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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Long-Term Attention Problems in Children With Traumatic Brain Injury.
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Long-Term Attention Problems in Children With Traumatic Brain Injury.

机译:脑外伤患儿的长期注意问题。

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OBJECTIVE:: To examine long-term attention problems and their cognitive correlates after childhood traumatic brain injury (TBI). METHOD:: Data were drawn from a prospective, longitudinal study conducted between 1992 and 2002. Participants included 41 children with severe TBI, 41 with moderate TBI, and 50 with orthopedic injury (OI), who were all between 6 and 12 years of age at the time of injury. Parent ratings of attention problems were obtained at a long-term follow-up on average 4 years post-injury and compared with ratings of premorbid attention problems obtained shortly after injury. At the long-term follow-up, children also completed several cognitive tests of attention and executive functions. RESULTS:: Hierarchical linear and logistic regression analyses indicated that the severe TBI group displayed significantly more attention problems than the OI group at 4 years post-injury, both behaviorally and cognitively, after controlling for race, socioeconomic status, and premorbid attention problems. At long-term follow-up, 46% of the severe TBI group displayed significant attention problems on the Child Behavior Checklist, as opposed to 26% of the OI group (odds ratio = 3.38; 95% confidence interval, 1.15-9.94). On the Attention-Deficit/Hyperactivity Disorder Rating Scale, 20% of the severe TBI group displayed clinically significant attention problems compared with 4% in the OI group (odds ratio = 9.59; 95% confidence interval, 1.24-73.99). However, group differences in behavioral symptoms were significantly larger for children with more premorbid symptoms than for children with fewer premorbid problems. Measures of executive functions were significantly related to behavioral attention problems, after controlling for group membership, race, and socioeconomic status. CONCLUSIONS:: Childhood TBI exacerbates premorbid attention problems. Long-term behavioral symptoms of attention problems are related to the cognitive deficits in attention and executive functions that often occur in association with childhood TBI.
机译:目的:研究儿童创伤性脑损伤(TBI)后的长期注意问题及其与认知的关系。方法:数据来自于1992年至2002年进行的一项前瞻性纵向研究。参与者包括41例重度TBI,41例中度TBI和50例骨科损伤(OI)的儿童,年龄均在6至12岁之间在受伤时。父母在受伤后平均4年进行了长期随访,获得了父母对注意力问题的评分,并将其与受伤后不久获得的病前注意力问题的评分进行了比较。在长期随访中,孩子们还完成了对注意力和执行功能的一些认知测试。结果:等级线性和逻辑回归分析表明,在控制种族,社会经济地位和病态前注意问题后,严重的TBI组在受伤后4年表现出比OI组更多的注意问题,无论是行为还是认知方面。在长期随访中,46%的严重TBI组在儿童行为清单上显示出明显的注意力问题,而OI组为26%(几率= 3.38; 95%的置信区间为1.15-9.94)。在注意缺陷/多动障碍评分量表上,严重TBI组中有20%表现出临床上显着的注意问题,而OI组中则为4%(几率= 9.59; 95%置信区间为1.24-73.99)。但是,病前症状多的儿童的行为症状组差异明显大于病前问题少的儿童。在控制了团体成员,种族和社会经济地位之后,执行功能的度量与行为注意问题显着相关。结论:童年期TBI加剧了病前注意问题。注意问题的长期行为症状与注意力和执行功能的认知缺陷有关,这些缺陷通常与儿童期TBI有关。

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