A typology of psychosocial functioning in pediatric closed-head injury

Abstract

A typology of psychosocial functioning following pediatric closed-head injury (CHI) was derived by subjecting Personality Inventory for Children-Revised (PIC-R) profiles to cluster analyses. Participants (N = 128) aged 6 to 16 years were classified into mild, moderate, and severe injury groups based on loss of consciousness (LOC), Glasgow Coma Scale (GCS), and so forth. On average, subjects were injured at 8.78 years of age and were assessed 2.12 years following their injury. Using four hierarchical-agglomera-tive clustering techniques, a seven-subtype typology was derived that overlapped, in part, with typologies previously reported for children with learning disabilities (LD). Based on clinical scale elevations of the mean PIC-R profiles, the subtypes were labeled Normal, Cognitive Deficit, Somatic Concern, Mild Anxiety, Internalized Psychopathology, Antisocial, and Social Isolation. Statistically significant relationships were found between psychosocial subtype membership and (a) injury severity, and (b) age at injury. Children assigned to the Social Isolation subtype were more likely to have severe CHI, and to have been injured at younger ages. Children tested after longer intervais since sustaining their CHI also tended to be assigned to the Social Isolation subtype. This subtype had elevations on the PIC-R cognitive triad and Psychosis scales, and may represent a persistent pattern of psychosocial disturbance following childhood CHI.