Parent psychological functioning and communication predict externalizing behavior problems after pediatric traumatic brain injury.
OBJECTIVE
Adolescents sustaining traumatic brain injury (TBI) show increased prevalence of behavior problems. This study investigated the associations of parent mental health, family functioning, and parent-adolescent interaction with adolescent externalizing behavior problems in the initial months after TBI, and examined whether injury severity moderated these associations.


METHODS
117 parent-adolescent dyads completed measures of family functioning, adolescent behavior, and parent mental health an average of 108 days post-TBI. Dyads also engaged in a 10-min video-recorded problem-solving activity coded for parent behavior and tone of interaction.


RESULTS
Overall, higher ratings of effective parent communication were associated with fewer externalizing behavior problems, whereas poorer caregiver psychological functioning was associated with greater adolescent externalizing behaviors. Results failed to reveal moderating effects of TBI severity on the relationship between socio-environmental factors and behavior problems.


CONCLUSIONS
Interventions targeting parent communication and/or improving caregiver psychological health may ameliorate potential externalizing behavior problems after adolescent TBI.
PhD, Division of Pediatric Rehabilitation, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 4009, Cincinnati, OH 45229, USA. shari.wade@cchmc.org.
Stacey P
SP
Raj
Shari L
SL
Wade
Amy
A
Cassedy
H Gerry
HG
Taylor
Terry
T
Stancin
Tanya M
TM
Brown
Michael W
MW
Kirkwood
D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D001930:Brain Injuries / Q000523:psychology*; D017028:Caregivers / Q000523:psychology; D002648:Child; D003142:Communication; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*
externalizing behavior problems; parent–adolescent interaction; protective factors; traumatic brain injury