Content Summary : The occurrence of personality change due to traumatic brain injury (PC), and its clinical and neuroimagingcorrelates were investigated. Ninety-four children, ages 5 through 14 at the time of hospitalization followingtraumatic brain injury (TBI; severe TBI N 5 37; mild–moderate TBI N 5 57), were assessed. Standardized psychiatric, adaptive functioning, cognitive functioning, family functioning, family psychiatric history, severity ofinjury, and neuroimaging assessments were conducted. The Neuropsychiatric Rating Schedule (NPRS) was used toestablish a diagnosis of PC. Approximately 40% of consecutively hospitalized severe TBI participants had ongoingpersistent PC an average of 2 years postinjury. An additional approximately 20% had a history of a remitted andmore transient PC. PC occurred in 5% of mild–moderate TBI but was always transient. Interrater reliability for thediagnosis of PC was good (Kappa 5 .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 toany psychosocial adversity variables. These findings suggest that PC is a frequent diagnosis following severe TBIin children and adolescents, but is much less common following mild–moderate TBI. (JINS, 2000, 6, 279–289.) Keywords: Traumatic brain injury, Children and adolescents, Personality change disorder