Emotional Aspects of Pediatric Post-Intensive Care Syndrome Following Traumatic Brain Injury

Kathryn R. Bradbury, Cydni Williams, Skyler Leonard, Emily Holding, Elise Turner, Amanda E. Wagner, Juan Piantino, Madison Luther, Trevor A. Hall

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Children with traumatic brain injury (TBI) requiring neurocritical care are at risk for neurocognitive, emotional, physical, and psychosocial difficulties, collectively known as Post-Intensive Care Syndrome. Our study assessed parent-reported emotional functioning and identified risk factors for emotional sequelae in the acute recovery phase. Fifty-three children between 5 and 18 years old hospitalized for TBI were assessed 1-month following discharge. Relevant injury-, child-, and family-specific variables were collected. Emotional functioning was assessed using PROMIS Parent Proxy Report Short Forms for Anxiety and Depressive Symptoms. We used Chi-square tests to evaluate differences between children with and without elevations in anxiety and depressive symptoms. Logistic regression determined predictors of elevations in symptoms among significant variables. Parents frequently endorsed moderate or worse anxiety (45.2%) and depressive (32.1%) symptoms among children. Mechanism of injury and elevated parent post-traumatic stress disorder (PTSD) symptoms were associated with elevated anxiety and depressive symptoms, while direct family involvement in the accident/injury was associated only with elevated anxiety symptoms. Results from logistic regression indicated that only elevated parent PTSD symptoms were a significant predictor for child anxiety and depressive symptoms. Anxiety and depressive symptoms are prevalent in the acute recovery phase of TBI. Consistent with previous research, elevations in anxiety and depressive symptoms were more related to psychosocial factors than injury severity. High levels of parent PTSD symptoms and their relationship with children’s internalizing symptoms highlight the need for mental health treatment for TBI patients and their families.

Original languageEnglish (US)
Pages (from-to)177-187
Number of pages11
JournalJournal of Child and Adolescent Trauma
Issue number2
StatePublished - Jun 2021


  • Acute recovery
  • Emotional functioning
  • Post-intensive care syndrome
  • Traumatic brain injury

ASJC Scopus subject areas

  • Emergency Medicine
  • Critical Care and Intensive Care Medicine


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