Research Reports - Injury versus noninjury factors as predictors of postconcussive symptoms following mild traumatic brain injury in children

Neuropsychology. 2013 Jan;27(1):1-12

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

Objective: To examine the relative contributions of injury characteristics and
noninjury child and family factors as predictors of postconcussive symptoms (PCS)
following mild traumatic brain injury (TBI) in children. Method: Participants
were 8- to 15-year-old children, 186 with mild TBI and 99 with mild orthopedic
injuries (OI). Parents and children rated PCS shortly after injury and at 1, 3,
and 12 months postinjury. Hierarchical regression analyses were conducted to
predict PCS from (1) demographic variables; (2) premorbid child factors (WASI IQ;
WRAT-3 Reading; Child Behavior Checklist; ratings of preinjury PCS); (3) family
factors (Family Assessment Device General Functioning Scale; Brief Symptom
Inventory; and Life Stressors and Social Resources Inventory); and (4) injury
group (OI, mild TBI with loss of consciousness [LOC] and associated injuries
[AI], mild TBI with LOC but without AI, mild TBI without LOC but with AI, and
mild TBI without LOC or AI). Results: Injury group predicted parent and child
ratings of PCS but showed a decreasing contribution over time. Demographic
variables consistently predicted symptom ratings across time. Premorbid child
factors, especially retrospective ratings of premorbid symptoms, accounted for
the most variance in symptom ratings. Family factors, particularly parent
adjustment, consistently predicted parent, but not child, ratings of PCS.
Conclusions: Injury characteristics predict PCS in the first months following
mild TBI but show a decreasing contribution over time. In contrast, noninjury
factors are more consistently related to persistent PCS.

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