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

Ashleigh M Johnson, Carolyn A McCarty, Lyscha A Marcynyszyn, Douglas F Zatzick, Sara Pd Chrisman, Frederick P Rivara
Brain Injury 2021 April 16, 35 (5): 574-586
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 InventoryTM 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 Mage  = 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.

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