Predictors of personality change due to traumatic brain injury in children and adolescents in the first six months after injury.
OBJECTIVE
To assess the phenomenology and predictive factors of personality change due to traumatic brain injury.


METHODS
Children (N = 177), aged 5 to 14 years with traumatic brain injury from consecutive admissions to five trauma centers, were followed prospectively at baseline and 6 months with semistructured psychiatric interviews. Injury severity, lesion characteristics, and preinjury variables including psychiatric disorder, family psychiatric history, family function, socioeconomic status, psychosocial adversity, and adaptive function were assessed with standardized instruments.


RESULTS
Personality change occurred in 22% of participants in the first 6 months after injury. Severity of injury predicted personality change, whereas none of the psychosocial variables predicted personality change. Lesions of the dorsal prefrontal cortex, specifically the superior frontal gyrus, were associated with personality change after controlling for severity of injury or the presence of other lesions.


CONCLUSIONS
These findings are consistent with models of affective dysregulation that implicate a dorsal prefrontal cortex system important for effortful regulation of affective states.
Max
Jeffrey E
JE
Department of Psychiatry, University of California, Children's Hospital and Health Center, San Diego, CA 92123, USA. jmax@ucsd.edu
Levin
Harvey S
HS
Landis
Julie
J
Schachar
Russell
R
Saunders
Ann
A
Ewing-Cobbs
Linda
L
Chapman
Sandra B
SB
Dennis
Maureen
M
D000293:Adolescent; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D005500:Follow-Up Studies; D006801:Humans; D010554:Personality Disorders / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011584:Psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors