1. Neuropsychological Performance of Youth with Secondary Attention-Deficit/Hyperactivity Disorder 6- and 12-Months after Traumatic Brain Injury
- Author
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Ornstein, Tisha J, Sagar, Sanya, Schachar, Russell J, Ewing-Cobbs, Linda, Chapman, Sandra B, Dennis, Maureen, Saunders, Ann E, Yang, Tony T, Levin, Harvey S, and Max, Jeffrey E
- Subjects
Clinical and Health Psychology ,Psychology ,Behavioral and Social Science ,Unintentional Childhood Injury ,Physical Injury - Accidents and Adverse Effects ,Neurosciences ,Clinical Research ,Traumatic Head and Spine Injury ,Attention Deficit Hyperactivity Disorder (ADHD) ,Traumatic Brain Injury (TBI) ,Brain Disorders ,Mental Health ,Childhood Injury ,Pediatric ,Mental health ,Injuries and accidents ,Attention Deficit Disorder with Hyperactivity ,Brain Injuries ,Child ,Cognition Disorders ,Female ,Humans ,Male ,Memory ,Short-Term ,Neuropsychological Tests ,Psychiatric Status Rating Scales ,Reaction Time ,Time Factors ,Traumatic brain injury ,Children ,Adolescents ,S-ADHD ,P-ADHD ,Neurocognitive function ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Experimental Psychology ,Biomedical and clinical sciences ,Health sciences - Abstract
The present study compared executive dysfunction among children with attention-deficit/hyperactivity disorder (ADHD) after traumatic brain injury (TBI), also called secondary ADHD (S-ADHD), pre-injury ADHD and children with TBI only (i.e., no ADHD). Youth aged 6-16 years admitted for TBI to five trauma centers were enrolled (n=177) and evaluated with a semi-structured psychiatric interview scheduled on three occasions (within 2 weeks of TBI, i.e., baseline assessment for pre-injury status; 6-months and 12-months post-TBI). This permitted the determination of 6- and 12-month post-injury classifications of membership in three mutually exclusive groups (S-ADHD; pre-injury ADHD; TBI-only). Several executive control measures were administered. Unremitted S-ADHD was present in 17/141 (12%) children at the 6-month assessment, and in 14/125 (11%) children at 12-months post-injury. The study found that children with S-ADHD exhibited deficient working memory, attention, and psychomotor speed as compared to children with pre-injury ADHD. Furthermore, the children with S-ADHD and the children with TBI-only were impaired compared to the children with pre-injury ADHD with regard to planning. No group differences related to response inhibition emerged. Age, but not injury severity, gender, or adaptive functioning was related to executive function outcome. Neuropsychological sequelae distinguish among children who develop S-ADHD following TBI and those with TBI only. Moreover, there appears to be a different pattern of executive control performance in those who develop S-ADHD than in children with pre-injury ADHD suggesting that differences exist in the underlying neural mechanisms that define each disorder, underscoring the need to identify targeted treatment interventions.
- Published
- 2014