Journal of neurotrauma
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Journal of neurotrauma · Jul 2015
Randomized Controlled TrialLong-term Behavioral Outcomes following a Randomized Clinical Trial of Counselor-Assisted Problem-Solving for Adolescents with Complicated Mild to Severe Traumatic Brain Injury.
Family problem-solving therapy (FPST) has been shown to reduce behavior problems after pediatric traumatic brain injury (TBI). It is unclear whether treatment gains are maintained. We sought to evaluate the maintenance of improvements in behavior problems after a Web-based counselor-assisted FPST (CAPS) intervention compared to an Internet resource comparison (IRC) intervention provided to adolescents within the initial year post-TBI. ⋯ Post-hoc analyses to elucidate the nature of effects on internalizing problems revealed significant group×time×grade interactions for the anxious/depressed (p=0.03) and somatic complaints subscales (p=0.04). Results also indicated significant improvement over time for CAPS participants who reported elevated externalizing behavior problems at baseline (F(1, 310)=7.17; p=0.008). Findings suggest that CAPS may lead to long-term improvements in behavior problems among older adolescents and those with pretreatment symptoms.
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Journal of neurotrauma · Jul 2015
The trajectory of long-term psychosocial development 16 years following childhood traumatic brain injury.
Childhood traumatic brain injury (CTBI) is one of the most common causes of impairment in children and adolescents, with psychosocial difficulties found to be the most persisting. Given that the transition into adolescence and adulthood can be a stressful period, it is likely that young people who have sustained a CTBI will be more vulnerable to developing psychosocial problems. To date, most research has focused on psychosocial development up to five years following a CTBI and it is unclear how survivors develop in the long-term as young adults. ⋯ The mild CTBI group scored in the borderline range for externalizing symptoms six months post-CTBI; however, all other mean scores were within the normal range. Over a period of 16 years, young adults with CTBI showed similar developmental trajectories regarding psychosocial outcomes, compared with healthy controls. This study confirmed previous literature that CTBI is associated with increased levels of psychosocial problems.
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Journal of neurotrauma · Jul 2015
Resilience is Associated with Outcome from Mild Traumatic Brain Injury.
Resilient individuals manifest adaptive behavior and are better able to recover from adversity. The association between resilience and outcome from mild traumatic brain injury (mTBI) is examined, and the reliability and validity of the Resilience Scale and its short form in mTBI research is evaluated. Patients with mTBI (n=74) and orthopedic controls (n=39) completed the Resilience Scale at one, six, and 12 months after injury. ⋯ Patients with mTBI and moderate-to-high resilience reported significantly fewer post-concussion symptoms, less fatigue, insomnia, traumatic stress, and depressive symptoms, and better quality of life, than the patients with low resilience. No association between resilience and time to return to work was found. Resilience was associated with self-reported outcome from mTBI, and based on this preliminary study, can be reliably evaluated with Resilience Scale and its short form in those with mTBIs.
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Journal of neurotrauma · Jul 2015
Risk Factors for Early Hemorrhagic Progression After Traumatic Brain Injury: A Focus on Lipid Profile.
The purpose of this study was to identify the risk factors related to the hemorrhagic progression (HP) of brain contusion in patients after traumatic brain injury (TBI). Recently, many studies have reported abnormal lipid levels associated with hemorrhagic stroke. Unlike hemorrhage stroke, however, the lipid profiles in patients with TBI have not been examined. ⋯ Current smoking and a triglyceride (TG) level <150 mg/dL were the only statistically significant predictors of HP in the multivariate analysis (p=0.019, p=0.021, respectively). HP with TBI is common in patients who currently smoke and have lower TG levels (150 mg/dL). These patients should be monitored closely, and surgery may be considered before deterioration occurs.