorder. Methods. This research was conducted on 171 adolescents, aged 15 to 18, using the Interpersonal Reactivity Index, Youth Self- Report and a Questionnaire constructed for the purpose of this research. Results. The results showed that adolescents with conduct disorder had significantly lower scores for Perspective Taking (t = 3.255, p = 0.001), Fantasy (t = 2.133, p = 0.034) and Empathic Concern (t = 2.479, p = 0.014) compared to the adolescents in the control group, while the values for Personal Distress (t = 1.818, p = 0.071) were higher compared to the control group, but the difference was not statistically significant. The study showed a statistically significant negative correlation between Perspective Taking and aggression (r = - 0.318, p = 0.003) and a negative correlation between Perspective Taking and the overall level of externalizing problems (r = -0.310, p = 0.004) in the group of adolescents with conduct disorder. Conclusion. This research contributes to better understanding of behavioral disorders in terms of individual factors, especially empathic reactivity. Preventive work with young people who have behavioral problems associated with empathy deficit disorder proved to be an important tool in preventing the development, or at least relieving the symptoms, of this ever more common disorder.


2021 ◽  
Vol 12 ◽  
Author(s):  
Linda Ewing-Cobbs ◽  
Janelle J. Montroy ◽  
Amy E. Clark ◽  
Richard Holubkov ◽  
Charles S. Cox ◽  
...  

Objective: To model pre-injury child and family factors associated with the trajectory of internalizing and externalizing behavior problems across the first 3 years in children with pediatric traumatic brain injury (TBI) relative to children with orthopedic injuries (OI). Parent-reported emotional symptoms and conduct problems were expected to have unique and shared predictors. We hypothesized that TBI, female sex, greater pre-injury executive dysfunction, adjustment problems, lower income, and family dysfunction would be associated with less favorable outcomes.Methods: In a prospective longitudinal cohort study, we examined the level of behavior problems at 12 months after injury and rate of change from pre-injury to 12 months and from 12 to 36 months in children ages 4–15 years with mild to severe TBI relative to children with OI. A structural equation model framework incorporated injury characteristics, child demographic variables, as well as pre-injury child reserve and family attributes. Internalizing and externalizing behavior problems were indexed using the parent-rated Emotional Symptoms and Conduct Problems scales from the Strengths and Difficulties questionnaire.Results: The analysis cohort of 534 children [64% boys, M (SD) 8.8 (4.3) years of age] included 395 with mild to severe TBI and 139 with OI. Behavior ratings were higher after TBI than OI but did not differ by TBI severity. TBI, higher pre-injury executive dysfunction, and lower income predicted the level and trajectory of both Emotional Symptoms and Conduct Problems at 12 months. Female sex and poorer family functioning were vulnerability factors associated with greater increase and change in Emotional Symptoms by 12 months after injury; unique predictors of Conduct Problems included younger age and prior emotional/behavioral problems. Across the long-term follow-up from 12 to 36 months, Emotional Symptoms increased significantly and Conduct Problems stabilized. TBI was not a significant predictor of change during the chronic stage of recovery.Conclusions: After TBI, Emotional Symptoms and Conduct Problem scores were elevated, had different trajectories of change, increased or stayed elevated from 12 to 36 months after TBI, and did not return to pre-injury levels across the 3 year follow-up. These findings highlight the importance of addressing behavioral problems after TBI across an extended time frame.


2020 ◽  
Vol 63 (6) ◽  
pp. 219-225 ◽  
Author(s):  
Ju Hyun Jin ◽  
Shin Won Yoon ◽  
Jungeun Song ◽  
Seong Woo Kim ◽  
Hee Jung Chung

Background: There is increasing concern that moderate preterm (32–33 weeks’ gestation) and late preterm (34–36 weeks’ gestation) birth may be associated with minor neurodevelopmental problems affecting poor school performance.Purpose: We explored the cognitive function, cognitive visual function, executive function, and behavioral problems at schoolage in moderate to late preterm infants.Methods: Children aged 7–10 years who were born at 32+0 to 36+6 weeks of gestation and admitted to the neonatal intensive care unit from August 2006 to July 2011 at the National Health Insurance Service Ilsan Hospital were included. We excluded children with severe neurologic impairments, congenital malformations, or chromosomal abnormalities. Neuropsychological assessments consisted of 5 neuropsychological tests and 3 questionnaires.Results: A total of 37 children (mean age, 9.1±1.2 years) participated. The mean gestational age at birth was 34.6±7.5 weeks, while the mean birth weight was 2,229.2±472.8 g. The mean full-scale intelligence quotient was 92.89±11.90; 24.3% scored between 70 and 85 (borderline intelligence functioning). An abnormal score was noted for at least one of the variables on the attention deficit hyperactivity disorder diagnostic system for 65% of the children. Scores below borderline function for executive quotient and memory quotient were 32.4% and 24.3%, respectively. Borderline or clinically relevant internalizing problems were noted in 13.5% on the Child Behavior Check List. There were no significant associations between perinatal factors or socioeconomic status and cognitive, visual perception, executive function, or behavior outcomes.Conclusion: Moderate to late preterm infants are at risk of developing borderline intelligence functioning and attention problems at early school age. Cognitive and executive functions that are important for academic performance must be carefully monitored and continuously followed up in moderate to late preterm infants.


Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012222
Author(s):  
Emily L Dennis ◽  
Karen Caeyenberghs ◽  
Kristen R Hoskinson ◽  
Tricia L Merkley ◽  
Stacy J Suskauer ◽  
...  

Objective:Our study addressed aims: (1) test the hypothesis that moderate-severe TBI in pediatric patients is associated with widespread white matter (WM) disruption; (2) test the hypothesis that age and sex impact WM organization after injury; and (3) examine associations between WM organization and neurobehavioral outcomes.Methods:Data from ten previously enrolled, existing cohorts recruited from local hospitals and clinics were shared with the ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric msTBI working group. We conducted a coordinated analysis of diffusion MRI (dMRI) data using the ENIGMA dMRI processing pipeline.Results:Five hundred and seven children and adolescents (244 with complicated mild to severe TBI [msTBI] and 263 controls) were included. Patients were clustered into three post-injury intervals: acute/subacute - <2 months, post-acute - 2-6 months, chronic - 6+ months. Outcomes were dMRI metrics and post-injury behavioral problems as indexed by the Child Behavior Checklist (CBCL). Our analyses revealed altered WM diffusion metrics across multiple tracts and all post-injury intervals (effect sizes ranging between d=-0.5 to -1.3). Injury severity is a significant contributor to the extent of WM alterations but explained less variance in dMRI measures with increasing time post-injury. We observed a sex-by-group interaction: females with TBI had significantly lower fractional anisotropy in the uncinate fasciculus than controls (𝞫=0.043), which coincided with more parent-reported behavioral problems (𝞫=-0.0027).Conclusions:WM disruption after msTBI is widespread, persistent, and influenced by demographic and clinical variables. Future work will test techniques for harmonizing neurocognitive data, enabling more advanced analyses to identify symptom clusters and clinically-meaningful patient subtypes.


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