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Lowet DS, Kolan A, Vaida F, Hesselink JR, Levin HS, Ewing-Cobbs L, Schachar RJ, Chapman SB, Bigler ED, Wilde EA, Saunders AE, Yang TT, Tymofiyeva O, Arif H, Max JE. Novel Oppositional Defiant Disorder 6 Months After Traumatic Brain Injury in Children and Adolescents. J Neuropsychiatry Clin Neurosci 2022; 34:68-76. [PMID: 34763527 PMCID: PMC10362978 DOI: 10.1176/appi.neuropsych.21020052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The investigators aimed to assess predictive factors of novel oppositional defiant disorder (ODD) among children and adolescents in the first 6 months following traumatic brain injury (TBI). METHODS Children ages 5-14 years who experienced a TBI were recruited from consecutive admissions to five hospitals. Testing of a biopsychosocial model that may elucidate the development of novel ODD included assessment soon after injury (baseline) of preinjury characteristics, including psychiatric disorders, adaptive function, family function, psychosocial adversity, family psychiatric history, socioeconomic status, injury severity, and postinjury processing speed (which may be a proxy for brain injury). MRI analyses were also conducted to examine potential brain lesions. Psychiatric outcome, including that of novel ODD, was assessed 6 months after the injury. RESULTS A total of 177 children and adolescents were recruited for the study, and 134 who were without preinjury ODD, conduct disorder, or disruptive behavior disorder not otherwise specified (DBD NOS) returned for the 6-month assessment. Of those who returned 6 months postinjury, 11 (8.2%) developed novel ODD, and none developed novel conduct disorder or DBD NOS. Novel ODD was significantly associated with socioeconomic status, preinjury family functioning, psychosocial adversity, and processing speed. CONCLUSIONS These findings show that an important minority of children with TBI developed ODD. Psychosocial and injury-related variables, including socioeconomic status, lower family function, psychosocial adversity, and processing speed, significantly increase risk for this outcome.
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Affiliation(s)
- Daniel S Lowet
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Anish Kolan
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Florin Vaida
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - John R Hesselink
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Harvey S Levin
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Linda Ewing-Cobbs
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Russell J Schachar
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Sandra B Chapman
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Erin D Bigler
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Elisabeth A Wilde
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Ann E Saunders
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Tony T Yang
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Olga Tymofiyeva
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Hattan Arif
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
| | - Jeffrey E Max
- Department of Psychiatry, University of California, San Diego (Lowet, Arif, Max); Quinnipiac University, Hamden, Conn. (Kolan); Herbert Wertheim School of Public Health, Division of Biostatistics & Bioinformatics, University of California, San Diego (Vaida); Department of Radiology, University of California, San Diego (Hesselink); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston (Levin); Departments of Pediatrics (Ewing-Cobbs) and Psychiatry (Saunders), University of Texas Health Science Center, Houston; the Hospital for Sick Children, University of Toronto (Schachar); Center for BrainHealth, University of Texas, Dallas (Chapman); Department of Psychology, Brigham Young University, Provo, Utah (Bigler); Department of Neurology, Traumatic Brain Injury and Concussion Center, University of Utah, Salt Lake City (Bigler, Wilde); Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, University of California, San Francisco (Yang); Department of Radiology and Biomedical Imaging, University of California, San Francisco (Tymofiyeva); and Rady Children's Hospital, San Diego (Max)
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