Social Outcomes in Pediatric Traumatic Brain Injury

小儿创伤性脑损伤的社会后果

• 批准号: 7103096
• 负责人: KEITH O YEATES
• 金额: $ 84.28万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7103096
• 关键词: amygdala; behavioral /social science research tag; brain injury; brain mapping; child behavior; cingulate gyrus; clinical research; executive function; human subject; magnetic resonance imaging; middle childhood (6-11); neural information processing; patient oriented research; pediatrics; prefrontal lobe /cortex; problem solving; psychological adaptation; self concept; social behavior; social perception; temporal lobe /cortex; trauma

DESCRIPTION (provided by applicant): The overall goal of this proposal is to undertake an integrative, multi-level study of the social outcomes of childhood traumatic brain injury (TBI). The study is grounded in models and methods drawn from both the emerging field of social cognitive neuroscience and the study of social competence in developmental psychology/psychopathology. The study's specific aims are to: (1) characterize the social interactions and adjustment of children with TBI; (2) examine social information processing in children with TBI; (3) determine the integrity of brain regions and structures known to be vulnerable to TBI and implicated in social information processing; and (4) study the linkages among brain structures, social information processing, and social behavior and adjustment among children with TBI. The study will involve 8 to 12 year old children, 150 with moderate to severe TBI and 150 with orthopedic injuries not involving the head, in a cross-sectional, concurrent cohort research design. Participants will complete several assessments: (1) structural magnetic resonance imaging, to enable measurement of brain abnormalities in regions implicated in social cognition; (2) measures of social information processing; (3) direct observations of interactions with friends and unfamiliar peers; (4) measures of perceived social adjustment, as reported both by the participants and by their friends, classmates, parents, and teachers; and (5) measures of environmental variables, such as family functioning and parenting practices, that may act as risk or resilience factors in moderating the effects of TBI on social development. Data analyses will involve between-group comparisons to test hypotheses linked to Aims 1-3, and structural equation modeling of within-group associations to test hypotheses linked to Aim 4. The project will represent a major expansion of the existing knowledge base about the outcomes of childhood TBI, and will also provide insights into the neural and cognitive-affective substrates of social behavior more generally. Its methods and findings will be applicable to children with other insults to the central nervous system, as well as to healthy children. Thus, the project will contribute to our understanding of both normal and aberrant social development. Practically speaking, the study will further the development of methods for measuring impairments and disabilities in children with TBI, and in the long run should assist in identifying residual deficits and designing interventions to promote better social outcomes following childhood TBI. Public health relevance: Traumatic brain injury (TBI) is a leading cause of death and disability in youth under the age of 15, and therefore represents a major public health problem. Poor social outcomes are an important aspect of the morbidity associated with pediatric TBI. By helping to better understand social outcomes after childhood TBI, the study's findings may suggest ways to promote children's behavioral adaptation to the functional losses and disabilities that frequently occur after TBI.

描述（由申请人提供）：本提案的总体目标是对儿童创伤性脑损伤（TBI）的社会后果进行综合性、多层次的研究。这项研究的基础是来自新兴的社会认知神经科学领域和发展心理学/精神病理学中的社会能力研究的模型和方法。本研究的具体目标是：（1）描述TBI儿童的社会互动和适应;（2）检查TBI儿童的社会信息处理;（3）确定已知易受TBI影响并与社会信息处理有关的脑区和结构的完整性;（4）研究脑外伤儿童的脑结构、社会信息加工、社会行为与适应之间的联系。这项研究将涉及8至12岁的儿童，150名中度至重度TBI和150名骨科损伤不涉及头部，在一个横断面，同期队列研究设计。参与者将完成几项评估：（1）结构磁共振成像，以测量与社会认知有关的大脑区域的异常;（2）社会信息处理的测量;（3）与朋友和不熟悉的同龄人互动的直接观察;（4）由参与者及其朋友，同学，父母和老师报告的感知社会适应的测量;（5）环境变量的测量，如家庭功能和养育方式，这些变量可能作为风险或弹性因素，在调节TBI对社会发展的影响中发挥作用。数据分析将涉及组间比较以检验与目标1-3相关的假设，以及组内关联的结构方程模型以检验与目标4相关的假设。该项目将代表有关儿童TBI结果的现有知识基础的重大扩展，并且还将更普遍地提供对社会行为的神经和认知情感基底的见解。其方法和发现将适用于中枢神经系统受到其他损伤的儿童以及健康儿童。因此，该项目将有助于我们理解正常和异常的社会发展。实际上，这项研究将进一步发展衡量创伤性脑损伤儿童损伤和残疾的方法，从长远来看，应有助于确定残余缺陷和设计干预措施，以促进儿童创伤性脑损伤后更好的社会成果。公共卫生相关性：创伤性脑损伤（TBI）是15岁以下青少年死亡和残疾的主要原因，因此是一个主要的公共卫生问题。不良的社会后果是与儿童TBI相关的发病率的一个重要方面。通过帮助更好地了解儿童TBI后的社会结果，该研究的发现可能会建议如何促进儿童对TBI后经常发生的功能丧失和残疾的行为适应。