{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:35Z","timestamp":1792787735572,"version":"4.5.0"},"reference-count":58,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Royal Children's Hospital Foundation","id":[{"id":"https:\/\/ror.org\/00nxtdr22","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>Understanding how post-concussive symptoms (PCS) evolve across multiple domains and how these patterns relate to biopsychosocial factors is critical for identifying children at risk of prolonged recovery following concussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To identify clinically meaningful recovery groups characterized by shared trajectories of cognitive, physical, emotional, and fatigue PCS over 3 months post-injury, and to examine associations between trajectory group membership and pre-injury, injury-related, and biopsychosocial factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants:<\/jats:title>\n                    <jats:p>This prospective longitudinal cohort study was conducted at the Royal Children\u2019s Hospital, Victoria, Australia. Participants were children aged 5\u201318 years presenting to the emergency department (ED) with concussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures:<\/jats:title>\n                    <jats:p>Cognitive, physical, emotional, and fatigue PCS above pre-injury baseline were assessed via parent report using the Postconcussion Symptom Inventory at ED presentation and at 2\u20134 days, 2 weeks, 1 month, and 3 months post-injury. Group-based multi-trajectory modeling identified recovery groups. Associations with pre-injury, injury-related, psychosocial, and child factors were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 326 children (231 males [70.9%]; mean [SD] age, 11.6 [3.2] years), five recovery trajectories were identified:\n                      <jats:italic toggle=\"yes\">resilient<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 45, 14%),\n                      <jats:italic toggle=\"yes\">early recovery<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 28, 9%),\n                      <jats:italic toggle=\"yes\">typical recovery<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 146, 45%),\n                      <jats:italic toggle=\"yes\">delayed symptom exacerbation<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 24, 7%), and\n                      <jats:italic toggle=\"yes\">persistently high symptom endorsement<\/jats:italic>\n                      (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 83, 25%). Exploratory comparisons suggested that persisting trajectories were associated with prior child mental health history and greater post-injury psychosocial difficulties.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance:<\/jats:title>\n                    <jats:p>Pediatric concussion symptom domains followed broadly similar time courses for most children; however, among children with delayed or persisting symptoms, some domains differed in the shape and timing of change. Recovery profiles characterized by persisting symptom endorsement were more strongly associated with psychosocial and mental health factors than with injury-related characteristics, underscoring the importance of early psychosocial screening and ongoing monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08977151261499596","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:15:48Z","timestamp":1792145748000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multidomain Post-Concussive Symptom Trajectories and Biopsychosocial Correlates Following Pediatric Concussion"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8361-7334","authenticated-orcid":false,"given":"Daniel A. P.","family":"Geraghty","sequence":"first","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Anderson","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia."},{"name":"Psychology Service, The Royal Children\u2019s Hospital, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2984-1172","authenticated-orcid":false,"given":"Stephen J.C.","family":"Hearps","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"School of Psychology, Deakin University, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Takagi","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabian","family":"Fabiano","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin A.","family":"Davis","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"Department of Neurosurgery, Austin and Cabrini Hospitals, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine O.","family":"Bray","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cathriona","family":"Clarke","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia M.","family":"Parkin","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa C.","family":"Rausa","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Anderson","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Ignjatovic","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"Departments of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Seal","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bressan","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"Department of Women\u2019s and Children\u2019s Health, Universit\u00e0 degli Studi di Padova, Padova, Veneto, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz E.","family":"Babl","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia."},{"name":"Emergency Department, The Royal Children\u2019s Hospital, Melbourne, Victoria, Australia."},{"name":"Department of Rehabilitation Medicine, The Royal Children\u2019s Hospital, Melbourne, Victoria, Australia."},{"name":"Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/2021.6.Peds20953"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-4635"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097699"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamapediatrics.216"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.434"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1203"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31828d57dd"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-2003"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0432"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/08977151251365530"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0925"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsr087"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.2900"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1017\/s0033291717003221"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2003.12.036"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2018.5792"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2016.4842"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/htr.0000000000000298"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0009922815589914"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0b013e31825ad658"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyaa310"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2020.1716996"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0018112"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699050903508226"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2021-105193"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijdevneu.2011.05.008"},{"key":"e_1_3_3_28_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0031370"},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1056"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-103548"},{"key":"e_1_3_3_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/15374416.2012.632348"},{"key":"e_1_3_3_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2019.06.014"},{"key":"e_1_3_3_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2023.0116"},{"key":"e_1_3_3_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/htr.0000000000000499"},{"key":"e_1_3_3_35_1","doi-asserted-by":"publisher","DOI":"10.1159\/000056009"},{"key":"e_1_3_3_36_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617718001169"},{"key":"e_1_3_3_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009427"},{"key":"e_1_3_3_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022098"},{"key":"e_1_3_3_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092313"},{"key":"e_1_3_3_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acu014"},{"key":"e_1_3_3_41_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2009.058255"},{"key":"e_1_3_3_42_1","doi-asserted-by":"publisher","DOI":"10.1542\/pir.21-8-265"},{"key":"e_1_3_3_43_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15374424jccp3003_9"},{"key":"e_1_3_3_44_1","first-page":"xxvii","volume-title":"Diagnostic and statistical manual of mental disorders","year":"1994","unstructured":"43.Diagnostic and statistical manual of mental disorders, 4th ed. Arlington, VA, US: American Psychiatric Publishing, Inc.; 1994. xxvii, x886.","edition":"4"},{"key":"e_1_3_3_45_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0033324"},{"key":"e_1_3_3_46_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291702006074"},{"key":"e_1_3_3_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199902000-00003"},{"key":"e_1_3_3_48_1","doi-asserted-by":"publisher","DOI":"10.3109\/17477160903111706"},{"key":"e_1_3_3_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10428"},{"key":"e_1_3_3_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/bf03405676"},{"key":"e_1_3_3_51_1","doi-asserted-by":"publisher","DOI":"10.1080\/07481756.2002.12069038"},{"key":"e_1_3_3_52_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216673085"},{"key":"e_1_3_3_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-022-01622-9"},{"key":"e_1_3_3_54_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360229"},{"key":"e_1_3_3_55_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2019.6683"},{"key":"e_1_3_3_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2020.09.017"},{"key":"e_1_3_3_57_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00220"},{"key":"e_1_3_3_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2016.03.009"},{"key":"e_1_3_3_59_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.80.7_supplement.P04.027"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08977151261499596","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08977151261499596","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08977151261499596","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T11:49:17Z","timestamp":1792324157000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08977151261499596"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":58,"alternative-id":["10.1177\/08977151261499596"],"URL":"https:\/\/doi.org\/10.1177\/08977151261499596","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"article-number":"08977151261499596"}}