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  1. Rhine, Tara MD, MS
  2. Cassedy, Amy PhD
  3. Yeates, Keith Owen PhD
  4. Taylor, Hudson Gerry
  5. Kirkwood, Michael W. PhD
  6. Wade, Shari L. PhD


Objective: To identify potentially modifiable individual and social-environmental correlates of posttraumatic stress symptoms (PTSS) among adolescents hospitalized for traumatic brain injury (TBI).


Setting: Four pediatric hospitals and 1 general hospital in the United States.


Participants: Children ages 11 to 18 years, hospitalized for moderate-severe TBI within the past 18 months.


Design: Retrospective cross-sectional analysis.


Main Measures: The University of California at Los Angeles (UCLA) Post-traumatic Stress Disorder (PTSD) Reaction Index and the Youth Self-Report (YSR) PTSD subscale.


Results: Of 147 adolescents enrolled, 65 (44%) had severe TBI, with an average time since injury of 5.8 +/- 4 months. Of the 104 who completed the UCLA-PTSD Reaction Index, 22 (21%) reported PTSS and 9 (8%) met clinical criteria for PTSD. Of the 143 who completed the YSR-PTSD subscale, 23 (16%) reported PTSS and 6 (4%) met clinical criteria for PTSD. In multivariable analyses, having a negative approach to problem solving and depressive symptoms were both associated (P < .001) with higher levels of PTSS based on the UCLA-PTSD Reaction Index ([beta] = 0.41 and [beta] = 0.33, respectively) and the YSR-PTSD subscale ([beta] = 0.33 and [beta] = 0.40, respectively).


Conclusion: Targeting negative aspects of problem solving in youths after brain injury may mitigate PTSS.