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）：该提案的总体目标是对儿童创伤性脑损伤（TBI）的社会结果进行综合的多层次研究。这项研究基于从社会认知神经科学的新兴领域和发展心理学/心理病理学中社会能力的研究的模型和方法基础。该研究的具体目的是：（1）表征TBI儿童的社会互动和调整； （2）检查TBI儿童的社会信息处理； （3）确定大脑区域和已知容易受到TBI并涉及社会信息处理的完整性； （4）研究大脑结构，社会信息处理以及TBI儿童的社会行为以及调整之间的联系。这项研究将涉及8至12岁的儿童，150名中度至重度TBI和150个儿童和150个儿童，其骨科伤害不涉及头部，并以横截面同时发生的研究设计。参与者将完成几项评估：（1）结构性磁共振成像，以实现与社会认知有关的区域中脑异常的测量； （2）社会信息处理的度量； （3）直接观察与朋友和陌生同龄人的互动； （4）参与者及其朋友，同学，父母和老师所报告的感知社会调整的衡量； （5）环境变量的度量，例如家庭功能和育儿实践，可能是调节TBI对社会发展影响的风险或弹性因素。 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.它的方法和发现将适用于对中枢神经系统和健康儿童的其他侮辱的儿童。因此，该项目将有助于我们对正常和异常社会发展的理解。实际上，这项研究将进一步开发衡量TBI儿童障碍和残疾的方法，从长远来看，应有助于确定残留的缺陷和设计干预措施，以促进儿童期间TBI后促进更好的社交结果。公共卫生相关性：创伤性脑损伤（TBI）是15岁以下青年死亡和残疾的主要原因，因此代表了一个重大的公共卫生问题。社会结果不佳是小儿TBI相关的发病率的重要方面。通过帮助更好地理解儿童童年时期的社会成果，该研究的发现可能提出了促进儿童对TBI经常发生的功能损失和残疾的行为适应的方法。