{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:02:34Z","timestamp":1785132154631,"version":"3.55.0"},"reference-count":69,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["FDN143304"],"award-info":[{"award-number":["FDN143304"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:p>\n                    The family environment plays an important role in children\u2019s recovery from traumatic brain injury (TBI); however, parental and family factors have not been examined in-depth in pediatric mild TBI (mTBI). Existing research on postconcussive symptoms (PCS) typically employs conventional statistical analyses that assume that children with mTBI are a homogenous group. However, children may display distinct trajectories of PCS across time after mTBI. Group-based multitrajectory modeling can identify latent clusters of individuals following similar trajectories across multiple indicators of an outcome. This study sought to: (1) identify trajectories of PCS after mTBI in children, and (2) examine their association with parental and family functioning. Participants were 506 children and adolescents aged 8- to 16-years-old who were recruited during emergency department (ED) visits within 48 h of injury at five Pediatric Emergency Research Canada hospitals. Injury information was collected in the ED, and parental and family functioning was measured at approximately 7 days postinjury. Child and parent PCS ratings were obtained weekly to 3 months and biweekly to 6 months postinjury using the Health and Behavior Inventory. Parental and family functioning were assessed using validated measures of family functioning, parental adjustment, perceived social support from parents, and parental responses to children\u2019s symptom complaints. Group-based multitrajectory modeling was used to classify individual children into distinct trajectories of child- and parent-reported cognitive and somatic PCS over time and to examine predictors of those trajectories. Six distinct trajectories were identified: \u201clow acute\/resolved PCS\u201d (\n                    <jats:italic toggle=\"yes\">n =<\/jats:italic>\n                    98), \u201clow acute\/declining PCS\u201d (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 64), \u201cmoderate acute\/elevated cognitive PCS\u201d (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 106), \u201cmoderate acute\/declining PCS\u201d (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 118), \u201chigh acute\/declining PCS\u201d (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 88), and \u201chigh acute\/persisting PCS\u201d (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 32). Parental adjustment, protectiveness, and social support were independent predictors of trajectory membership after adjusting for demographic and injury characteristics. The identification of different symptom trajectories and specific aspects of parental and family functioning as predictors of these trajectories provides guidance for developing family-based treatments and targeting treatments to children at risk for poor recovery.\n                  <\/jats:p>","DOI":"10.1177\/08977151251393718","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T10:35:44Z","timestamp":1762770944000},"page":"605-617","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Parental and Family Functioning as Predictors of Longitudinal Trajectories of Postconcussive Symptoms Following Pediatric Mild Traumatic Brain Injury: An Advancing Concussion Assessment in Pediatrics Study"],"prefix":"10.1177","volume":"43","author":[{"given":"Leah","family":"Chadwick","sequence":"first","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada."},{"name":"Alberta Children\u2019s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheri","family":"Madigan","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada."},{"name":"Alberta Children\u2019s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandy L.","family":"Callahan","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam H.","family":"Beauchamp","sequence":"additional","affiliation":[{"name":"Department of Psychology, Universit\u00e9 de Montreal and Ste-Justine Hospital Azrieli Research Center, Montreal, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Craig","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alberta and Stollery Children\u2019s Hospital, Edmonton, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quynh","family":"Doan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of British Columbia and BC Children\u2019s Hospital Research Institute, Vancouver, British Columbia, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen B.","family":"Freedman","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Gravel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, CHU Sainte-Justine, Universite de Montreal, Montreal, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zemek","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Emergency Medicine, Children\u2019s Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith Owen","family":"Yeates","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Calgary, Calgary, Alberta, Canada."},{"name":"Alberta Children\u2019s Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada."},{"name":"Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Pediatric Emergency Research Canada (PERC) A-CAP Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4635"},{"key":"e_1_3_3_3_2","unstructured":"Centers for Disease Control and Prevention. 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