title: Anxiety disorders in children and adolescents in the second six months after traumatic brain injury.
abstract: The objective of this prospective longitudinal study was to assess the nature, rate, predictive variables, and neuroimaging characteristics of novel (new-onset) anxiety disorders (compared with no novel anxiety disorders) 6-12 months after pediatric traumatic brain injury (TBI). Psychiatric and psychosocial interviews were administered to children who sustained mild to severe TBI at baseline (soon after injury) and at the 12-month follow-up post-injury (n= 125). The psychiatric outcome of children 12-months post-injury revealed that novel anxiety disorders present in the second six months after TBI were heterogeneous and occurred in 13 (10.4%) participants. Novel anxiety disorder was significantly associated with concurrent novel depressive disorder and with novel personality change due to TBI. Novel anxiety disorder was marginally associated with younger age at injury and with pre-injury anxiety disorder in univariate analyses. Age at injury, pre-injury anxiety disorder, and personality change due to TBI were each significantly and independently related to novel anxiety disorder in a logistic regression analysis. There were no significant neuroimaging group differences. These findings suggest that the emergence of novel anxiety disorder after TBI might be related to a broader problem of affective dysregulation especially in younger children and those with a vulnerability even to pre-injury anxiety disorder.
authors.affiliation: University of California, San Diego, La Jolla, CA, USA.|Rady Children's Hospital, San Diego, CA, USA.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Max
authors.affiliation: University of California, San Diego, La Jolla, CA, USA.
authors.forename: Aholibama
authors.initials: A
authors.lastname: Lopez
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.affiliation: Brigham Young University, Provo, UT, USA.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.affiliation: The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors.forename: Russell J
authors.initials: RJ
authors.lastname: Schachar
authors.affiliation: University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Saunders
authors.affiliation: University of Texas Health Science Center, Houston, TX, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.affiliation: University of Texas, Dallas, TX, USA.
authors.forename: Sandra B
authors.initials: SB
authors.lastname: Chapman
authors.affiliation: University of California, San Francisco, CA, USA.
authors.forename: Tony T
authors.initials: TT
authors.lastname: Yang
authors.affiliation: Baylor College of Medicine, Houston, TX, USA.
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D013997:Time Factors
keywords: Anxiety; child and adolescent psychiatric disorders; traumatic brain injury