Research Reports - Neurocognitive predictors of posttraumatic stress disorder symptoms in children 6 months after traumatic brain injury

Neuropsychology. 2016 Sep 12. [Epub ahead of print]

Guo X, Edmed SL, Anderson V, Kenardy J.

Objective: Various neurocognitive mechanisms have been proposed to explain the
development of Posttraumatic Stress Disorder (PTSD) symptoms. However, the
neurocognitive mechanisms underlying comorbid PTSD following Traumatic Brain
Injury (TBI) have not been fully investigated, especially among children. This
study prospectively examined the influence of theorized neurocognitive deficits
at 3 months post pediatric TBI on the development of PTSD symptoms 6 months
postinjury. Method: One hundred sixty-six children aged between 6 and 14 years
were recruited after sustaining a TBI. Their demographic information and injury
severity were assessed at 2 months postinjury, their neurocognitive outcomes in
selective attention, sustained attention, verbal learning, working memory, and
processing speed were assessed at 3 months postinjury, and PTSD symptoms were
measured at 6 months postinjury. Results: Consistent with the Neurobiological
Theory of PTSD, sustained attention deficits 3 months postinjury emerged as the
key predictor for greater future PTSD severity at 6 months, especially following
a mild TBI. However, contrary to the expectations of the Emotional Processing
Theory and Dual Representation Theory, verbal learning and working memory
deficits at 3 months postinjury protected children from the development of PTSD
symptoms 6 months postinjury. Conclusions: PTSD involves a complex interplay
between attention and memory functions post pediatric TBI. When trauma memory is
relatively intact, difficulties disengaging from distractors contribute to the
development of PTSD symptoms. 

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