Psychological and Adjustment Problems Due to Acquired Brain Lesions in Pediatric Patients

Abstract

The aim of this study was to describe psychological, behavioral, and adjustment problems in children and adolescents with acquired brain lesions of different origins. Three groups of patients with acquired brain lesions (15 patients with infectious origin, 37 with vascular origin, and 15 with other origin), ranging in age from 4 to 18 years, received a psychological evaluation, including the Child Behavior Checklist for ages 4 to 18 and the Vineland Adaptive Behavior Scale. About half of the total sample (47.8%) showed psychological problems. Difficulties varied according to the cause of the brain lesions. The most problematic patients were children with brain lesions of infectious origin, whereas children with brain lesions of vascular origin scored lower on most of the Child Behavior Checklist scales. The authors conclude that psychological and behavioral difficulties are very common among school-aged children with acquired brain lesions, and their relevance and impact must necessarily be considered.

Psychological problems, self-esteem and body dissatisfaction in a sample of adolescents with brain lesions: A comparison with a control group

“…After a brain lesion, symptoms of anxiety and depression are frequently described [16,19,52] which, to a certain extent, appear strictly related to the patients' social difficulties and the resulting isolation. On the other hand, previous studies [8,19] on patients with TBI and vascular brain lesions confirmed that internalizing problems were more common than externalizing problems in school age. In more general terms, anxiety and depression are less frequent in young subjects with brain lesions [20], while their incidence tends to increase when patients grow up and achieve a greater awareness of their residual limitations.…”

“…Based on previous research [5][6][7][8], more marked difficulties in all investigated domains were expected for the clinical sample vs the control group. Because of the visible effects of the diseases and the associated social difficulties, the authors also expected a poorer self-esteem and more marked body dissatisfaction in adolescents with a history of brain lesions as well as specific difficulties and a characteristic profile depending on the aetiology of brain lesions.…”

“…The outcomes of ABI in adolescence have a profound impact on the individual [2] and the family system [3,4]. In point of fact, in most subjects, moderate-to-severe TBI and stroke do not only determine motor, sensory and neuropsychological impairments, but they are also often related to relevant psychological and behavioural problems and difficulties in adaptive functioning [5][6][7][8] as well as deficits in academic and cognitive skills [9][10][11][12][13]. As these aspects have the potential to significantly affect the social and school re-entry of teenagers, they should be closely monitored by clinicians.…”

Investigation of children and adolescents’ mood and self-concept after acquired brain injury

“…Impairments in emotional and behavioral functioning in particular have been found to have adverse effects on children's psychosocial functioning (Anderson et al, 2013;Catroppa et al, 2015;Catroppa et al, 2017;Rosema, Crowe, & Anderson, 2012;Zyrianova, Alexander, & Faruqui, 2016). Parents commonly report emotion regulation difficulties for their children, such as irritability, agitation, reduced capacity to manage stress and frustration, and externalizing and internalizing problems (i.e., depression, anxiety, and withdrawal) (Catroppa et al, 2017;Max et al, 2012;Pastore et al, 2013;Pastore et al, 2014;Poggi et al, 2009). Such difficulties may arise from direct damage to fronto-limbic structures that underlie emotion processing and regulation and/or relate to a psychological reaction to their changing life circumstances (Jorge et al, 2004;Ownsworth et al, 2011).…”

“…Such difficulties may arise from direct damage to fronto-limbic structures that underlie emotion processing and regulation and/or relate to a psychological reaction to their changing life circumstances (Jorge et al, 2004;Ownsworth et al, 2011). Children with ABI face the challenge of adjusting to their post-injury impairments and associated changes in lifestyle, family and peer relationships, and school and vocational pursuits (Wakefield et al, 2010;Bilbao et al, 2003;Pastore et al, 2014). In turn, children's psychological well-being, including their emerging self-concept or global beliefs about their own competency and self-worth, can be negatively affected by ABI (Ownsworth, 2014).…”