The Trajectory of Long-Term Psychosocial Development 16 Years following Childhood Traumatic Brain Injury

Abstract

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 aim of this research was to track the long-term psychosocial outcomes of children with CTBI and compare them with healthy controls over a period of 16 years. Seventy-five participants with a CTBI and 29 control participants were followed up at five time-points over a period of 16 years. To measure psychosocial functioning (social skills, internalizing, and externalizing symptoms), questionnaires were completed by the primary caregiver acutely (pre-injury baseline), then six months, five years, 10 years, and 16 years post-injury. No significant group differences were found regarding the developmental trajectory of social skills, or internalizing and externalizing symptoms between the CTBI and control groups. The severe CTBI group demonstrated a trend of lower social skills, while the mild CTBI group showed a trend of higher internalizing and externalizing skills at six months, five years, and ten years post-CTBI event, compared with other groups. 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.