Research Reports - Personality change due to traumatic brain injury in children and adolescents: Neurocognitive correlates

J Neuropsychiatry Clin Neurosci. 2015 Jul 17

Max JE(1), Wilde EA(1), Bigler ED(1), Hanten G(1), Dennis M(1), Schachar RJ(1),
Saunders AE(1), Ewing-Cobbs L(1), Chapman SB(1), Thompson WK(1), Yang TT(1),
Levin HS(1)

Personality change due to traumatic brain injury (PC) in children is an important
psychiatric complication of injury and is a form of severe affective
dysregulation. This study aimed to examine neurocognitive correlates of PC. The
sample included 177 children 5-14 years old with traumatic brain injury who were
enrolled from consecutive admissions to five trauma centers. Patients were
followed up prospectively at baseline and at 6 months, and they were assessed
with semistructured psychiatric interviews. Injury severity, socioeconomic
status, and neurocognitive function (measures of attention, processing speed,
verbal memory, IQ, verbal working memory, executive function, naming/reading,
expressive language, motor speed, and motor inhibition) were assessed with
standardized instruments. Unremitted PC was present in 26 (18%) of 141
participants assessed at 6 months postinjury. Attention, processing speed, verbal
memory, IQ, and executive function were significantly associated with PC even
after socioeconomic status, injury severity, and preinjury attention deficit
hyperactivity disorder were controlled. These findings are a first step in
characterizing concomitant cognitive impairments associated with PC. The results
have implications beyond brain injury to potentially elucidate the neurocognitive
symptom complex associated with mood instability regardless of etiology.

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