Child- compared with parent-report ratings on psychosocial measures following a mild traumatic brain injury among youth with persistent post-concussion symptoms

ABSTRACT

Primary Objective: To compare child- and parent-report ratings on the Health Behavior Inventory, Revised Child Anxiety and Depression Scale-Short Version (anxiety subscale), Patient Health Questionnaire-9, and Pediatric Quality of Life Inventory^TM among children with persistent post-concussive symptoms following a sports- or recreation-related concussion, overall and by child age and gender.

Research Design: Cross-sectional study examining baseline data from a randomized, comparative effectiveness trial.

Methods and Procedures: Inter-rater reliability was assessed using two-way random effects model (absolute agreement) intraclass correlations, correlations were examined using Spearman’s rho, mean differences were determined using paired t-tests, and agreement was examined using Bland–Altman plots.

Main Outcomes and Results: The final analytic sample was 200 parent–child dyads [child M_age = 14.7 (95% CI: 14.5, 15.0)]. Reliability and correlations were modest overall. When considering child age and gender, reliability ranged from poor to excellent (−1.01–0.95) and correlations ranged from weak to strong (−0.64–0.94). Overall, children reported more symptoms but better functioning than parents, and mean differences in scores were greater among females (versus males) and ages 16–18 (versus younger groups).

Conclusions: Findings should inform the use and interpretation of psychosocial measures when developing appropriate youth concussion treatment plans.

KEYWORDS:

• Concussion
• parent–child agreement
• quality of life
• anxiety
• depression

Acknowledgments

The authors thank Drs. Jinguji, Quitiquit, and Osorio for referring patients to the study. We also thank Teah Hoopes for her meticulous study oversight as well as the Clinical Research Coordinators who spearheaded participant recruitment and data collection efforts: Lauren Fay and Lauren Stanek. Finally, we thank the adolescents and families who participated in this research.

Disclosure of interest

The authors report no conflict of interest. The parent study, CARE4PCS II, was supported by funding from the National Institute of Child Health and Human Development, R01 HD090230 (PIs: McCarty, Rivara, and Zatzick).

Additional information

Funding

This work was supported by the National Institute of Child Health and Human Development [R01 HD090230].