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What predicts persisting social impairment following pediatric traumatic brain injury: contribution of a biopsychosocial approach

Version 3 2024-06-02, 14:19
Version 2 2023-07-06, 22:17
Version 1 2022-02-23, 03:17
journal contribution
posted on 2024-06-02, 14:19 authored by Vicki Anderson, Stephen JC Hearps, Cathy Catroppa, Miriam H Beauchamp, Nicholas RyanNicholas Ryan
Abstract Background Psychosocial deficits, such as emotional, behavioral and social problems, reflect the most common and disabling consequences of pediatric traumatic brain injury (TBI). Their causes and recovery likely differ from physical and cognitive skills, due to disruption to developing brain networks and the influence of the child's environment. Despite increasing recognition of post-injury behavioral and social problems, there exists a paucity of research regarding the incidence of social impairment, and factors predicting risk and resilience in the social domain over time since injury. Methods Using a prospective, longitudinal design, and a bio-psychosocial framework, we studied children with TBI (n = 107) at baseline (pre-injury function), 6 months, 1 and 2-years post-injury. We assessed intellectual ability, attention/executive function, social cognition, social communication and socio-emotional function. Children underwent structural magnetic resonance imaging (MRI) at 2–8 weeks post-injury. Parents rated their child's socio-emotional function and their own mental health, family function and perceived burden. Results We distinguished five social recovery profiles, characterized by a complex interplay between environment and pre- and post-TBI factors, with injury factors playing a lesser role. Resilience in social competence was linked to intact family and parent function, intact pre-injury adaptive abilities, post-TBI cognition and social participation. Vulnerability in the social domain was related to poor pre- and post-injury adaptive abilities, greater behavioral concerns, and poorer pre- and post-injury parent health and family function. Conclusions We identified five distinct social recovery trajectories post-child-TBI, each characterized by a unique biopsychosocial profile, highlighting the importance of comprehensive social assessment and understanding of factors contributing to social impairment, to target resources and interventions to children at highest risk.

History

Journal

Psychological Medicine

Volume

53

Pagination

3568-3579

Location

Cambridge, Eng.

ISSN

0033-2917

eISSN

1469-8978

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Issue

8

Publisher

Cambridge University Press