title: Premorbid child and family functioning as predictors of post-concussive symptoms in children with mild traumatic brain injuries.
abstract: OBJECTIVE
  This study sought to determine whether premorbid child and family functioning accounts for or moderates group differences in post-concussive symptoms following mild traumatic brain injury (TBI) in childhood.
  
  
  METHODS
  This prospective, longitudinal cohort study recruited 8- to 15-year-old children, 186 with mild TBI and 99 with orthopedic injuries (OI), from consecutive emergency department admissions. Parents and children rated post-concussive symptoms within 3 weeks of injury and at 1, 3, and 12 months post injury. Parents also provided retrospective ratings of pre-injury symptoms, as well as of premorbid child behavioral adjustment, overall family functioning, and other stressors and resources in the family environment.
  
  
  RESULTS
  Children with mild TBI reported more post-concussive symptoms than those with OI, as did their parents, although premorbid child behavioral adjustment and symptoms also were significant predictors of post-concussive symptoms. Group differences in somatic symptoms as reported by parents were more pronounced among children from families that were higher functioning and had more environmental resources.
  
  
  CONCLUSIONS
  Mild TBI during childhood results in more post-concussive symptoms than OI, even after children's premorbid adjustment is taken into account. Counter to expectations, post-concussive symptoms following mild TBI may actually be more apparent among children from higher-functioning families with greater resources.
authors.affiliation: Department of Pediatrics, The Ohio State University, Columbus, OH 43205, USA. keith.yeates@nationwidechildrens.org
authors.forename: Keith Owen
authors.initials: KO
authors.lastname: Yeates
authors.forename: H Gerry
authors.initials: HG
authors.lastname: Taylor
authors.forename: Jerome
authors.initials: J
authors.lastname: Rusin
authors.forename: Barbara
authors.initials: B
authors.lastname: Bangert
authors.forename: Ann
authors.initials: A
authors.lastname: Dietrich
authors.forename: Kathryn
authors.initials: K
authors.lastname: Nuss
authors.forename: Martha
authors.initials: M
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000453:epidemiology*; D002648:Child; D003072:Cognition Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D055815:Young Adult