Do preinjury life events moderate the outcomes of mild traumatic brain injuries in children? An A-CAP Study.

IF 2.7 3区心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL

Journal of Pediatric Psychology Pub Date : 2024-03-20 DOI:10.1093/jpepsy/jsae007

Safira Dharsee, Ken Tang, Miriam H Beauchamp, William Craig, Quynh Doan, Stephen B Freedman, Jocelyn Gravel, Roger Zemek, Keith Owen Yeates

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引用次数: 0

Abstract

Objective: To examine preinjury life events as moderators of postconcussive symptoms (PCS) and quality of life (QoL) in children with pediatric mild traumatic brain injury (mTBI) versus orthopedic injury (OI).

Methods: Participants were 633 children with mTBI and 334 with OI, ages 8-16.99, recruited from 5 pediatric emergency departments and followed for 6 months postinjury as part of a prospective cohort study. Preinjury life events were measured retrospectively using the Child and Adolescent Survey of Experiences, PCS using the Health and Behavior Inventory (HBI) and Post-Concussion Symptom Interview (PCS-I), and QoL using the Pediatric Quality of Life Inventory (PedsQL). Analyses involved longitudinal regression using restricted cubic splines, with group, positive and negative life events, and time as primary predictors. Covariates included age, sex, race, socioeconomic status, preinjury history (i.e., headache, migraine, previous concussion), and parent-rated retrospective PCS-I, HBI, and PedsQL scores.

Results: PCS and QoL were worse after mTBI than OI, but group differences declined with time (all p < .001). Group differences in PCS were larger at higher levels of positive life events, which predicted lower PCS (p= .03 to p < .001) and higher QoL (p = .048) after OI but not after mTBI. Negative life events predicted worse PCS and QoL in both groups (p = .002 to p < .001).

Conclusions: Preinjury positive life events moderate outcomes after pediatric injury, with a protective effect seen in OI but not in mTBI. Negative life events are consistently associated with worse outcomes regardless of injury type.

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受伤前的生活事件会减缓儿童轻度脑外伤的后果吗？A-CAP 研究。

目的研究受伤前的生活事件对小儿轻度脑损伤（mTBI）和骨科损伤（OI）儿童的撞击后症状（PCS）和生活质量（QoL）的调节作用：作为一项前瞻性队列研究的一部分，从 5 个儿科急诊部门招募了 633 名轻微脑损伤儿童和 334 名矫形损伤儿童，年龄在 8-16.99 岁之间，并对他们进行了为期 6 个月的伤后随访。研究人员使用儿童和青少年经历调查（Child and Adolescent Survey of Experiences）对受伤前的生活事件进行了回顾性测量，使用健康与行为量表（HBI）和脑震荡后症状访谈（PCS-I）对PCS进行了测量，并使用儿科生活质量量表（PedsQL）对QoL进行了测量。分析采用限制性三次样条进行纵向回归，以群体、积极和消极生活事件以及时间作为主要预测因素。协变量包括年龄、性别、种族、社会经济地位、受伤前病史（即头痛、偏头痛、既往脑震荡）以及家长评定的回顾性 PCS-I、HBI 和 PedsQL 分数：结果：mTBI 后的 PCS 和 QoL 比 OI 差，但随着时间的推移，组间差异逐渐缩小（所有 p <.001）。积极生活事件水平越高，PCS 的组间差异越大，积极生活事件可预测 OI 后较低的 PCS (p= .03 至 p < .001)和较高的 QoL (p = .048)，但 mTBI 后则不然。消极的生活事件预示着两组患者的PCS和QoL均较差（p = .002 to p < .001）：结论：受伤前的积极生活事件可缓解儿科损伤后的结果，对创伤性脑损伤有保护作用，但对创伤性脑损伤无保护作用。无论受伤类型如何，负面生活事件始终与较差的预后相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Psychology PSYCHOLOGY, DEVELOPMENTAL-

CiteScore

6.00

自引率

11.10%

发文量

期刊介绍： The Journal of Pediatric Psychology is the official journal of the Society of Pediatric Psychology, Division 54 of the American Psychological Association. The Journal of Pediatric Psychology publishes articles related to theory, research, and professional practice in pediatric psychology. Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the context of pediatric health. The field aims to promote the health and development of children, adolescents, and their families through use of evidence-based methods.