OPPOSITIONAL DEFIANT-DISORDER SYMPTOMATOLOGY AFTER TRAUMATIC BRAIN-INJURY - A PROSPECTIVE-STUDY

Our goal was to prospectively study the course of oppositional defiant disorder (ODD) symptomatology in children and adolescents in the firs t 2 years after traumatic brain injury (TBI). Fifty children aged 6 to 14, hospitalized after TBI, were assessed soon after TBI regarding in jury severity; preinjury psychiatric, socioeconomic, family functionin g, and family psychiatric history status; and neuroimaging was analyze d. ODD symptomatology in the first year after TBI was related to prein jury family function, social class, and preinjury ODD symptomatology. Increased severity of TBI predicted ODD symptomatology 2 years after i njury. Change (from before TBI) in ODD symptomatology at 6, 12, and 24 months after TBI was influenced by socioeconomic status. Only at 2 ye ars after injury was severity of injury a predictor of change in ODD s ymptomatology. The influence of psychosocial factors appears greater t han severity of injury in accounting for ODD symptomatology and change in such symptomatology in the first but not the second year after TBI in children and adolescents. This appears related to persistence of n ew ODD symptomatology after more serious TBL.