CHILD AND ADOLESCENT TRAUMATIC BRAIN INJURY - CORRELATES OF DISRUPTIVE BEHAVIOR DISORDERS

A record review focused on children and adolescents, with a history of traumatic brain injury (TBI), who were consecutively admitted to a br ain injury clinic in which all new patients are psychiatrically evalua ted. Correlates of post-injury oppositional defiant disorder/conduct d isorder (ODD/CD) and post-injury attention deficit hyperactivity disor der (AHD) were investigated. Subjects who developed ODD/CD following T BI, when compared to subjects without a lifetime history of the disord er, had significantly more impaired family functioning, showed a trend toward a greater family history of alcohol dependence/abuse and suffe red a milder TBI. In contrast, there were no variables which discrimin ated between subjects who developed ADHD following injury and those wi th no lifetime history of ADHD. It is difficult to determine whether O DD, CD and ADHD occurring after TBI in the patient is related to the T BI, directly or indirectly. Appropriate clinical assessment requires c onsideration of the important mediating role of family functioning, se verity of injury and family psychiatric history.