Personality change disorder in children and adolescents following traumatic brain injury

Jeffrey E. Max, Sharon L. Koele, Carlos C. Castillo, Scott D. Lindgren, Stephan Arndt, Hirokazu Bokura, Donald A. Robin, Wilbur L. Smith, Yutaka Sato

Research output: Contribution to journalArticlepeer-review

68 Scopus citations


The occurrence of personality change due to traumatic brain injury (PC), and its clinical and neuroimaging correlates were investigated. Ninety-four children, ages 5 through 14 at the time of hospitalization following traumatic brain injury (TBI; severe TBI N = 37; mild-moderate TBI N = 57), were assessed. Standardized psychiatric, adaptive functioning, cognitive functioning, family functioning, family psychiatric history, severity of injury, and neuroimaging assessments were conducted. The Neuropsychiatric Rating Schedule (NPRS) was used to establish a diagnosis of PC. Approximately 40% of consecutively hospitalized severe TBI participants had ongoing persistent PC an average of 2 years postinjury. An additional approximately 20% had a history of a remitted and more transient PC. PC occurred in 5% of mild-moderate TBI but was always transient. Interrater reliability for the diagnosis of PC was good (Kappa = .70). In severe TBI participants, persistent PC was significantly associated with severity of injury, particularly impaired consciousness over 100 hr, adaptive and intellectual functioning decrements, and concurrent diagnosis of secondary attention deficit hyperactivity disorder, but was not significantly related to any psychosocial adversity variables. These findings suggest that PC is a frequent diagnosis following severe TBI in children and adolescents, but is much less common following mild-moderate TBI.

Original languageEnglish (US)
Pages (from-to)279-289
Number of pages11
JournalJournal of the International Neuropsychological Society
Issue number3
StatePublished - Mar 2000


  • Children and adolescents
  • Personality change disorder
  • Traumatic brain injury

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health


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