Research Reports - Premorbid child and family functioning as predictors of post-concussive symptoms in children with mild traumatic brain injuries

Int J Dev Neurosci. 2012 May;30(3):231-7

Yeates KO, Taylor HG, Rusin J, Bangert B, Dietrich A, Nuss K, Wright M.

STUDY AIM: This study sought to determine whether premorbid child and family
functioning accounts for or moderates group differences in post-concussive
symptoms following mild traumatic brain injury (TBI) in childhood.

METHODS: This prospective, longitudinal cohort study recruited 8- to 15-year-old
children, 186 with mild TBI and 99 with orthopedic injuries (OI), from
consecutive emergency department admissions. Parents and children rated
post-concussive symptoms within 3 weeks of injury and at 1, 3, and 12 months post
injury. Parents also provided retrospective ratings of pre-injury symptoms, as
well as of premorbid child behavioral adjustment, overall family functioning, and
other stressors and resources in the family environment.

RESULTS: Children with mild TBI reported more post-concussive symptoms than those
with OI, as did their parents, although premorbid child behavioral adjustment and
symptoms also were significant predictors of post-concussive symptoms. Group
differences in somatic symptoms as reported by parents were more pronounced among
children from families that were higher functioning and had more environmental

DISCUSSION: Mild TBI during childhood results in more post-concussive symptoms
than OI, even after children's premorbid adjustment is taken into account.
Counter to expectations, post-concussive symptoms following mild TBI may actually
be more apparent among children from higher-functioning families with greater

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