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Adolescents’ Internalizing Problems Following Traumatic Brain Injury Are Related to Parents’ Psychiatric Symptoms

Peterson, Robin L. PhD; Kirkwood, Michael W. PhD; Taylor, H. Gerry PhD; Stancin, Terry PhD; Brown, Tanya M. PhD; Wade, Shari L. PhD

The Journal of Head Trauma Rehabilitation: September/October 2013 - Volume 28 - Issue 5 - p E1–E12
doi: 10.1097/HTR.0b013e318263f5ba
Original Articles

Background: A small body of previous research has demonstrated that pediatric traumatic brain injury (TBI) increases risk for internalizing problems, but findings have varied regarding their predictors and correlates.

Methods: We examined the level and correlates of internalizing symptoms in 130 teens who had sustained a complicated mild to severe TBI within the past 1 to 6 months. Internalizing problems were measured via both maternal- and paternal-report Child Behavior Checklist. We also measured family functioning, parent psychiatric symptoms, and postinjury teen neurocognitive function.

Results: Mean parental ratings of internalizing problems were within the normal range. Depending on informant, 22% to 26% of the sample demonstrated clinically elevated internalizing problems. In multiple and binary logistic regression models, only parent psychiatric symptoms consistently provided unique prediction of teen internalizing symptoms. For maternal but not paternal report, female gender was associated with greater internalizing problems.

Conclusion: Parent and teen emotional problems are associated following adolescent TBI. Possible reasons for this relationship, including the effects of TBI on the family unit, are discussed.

Department of Psychology, University of Denver, Denver, Colorado (Dr Peterson); Department of Physical Medicine and Rehabilitation, Children's Hospital Colorado and University of Colorado Denver School of Medicine, Aurora, Colorado (Dr Kirkwood); Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, Ohio (Dr Taylor); Department of Psychiatry, MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio (Dr Stancin); Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Dr Brown); and Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Wade).

Corresponding Author: Robin L. Peterson, PhD, Department of Psychology, University of Denver, 2155 South Race Street, Denver, CO 80208 (

This work was supported in part by (1) NIH grant R01-MH073764 from the National Institute of Mental Health and (2) a grant from the Colorado Traumatic Brain Injury Trust Fund Research Program, Colorado Department of Human Services, Division of Vocational Rehabilitation, Traumatic Brain Injury Program.

The authors declare no conflicts of interest.

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins