Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury.
The degree to which postinjury posttraumatic stress disorder (PTSD) and/or depressive symptoms in adolescents are associated with cognitive and functional impairments at 12 and 24 months after traumatic brain injury (TBI) is not yet known. The current study used a prospective cohort design, with baseline assessment and 3-, 12-, and 24-month followup, and recruited a cohort of 228 adolescents ages 14-17 years who sustained either a TBI (n = 189) or an isolated arm injury (n = 39). Linear mixed-effects regression was used to assess differences in depressive and PTSD symptoms between TBI and arm-injured patients and to assess the association between 3-month PTSD and depressive symptoms and cognitive and functional outcomes. Results indicated that patients who sustained a mild TBI without intracranial hemorrhage reported significantly worse PTSD (Hedges g = 0.49, p = .01; Model R(2)  = .38) symptoms across time as compared to the arm injured control group. Greater levels of PTSD symptoms were associated with poorer school (η(2)  = .07, p = .03; Model R(2)  = .36) and physical (η(2)  = .11, p = .01; Model R(2)  = .23) functioning, whereas greater depressive symptoms were associated with poorer school (η(2)  = .06, p = .05; Model R(2)  = .39) functioning.
Harborview Injury Prevention & Research Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. oconnor7@u.washington.edu
Stephen S
SS
O'Connor
Douglas F
DF
Zatzick
Jin
J
Wang
Nancy
N
Temkin
Thomas D
TD
Koepsell
Kenneth M
KM
Jaffe
Dennis
D
Durbin
Monica S
MS
Vavilala
Andrea
A
Dorsch
Frederick P
FP
Rivara
D000293:Adolescent; D001134:Arm Injuries / Q000523:psychology; D001930:Brain Injuries / Q000523:psychology*; D003072:Cognition Disorders / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D014481:United States / Q000453:epidemiology