Impact of TBI in children extends beyond initial injury, research finds

Children with TBI face higher rates of anxiety and depression, while strong family support may help lower the risk of depression after injury, new research has revealed.

Researchers analysed links between medically diagnosed traumatic brain injury, or TBI, and mental and physical health outcomes in US children and teenagers aged six to 17.

They found those with TBI had a significantly higher prevalence of poor health than those without TBI, along with increased odds of current anxiety, frequent headaches and chronic pain.

The study also found that family resilience, meaning how families respond to stress, communicate effectively and draw on shared strengths in a crisis, was associated with decreased odds of depression after TBI.

Henry Xiang, principal investigator and senior author of the study, said: “Our study shows that the impact of traumatic brain injury in children often extends well beyond the initial injury.

“Children who experience TBI face increased risks of mental health challenges such as anxiety and depression, highlighting the importance of routine mental health screening and long-term follow-up care.”

The research was carried out by the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s Hospital, The Ohio State University and the University of Washington.

It used data from the 2022 and 2023 National Survey of Children’s Health, a nationally representative survey collecting caregiver-reported data on health and wellbeing, healthcare access, family environments and social factors affecting health for children and adolescents across all 50 US states and the District of Columbia.

Xiang said: “One of the most encouraging findings from our research is that family resilience appears to play an important role in a TBI patient’s recovery.

“Children recovering from traumatic brain injury who grow up in supportive families may have lower risks of long-term mental health problems.

“Strengthening family support systems and resilience may be an important pathway to improving TBI patients’ long-term outcomes.”

These findings underline the importance of strategies families can use to build resilience during recovery.

Christine Koterba, a paediatric neuropsychologist at Nationwide Children’s who was not involved in the study, said: “Recovery following brain injury in children is about so much more than the child themselves.

“Recovery happens in many contexts with many people, with home and primary caregivers being some of the most important.”

“I see how recovery actually happens outside the brain, in environments where children spend their time surrounded by steady caregivers in their lives.

“This study opens the door for future research focused on caregiver resilience.”