Neurocognitive predictors of posttraumatic stress disorder symptoms in children 6 months after traumatic brain injury: A prospective study.

OBJECTIVE: Various neurocognitive mechanisms have been proposed to explain the development of Posttraumatic Stress Disorder (PTSD) symptoms. However, the neurocognitive mechanisms underlying comorbid PTSD following Traumatic Brain Injury (TBI) have not been fully investigated, especially among children. This study prospectively examined the influence of theorized neurocognitive deficits at 3 months post pediatric TBI on the development of PTSD symptoms 6 months postinjury.

METHOD: One hundred sixty-six children aged between 6 and 14 years were recruited after sustaining a TBI. Their demographic information and injury severity were assessed at 2 months postinjury, their neurocognitive outcomes in selective attention, sustained attention, verbal learning, working memory, and processing speed were assessed at 3 months postinjury, and PTSD symptoms were measured at 6 months postinjury.

RESULTS: Consistent with the Neurobiological Theory of PTSD, sustained attention deficits 3 months postinjury emerged as the key predictor for greater future PTSD severity at 6 months, especially following a mild TBI. However, contrary to the expectations of the Emotional Processing Theory and Dual Representation Theory, verbal learning and working memory deficits at 3 months postinjury protected children from the development of PTSD symptoms 6 months postinjury.

CONCLUSIONS: PTSD involves a complex interplay between attention and memory functions post pediatric TBI. When trauma memory is relatively intact, difficulties disengaging from distractors contribute to the development of PTSD symptoms. (PsycINFO Database Record