Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-25T04:38:55.289Z Has data issue: false hasContentIssue false
  • English
  • Français

Dimensions of postconcussive symptoms in children with mild traumatic brain injuries

Published online by Cambridge University Press:  01 January 2009

LAUREN K. AYR ,
KEITH OWEN YEATES ,
H. GERRY TAYLOR  and
MICHAEL BROWNE
LAUREN K. AYR
Affiliation:
Department of Pediatrics, The Ohio State University, and the Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
KEITH OWEN YEATES*
Affiliation:
Department of Pediatrics, The Ohio State University, and the Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio
H. GERRY TAYLOR
Affiliation:
Department of Pediatrics, Case Western Reserve University, and Rainbow Babies & Children’s Hospital, Cleveland, Ohio
MICHAEL BROWNE
Affiliation:
Department of Psychology, The Ohio State University, Columbus, Ohio
*
*Correspondence and reprint requests to: Keith Owen Yeates, Department of Psychology, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The dimensions of postconcussive symptoms (PCS) were examined in a prospective, longitudinal study of 186 8 to 15 year old children with mild traumatic brain injuries (TBI). Parents and children completed a 50-item questionnaire within 2 weeks of injury and again at 3 months after injury, rating the frequency of PCS on a 4-point scale. Common factor analysis with target rotation was used to rotate the ratings to four hypothesized dimensions, representing cognitive, somatic, emotional, and behavioral symptoms. The rotated factor matrix for baseline parent ratings was consistent with the target matrix. The rotated matrix for baseline child ratings was consistent with the target matrix for cognitive and somatic symptoms but not for emotional and behavioral symptoms. The rotated matrices for ratings obtained 3 months after injury were largely consistent with the target matrix derived from analyses of baseline ratings, except that parent ratings of behavioral symptoms did not cluster as before. Parent and child ratings of PCS following mild TBI yield consistent factors reflecting cognitive and somatic symptom dimensions, but dimensions of emotional and behavioral symptoms are less robust across time and raters. (JINS, 2009, 15, 19–30.)

Keywords

Nervous system traumaPediatricPostconcussion syndromeFactor analysisParent-child agreementProspective studiesHead injuries
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 1 , January 2009 , pp. 19 - 30
Copyright
Copyright © INS 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Achenbach, T.M. (2006). As others see us: Clinical and research implications of cross-informant correlations for psychopathology. Current Directions in Psychological Science, 15, 94–98.CrossRefGoogle Scholar
Alexander, M.P. (1997). Minor traumatic brain injury: A review of physiogenesis and psychogenesis. Seminars in Clinical Neuropsychiatry, 2, 177–187.Google ScholarPubMed
American Association for Automotive Medicine. (1990). The abbreviated injury scale (AIS)-1990 revision. Des Plaines, IL: American Association for Automotive Medicine.Google Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Asarnow, R.F., Satz, P., Light, R., Zaucha, K., Lewis, R., & McCleary, C. (1995). The UCLA study of mild head injury in children and adolescents. In Michel, M.E. & Broman, S. (Eds.), Traumatic head injury in children (pp. 117–146). New York: Oxford University Press.Google Scholar
Axelrod, B., Fox, D.D., Less-Haley, P.R., Earnest, K., Dolezal-Wood, S., & Goldman, R.S. (1996). Latent structure of the Postconcussion Syndrome Questionnaire. Psychological Assessment 8, 422–427.CrossRefGoogle Scholar
Barry, C.T., Taylor, H.G., Klein, S., & Yeates, K.O. (1996). The validity of neurobehavioral symptoms reported in children after traumatic brain injury. Child Neuropsychology, 2, 213–226.CrossRefGoogle Scholar
Bazarian, J.J., McClung, J., Shah, M.N., Chen, Y.T., Flesher, W., & Kraus, J. (2005). Mild traumatic brain injury in the United States, 1998–2000. Brain Injury, 19, 85–91.CrossRefGoogle ScholarPubMed
Boake, C., McCauley, S.R., Levin, H.S., Contant, C.F., Song, J.X., Brown, S.A., Goodman, H.S., Brundage, S.I., Diaz-Marcham, P.J., & Merritt, S.G. (2004). Limited agreement between criteria-based diagnoses of postconcussional syndrome. Journal of Neuropsychiatry and Clinical Neurosciences, 16, 493–499.CrossRefGoogle ScholarPubMed
Boake, C., McCauley, S.R., Levin, H.S., Pedroza, C., Contant, C.F., Song, J.X., Brown, S.A., Goodman, H.S., Brundage, S.I., & Diaz-Marcham, P.J. (2005). Diagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 350–356.CrossRefGoogle ScholarPubMed
Bohnen, N., Wijnen, G., Twijnstra, A., Zutphen, W.V., & Jolles, J. (1995). The constellation of late post-traumatic symptoms of mild head injury patients. Neurorehabilitation and Neural Repair, 9, 33–39.CrossRefGoogle Scholar
Brown, S.J., Fann, J.R., & Grant, I. (1994). Postconcussional disorder: Time to acknowledge a common source of neurobehavioral morbidity. Journal of Neuropsychiatry and Clinical Neurosciences, 6, 15–22.Google ScholarPubMed
Browne, M.W. (2001). An overview of analytic rotation in exploratory factor analysis. Multivariate Behavioral Research, 36, 111–150.CrossRefGoogle Scholar
Browne, M.W., Cudeck, R., Tateneni, K., & Mels, G. (2004). CEFA: Comprehensive exploratory factor analysis, version 2.00 [Computer software and manual]. http://faculty.psy.ohio-state.edu/browne/programs.htm.Google Scholar
Carroll, L.J., Cassidy, J.D., Peloso, P.M., Borg, J., von Holst, H., Holm, L., Paniak, C., & Pépin, M. (2004). Prognosis for mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(suppl), 84–105.CrossRefGoogle Scholar
Cicerone, K.D. & Kalmar, K. (1995). Persistent postconcussion syndrome: The structure of subjective complaints after mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 10, 1–17.CrossRefGoogle Scholar
Edelbrock, C., Costello, A.J., Dulcan, M.K., Conover, N.C., & Kala, R. (1986). Parent-child agreement on child psychiatric symptoms assessed via structured interview. Journal of Child Psychology & Psychiatry, 27, 181–190.CrossRefGoogle ScholarPubMed
Fabrigar, L.R., Wegener, D.T., MacCallum, R.C., & Strahan, E.J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4, 272–299.CrossRefGoogle Scholar
Floyd, F.J. & Widaman, K.F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286–299.CrossRefGoogle Scholar
Gerber, D.J. & Schraa, J.C. (1995). Mild traumatic brain injury: Searching for the syndrome. Journal of Head Trauma Rehabilitation, 10, 28–40.CrossRefGoogle Scholar
Gorsuch, R.L. (1983). Factor analysis (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Gouvier, W.D., Cubic, B., Jones, G., Brantley, P., & Cutlip, Q. (1992). Postconcussion symptoms and daily stress in normal and head-injured college populations. Archives of Clinical Neuropsychology, 7, 193–211.CrossRefGoogle ScholarPubMed
Guadagnoli, E. & Velicer, W.F. (1988). Relation of sample size to the stability of component patterns. Psychological Bulletin, 103, 265–275.CrossRefGoogle Scholar
Hodges, K., Gordon, Y., & Lennon, M.P. (1990). Parent-child agreement on symptoms assessed via a clinical research interview for children: The Child Assessment Schedule (CAS). Journal of Child Psychology & Psychiatry, 31, 427–436.CrossRefGoogle Scholar
Kraus, J.F. (1995). Epidemiological features of brain injury in children: Occurrence, children at risk, causes and manner of injury, severity, and outcomes. In Broman, S.H. & Michel, M.E. (Eds.), Traumatic head injury in children (pp. 22–39). New York: Oxford University Press.Google Scholar
Lishman, W.A. (1988). Physiogenesis and psychogenesis in the post-concussion syndrome. British Journal of Psychiatry, 153, 460–469.CrossRefGoogle Scholar
Luis, C.A., Vanderploeg, R.D., & Curtiss, G. (2003). Predictors of postconcussion symptom complex in community dwelling male veterans. Journal of the International Neuropsychological Society, 9, 1001–1015.CrossRefGoogle ScholarPubMed
MacCallum, R.C., Widaman, K.F., Zhang, S., & Hong, S. (1999). Sample size in factor analysis. Psychological Methods, 4, 84–89.CrossRefGoogle Scholar
Mayer, T., Matlak, M., Johnson, D., & Walker, M. (1980). The Modified Injury Severity Scale in pediatric multiple trauma patients. Journal of Pediatric Surgery, 15, 19–726.CrossRefGoogle ScholarPubMed
Millsap, R.E. & Meredith, W. (2007). Factorial invariance: Historical perspectives and new problems. In Cudeck, R. & MacCallum, R.C. (Eds.), Factor analysis at 100: Historical developments and future directions (pp. 131–152). Mahwah, NJ: Erlbaum.Google Scholar
Mittenberg, W. & Strauman, S. (2000). Diagnosis of mild head injury and the postconcussion syndrome. Journal of Head Trauma Rehabilitation, 15, 783–791.CrossRefGoogle ScholarPubMed
Mittenberg, W., Wittner, M.S., & Miller, L.J. (1997). Postconcussion syndrome occurs in children. Neuropsychology, 11, 447–452.CrossRefGoogle ScholarPubMed
Piland, S.G., Motl, R.W., Guskiewicz, K.M., McCrea, M., & Ferrara, M.S. (2006). Structural validity of a self-report concussion-related symptom scale. Medicine & Science in Sports and Exercise, 38, 27–32.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Ayton, G., Nelms, R., Curran, C., & Ng, K.T. (1999). Cognitive and behavioral outcomes following mild traumatic head injury in children. Journal of Head Trauma Rehabilitation, 14, 360–372.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A-M., Nelms, R., Curran, C., & Ng, K. (2000). Factors influencing outcome following mild traumatic brain injury in adults. Journal of the International Neuropsychological Society; JINS, 6, 568–579.CrossRefGoogle ScholarPubMed
Rivara, J.B., Jaffe, J.M., Polissar, N.L., Fay, G.C., Martin, K.M., Shurtleff, H.A., & Liao, S. (1994). Family functioning and children’s academic performance and behavior problems in the year following traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 75, 369–379.CrossRefGoogle ScholarPubMed
Satz, P. (2001). Mild head injury in children and adolescents. Current Directions in Psychological Science, 10, 106–109.CrossRefGoogle Scholar
Satz, P., Zaucha, K., McCleary, C., Light, R., & Asarnow, R. (1997). Mild head injury in children and adolescents: A review of studies (1970–1995). Psychological Bulletin, 122, 107–131.CrossRefGoogle ScholarPubMed
Stevens, G. & Cho, J.H. (1985). Socioeconomic indexes and the new 1980 census occupational classification scheme. Social Science Research, 14, 142–168.CrossRefGoogle Scholar
Teasdale, G. & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, 2, 81–84.CrossRefGoogle ScholarPubMed
Velicer, W.F. & Fava, J.L. (1998). Effects of variable and subject sampling on factor pattern recovery. Psychological Methods, 3, 231–251.CrossRefGoogle Scholar
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.Google Scholar
Yeates, K.O. (2000). Closed-head injury. In Yeates, K.O., Ris, M.D. & Taylor, H.G. (Eds.), Pediatric neuropsychology: Research, theory, and practice (pp. 92–116). New York: Guilford.Google Scholar
Yeates, K.O., Luria, J., Bartkowski, H., Rusin, J., Martin, L., & Bigler, E.D. (1999). Post-concussive symptoms in children with mild closed-head injuries. Journal of Head Trauma Rehabilitation, 14, 337–350.CrossRefGoogle Scholar
Yeates, K.O. & Taylor, H.G. (2005). Neurobehavioral outcomes of mild head injury in children and adolescents. Pediatric Rehabilitation, 8, 5–16.Google ScholarPubMed
Yeates, K.O., Taylor, H.G., Barry, C.T., Drotar, D., Wade, S.L., & Stancin, T. (2001). Neurobehavioral symptoms in childhood closed-head injuries: Changes in prevalence and correlates during the first year post injury. Journal of Pediatric Psychology, 26, 79–91.CrossRefGoogle Scholar
Yeates, K.O., Taylor, H.G., Rusin, J., Bangert, B., Dietrich, A., Nuss, K., Wright, M., Nagin, D.S., & Jones, B.L. (in press). Longitudinal trajectories of post-concussive symptoms in children with mild traumatic brain injuries and their relationship to acute clinical status. Pediatrics.Google Scholar