title: Personality Change Due to Traumatic Brain Injury in Children and Adolescents: Neurocognitive Correlates.
abstract: Personality change due to traumatic brain injury (PC) in children is an important psychiatric complication of injury and is a form of severe affective dysregulation. This study aimed to examine neurocognitive correlates of PC. The sample included 177 children 5-14 years old with traumatic brain injury who were enrolled from consecutive admissions to five trauma centers. Patients were followed up prospectively at baseline and at 6 months, and they were assessed with semistructured psychiatric interviews. Injury severity, socioeconomic status, and neurocognitive function (measures of attention, processing speed, verbal memory, IQ, verbal working memory, executive function, naming/reading, expressive language, motor speed, and motor inhibition) were assessed with standardized instruments. Unremitted PC was present in 26 (18%) of 141 participants assessed at 6 months postinjury. Attention, processing speed, verbal memory, IQ, and executive function were significantly associated with PC even after socioeconomic status, injury severity, and preinjury attention deficit hyperactivity disorder were controlled. These findings are a first step in characterizing concomitant cognitive impairments associated with PC. The results have implications beyond brain injury to potentially elucidate the neurocognitive symptom complex associated with mood instability regardless of etiology.
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Max
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Gerri
authors.initials: G
authors.lastname: Hanten
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Schachar
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Ann E
authors.initials: AE
authors.lastname: Saunders
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Chapman
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Wesley K
authors.initials: WK
authors.lastname: Thompson
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Tony T
authors.initials: TT
authors.lastname: Yang
authors.affiliation: From the Dept. of Psychiatry, University of California, San Diego (JEM, WKT); Rady Children's Hospital, San Diego, CA (JEM); the Depts. of Physical Medicine and Rehabilitation (EAW, GH, HSL), Neurology (EAW), and Radiology (EAW), Baylor College of Medicine, Houston, TX; the Depts. of Neuroscience and Psychology, Brigham Young University, Provo, UT (EDB); the Dept. of Psychiatry, University of Utah, Salt Lake City (EDB); the Program in Neurosciences and Mental Health (MD), and the Brain and Behaviour Program, Dept. of Psychiatry, Research Institute (RJS), The Hospital for Sick Children, Toronto, Canada; the Depts. of Psychiatry (AES) and Pediatrics (LE-C), University of Texas Health Science Center, Houston; the Center for BrainHealth, University of Texas, Dallas (SBC); and the Dept. of Psychiatry, University of California, San Francisco (TTY).
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D001288:Attention / Q000502:physiology; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D007360:Intelligence / Q000502:physiology; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D010551:Personality; D010554:Personality Disorders / Q000209:etiology* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors