Rehabil Psychol. 2025 Dec 18. doi: 10.1037/rep0000644. Online ahead of print.
ABSTRACT
OBJECTIVE: Examine the moderating effect of preinjury attention-deficit hyperactivity disorder (ADHD) and secondary ADHD on response to a family-based problem solving (FBPS) intervention following pediatric traumatic brain injury.
METHOD: Analyses included 233 participants (114 FBPS and 119 internet resource comparison group), aged 11-18 who had been hospitalized for a moderate-severe traumatic brain injury within the previous 18 months. Parents completed measures of child functioning and their own functioning at time of enrollment, 6-, 12-, and 18-month follow-ups. Linear mixed models examined the moderating effect of ADHD status on the effect of treatment over time.
RESULTS: Main effect of ADHD status was significant for executive functioning, F(2, 429) = 55.15, p < .0001; social competence, F(2, 421) = 22.94, p < .0001; parental depression, F(2, 420) = 4.83, p = .0085; and parental distress, F(2, 413) = 6.35, p = .0019. Consistently, those with ADHD demonstrated worse outcomes than those without ADHD. ADHD status moderated the effect of FBPS on functional impairment, F(6, 430) = 5.16, p < .0001. Among those who received FBPS, those without ADHD demonstrated the expected improvement in functional outcomes over time. The secondary ADHD group had a delayed improvement in outcomes, not present until the 18-month follow-up. The preinjury attention-deficit hyperactivity disorder group showed no change in outcomes over time.
CONCLUSIONS/IMPLICATIONS: ADHD status had a significant effect on adolescent and parent outcomes and moderated the effect of FBPS on functional outcomes. Findings highlight the importance of identifying children with preinjury ADHD as well as new onset ADHD symptoms after injury to guide intervention delivery. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
PMID:41411026 | DOI:10.1037/rep0000644
