Behavior Problems Following Childhood TBI: The Role of Sex, Age, and Time Since Injury.
Behavior Problems Following Childhood TBI: The Role of Sex, Age, and Time Since Injury.
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儿童期 TBI 后的行为问题：性别、年龄和受伤后时间的作用。
DOI：
10.1097/htr.0000000000000567
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Zhang,Nanhua
中科院分区：
文献类型：
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作者：
Wade,ShariL;Kaizar,EloiseE;Narad,MeganE;Zang,Huaiyu;Kurowski,BradG;Miley,AimeeE;Moscato,EmilyL;Aguilar,JessicaM;Yeates,KeithOwen;Taylor,HGerry;Zhang,Nanhua
目的：研究儿童创伤性脑损伤（TBI）后行为问题的频率及其与损伤严重程度、性别和社会环境因素的关系。设置：美国中西部/西部的儿童医院。参与者：381名中度（n= 359）和重度（n= 227）TBI的男孩和210名女孩，平均受伤年龄为11.7岁（范围0.3-18），受伤时间≤ 3年。设计：多研究队列的次要数据分析。主要测量：儿童行为量表（CBCL）进行治疗前管理。结果：37%的儿童CBCL总问题量表边缘/临床升高，内化和外化问题的发生率相当（分别为33%和31%）。父母教育程度越低，内化、外化和总体问题的发生率越高。受伤后的时间与内化症状呈线性相关，伤后时间越长，症状越严重。年轻的男孩有显着较高水平的对立违抗症状比女孩，而年龄较大的女孩有显着更大的注意力缺陷多动障碍症状比boy.Conclusions：小儿创伤性脑损伤与行为问题的高发病率，与较低的社会经济地位预测大幅升高的风险。更高水平的内化症状与受伤后更长时间的关联突出了随时间跟踪儿童的重要性。
Objective:To examine the frequency of behavioral problems after childhood traumatic brain injury (TBI) and their associations with injury severity, sex, and social environmental factors.Setting:Children's hospitals in the Midwestern/Western United States.Participants:381 boys and 210 girls with moderate (n= 359) and severe (n= 227) TBI, with an average age at injury of 11.7 years (range 0.3-18) who were injured≤ 3 years ago.Design:Secondary data analysis of a multistudy cohort.Main Measures:Child Behavior Checklist (CBCL) administered pretreatment.Results:Thirty-seven percent had borderline/clinical elevations on the CBCL Total Problem Scale, with comparable rates of Internalizing and Externalizing problems (33% and 31%, respectively). Less parental education was associated with higher rates of internalizing, externalizing, and total problems. Time since injury had a linear association with internalizing symptoms, with greater symptoms at longer postinjury intervals. Younger boys had significantly higher levels of oppositional defiant symptoms than girls, whereas older girls had significantly greater attention-deficit hyperactivity disorder symptoms than boys.Conclusions:Pediatric TBI is associated with high rates of behavior problems, with lower socioeconomic status predicting substantially elevated risk. Associations of higher levels of internalizing symptoms with greater time since injury highlight the importance of tracking children over time.