Browsing by Author "Chadwick, Leah"

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    Injury Setting and Social Support as Moderators of the Effects of Pediatric Concussion on Post-Concussive Symptoms
    (2020-09-16) Chadwick, Leah; Yeates, Keith Owen; Emery, Carolyn A.; Brooks, Brian L.; Madigan, Sheri L.
    Concussions are a pressing public health concern. Concussions often result in physical, cognitive, and emotional problems, known as post-concussive symptoms (PCS). Although most children recover from concussions without complication, a subset are hindered by persistent PCS that reduce their quality of life. Previous research tends to differentiate between sport-and-recreation-related and non-sport-related concussions because there may be differences between these settings that affect concussion outcomes. Social support, the perceived or actual support a person receives from their community and social networks, is known to protect against detrimental consequences of health problems. However, little research has examined the effect of social support on PCS after concussion. Social support may foster recovery, particularly for children with sport-related concussions, who are often isolated from their teams during recovery, resulting in feelings of loneliness and isolation. This study aimed to identify the effects of social support on PCS in children after sport-related versus non-sport-related concussion. Participants were children/adolescents aged 8-16 years with either concussion or orthopedic injury who were recruited during Emergency Department visits at five sites across Canada. Injury information was collected in the Emergency Department, social support was measured at 10 days, and PCS were measured at 10 days, 3 months, and 6 months post-injury. Linear multi-level modelling analysis was used to examine injury group (concussion versus orthopedic injury), injury setting (sport-related versus non-sport-related), and social support as predictors of PCS over time. The analyses found that social support predicted lower ratings of cognitive PCS, but regardless of the type of injury. However, injury setting did have a specific moderating effect on recovery from concussion, such that concussions in non-sport-related settings were associated with higher cognitive PCS relative to orthopedic injuries and concussions occurring in sport-related settings. We did not find any significant effects of social support or injury setting on somatic PCS, which suggests that trajectories of somatic and cognitive PCS after concussion may be associated with different risk factors.
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    The Relation between Parental and Family Functioning and Post-concussive Symptoms after Pediatric Mild Traumatic Brain Injury
    (2024-07-15) Chadwick, Leah; Yeates, Keith Owen; Callahan, Brandy; Madigan, Sheri; Giesbrecht, Gerald; Babikian, Talin
    Mild traumatic brain injuries (TBI) are commonly sustained by children and adolescents. An extensive literature documents the reciprocal relationship between family functioning and outcomes of childhood moderate and severe TBI, however, the influence of parental and family functioning on children’s post-concussive symptoms (PCS) after mild TBI is not well understood. The goal of this dissertation was to examine the influence of parental and family functioning on PCS after mild TBI. Study 1 consists of a scoping review that examined the existing research on the relationship between parental and family functioning and pediatric mild TBI to determine relevant parental and family factors, summarize findings, and identify areas for further research. Study 2 consists of an original research study that aimed to identify distinct trajectories of PCS after mild TBI in 8- to 16-year-old children and to examine their association with parental and family functioning, as compared to children with orthopedic injuries (OI). Study 1 identified 15 articles that address three questions: (1) Does mild TBI result in more parental distress or poorer family functioning than other injuries?; (2) Does pre-injury or acute parental distress and family functioning predict PCS after mild TBI?; and (3) Does acute PCS predict later parental distress and family functioning? Overall, findings were mixed, although the available evidence suggests that parent and family functioning may have an important, perhaps bidirectional, association with PCS after pediatric mild TBI. Study 2 employed group-based multi-trajectory modeling to classify children into distinct trajectories of child- and parent-reported cognitive and somatic PCS across the first 6 months post-injury and to examine parental and family functioning as predictors of those trajectories. Several parental and family factors were identified as significant predictors of trajectory membership after mild TBI, including parental adjustment, protectiveness, and social support. Study 2 demonstrates that better parental functioning tends to be associated with a more rapid recovery for children with mild TBI. Identification of different symptom trajectories and the influence of parental and family functioning as predictors of those trajectories provides guidance in developing family-based treatments and enabling the targeting of those treatments to children at risk for poor recovery.