Objective.
The present study aimed to explore the prevalence of subconcussive head trauma, traumatic brain injury (TBI), potential hypoxic events, and hypoxic brain injury (HBI) in victims of ...physical intimate partner violence (IPV). The study also aimed to characterize the injury presentation and mechanisms of injury in this population.
Method.
A group of 47 female participants with a history of at least one relationship that included physical violence completed a structured interview assessing for subconcussive hits, TBI, and HBI. Participants ranged in age from 19 to 55, and had an average of 15.3 years of education. Forty-four participants completed the structured interview in person and three participants completed the interview over the phone.
Results.
The majority of participants reported sustaining at least one impact to the head and approximately half of the participants sustained at least one impact that resulted in a mild TBI. Approximately half of the participants experienced at least one incident of having difficulty breathing due to a violent act from their partner, and approximately one-third of participants reported symptoms consistent with mild HBI. The most common mechanisms of injury were being hit with a closed fist and being strangled.
Conclusions.
The high levels of head trauma observed in this study highlight the need for clinical and community providers to screen victims of physical IPV for head trauma. The unique characteristics of this population (female sex, high frequency of injuries, and presence of HBIs) indicate that research evaluating the cognitive effects of injuries in this population is needed.
Depression is common after concussion and is associated with functional outcome and quality of life after injury. However, few baseline predictors of postconcussion depressive symptoms (PCDS) have ...been found.
To describe the prevalence of depressive symptoms in a collegiate athlete sample at baseline and postconcussion, compare these levels of symptoms and change in symptoms with those of a control group with no reported concussions in the past year, and examine the baseline predictors for PCDS.
Case-control study.
Undergraduate institution.
Participants were 84 collegiate athletes (65 men, 19 women) with concussion and 42 individuals (23 men, 21 women) with no history of recent concussion who served as controls.
The Beck Depression Inventory-Fast Screen was administered to the concussion group at baseline and postconcussion and to the control group at 2 time points.
Seventeen athletes (20%) showed a reliable increase in depression, and more athletes reported clinically important depression postconcussion than at baseline. Only 2 participants (5%) in the control group showed a reliable increase in depression. Concussed athletes were more likely to show a reliable increase in depression symptoms than control participants (χ(2)1 = 5.2, P = .02). We also found several predictors of PCDS in the athletes, including baseline depression symptoms (r = 0.37, P < .001), baseline postconcussion symptoms (r = 0.25, P = .03), estimated premorbid intelligence (full-scale IQ; r = -0.29, P = .009), and age of first participation in organized sport (r = 0.34, P = .002). For the control group, predictors of depression symptoms at time 2 were number of previous head injuries (r = 0.31, P = .05) and baseline depression symptoms (r = 0.80, P < .001).
A large proportion of athletes showed a reliable increase in depression after concussion, and we identified several baseline predictors. Given that depression affects quality of life and recovery from concussion, more research is necessary to better understand why certain athletes show an increase in PCDS and how these can be better predicted and prevented.
Abstract
Objective
To explore self-efficacy as a possible mediator in the relationship between adaptive coping and psychological well-being (PWB) in persons with relapsing–remitting multiple ...sclerosis (RRMS).
Method
174 persons with RRMS (95% Female) completed an online survey consisting of psychosocial questionnaires. The COPE Inventory was used to create an adaptive coping composite that accounts for the relative contributions of both active and avoidant coping. Self-efficacy was measured using the General Self-Efficacy Scale. The Ryff Psychological Well-Being Scales captured several domains of PWB: Positive relations with others, autonomy, purpose in life, self-acceptance, and personal growth. The SPSS PROCESS macro was used to test whether self-efficacy mediated the association between adaptive coping and each PWB subscale, using 5000 bootstrap samples to estimate confidence intervals.
Results
In each mediational model, adaptive coping significantly predicted each PWB subscale and self-efficacy (all p’s ≤ 0.001). Self-efficacy significantly predicted each PWB subscale (p ≤ 0.001). After controlling for self-efficacy, the associations between adaptive coping and positive relations with others (indirect effect = 0.021, 95% CI 0.011, 0.033) and autonomy (indirect effect = 0.019, 95% CI 0.011, 0.028) became non-significant. The separate associations between adaptive coping and purpose in life (p = 0.004), self-acceptance (p = 0.026), and personal growth (p < 0.001) remained significant, despite controlling for self-efficacy.
Conclusions
Self-efficacy fully mediated the relationships between adaptive coping and positive relations with others and autonomy in our sample of persons with RRMS. Interventions aimed at increasing adaptive coping skills and self-efficacy may improve relations with others and autonomy among persons with MS.
The development of a new measure of concussion knowledge and attitudes that is more comprehensive and psychometrically sound than previous measures is described. A group of high-school students (N = ...529) completed the measure. The measure demonstrated fair to satisfactory test-retest reliability (knowledge items, r = .67; attitude items, r = .79). Exploratory factor analysis of the attitude items revealed a four-factor solution (eigenvalues ranged from 1.07-3.35) that displayed adequate internal consistency (Cohen's alpha range = .59-.72). Cluster analysis of the knowledge items resulted in a three-cluster solution distributed according to their level of difficulty. The potential uses for the measure are described.
Because of its high prevalence and implications for quality of life and possibly even disease progression, depression has been intensively studied in multiple sclerosis (MS) over the past 25 years. ...Despite the publication of numerous excellent empirical research papers on this topic during that time, the publication of theoretical work that attempts to explain depression in a comprehensive way is scarce. In this study, we present a theoretical model that attempts to integrate existing work on depression in MS and provide testable hypotheses for future work. The model suggests that risk for depression begins with the onset of MS. MS results in disease-related changes such as increased lesion burden/brain atrophy and immunological anomalies that are associated with depression in MS, but explain only a relatively limited proportion of the variance. Common sequelae of MS including fatigue, physical disability, cognitive dysfunction, and pain, have all been shown to have an inconsistent or relatively weak relationship to depression in the literature. In the model, we propose that four variables--social support, coping, conceptions of the self and illness, and stress--may moderate the relationship between the above common MS sequelae with depression and help to explain inconsistencies in the literature.
Highlights ► Prolonged administration of neuropsychological testing induces increased self-reported and performance-related fatigue. ► Modulation of EEG activity during neuropsychological testing is ...an index of fatigue rather than a training effect. ► Fatigue effect should be taken into consideration during administration of a neuropsychological test battery in clinical populations.
The ultimate objective of the present investigation was to improve the detection of depression in multiple sclerosis (MS) by comparing common self-report depression measures to a new, modified ...measure, which takes into account the contribution that symptoms of MS may have on individuals' reports. There has been a longstanding concern regarding the accurate assessment of depression in MS, particularly with regard to the overlap of MS symptomatology and neurovegetative depression symptoms on self-report questionnaires, which may lead to an overdiagnosis of depression in MS. To address these difficulties, we previously proposed a "trunk and branch" of depression in MS. This model allows for the delineation of what symptoms are most reflective of depression in MS. By identifying these symptoms, it was possible to develop a modified Beck Depression Inventory (BDI) in which only the items found to be most related to depression in MS are included in the new measure, the MS Specific BDI (MS-BDI). We compared this measure to common self-report instruments (Beck Depression Inventory-Second Edition, BDI-II; Beck Depression Inventory-Fast Screen, BDI-FS; Chicago Multiscale Depression Inventory, CMDI). Results suggest that cutoffs of 4 on the BDI-FS and 23 on the CMDI Mood subscale are most useful when screening for depression in MS, with a sensitivity for both of 100%, while a cutoff of 19 on the BDI-II, a cutoff of 22 on the CMDI Evaluative scale, and a cutoff of 8 on the MS-BDI had high specificities, suggesting they can be used as to assist in diagnosing depression in MS.
Introduction: In recent years, the sports community has been faced with the challenge of determining when it is safe to return concussed athletes to play. Given that return-to-play decisions are ...partially dependent upon athletes' endorsement of symptoms, better understanding what factors contribute to the presence of symptoms following concussion is crucial. The purpose of the present study was to better characterize the symptoms that athletes endorse at baseline and to determine what impact various premorbid (or preinjury) characteristics have on the presence and severity of postconcussion symptoms in the acute injury period following concussion. Method: Two groups of participants with similar ages and levels of education were examined: athletes at baseline (N = 702) and postconcussion (N = 55). Athletes were administered a comprehensive battery of neuropsychological tests, consisting of neurocognitive and neurobehavioral measures, at both time periods. The main outcome measure was the Post-Concussion Symptoms Scale (PCSS). A factor analysis was conducted on the participants' baseline PCSS data to determine the factor structure of the PCSS, and separate logistic regression analyses were conducted that examined the baseline PCSS symptom clusters (derived from the factor analysis), demographic variables, and baseline neurocognitive variables as predictors of dichotomized postconcussion PCSS total scores (i.e., low versus high symptom reporting following concussion). Results: Four distinct clusters emerged from the factor analysis measuring cognitive, physical, affective, and sleep symptoms. Logistic regression results indicated that the physical and affective symptom clusters at baseline reliably predicted athletes' postconcussion symptom group, as did sex and the neurocognitive composite score. Conclusions: These findings show that certain baseline characteristics of athletes confer risk for greater symptomatology postconcussion. Knowledge of these risk factors can assist the management and treatment of sports-related concussion.
Objective: To examine neuropsychological test differences following concussion between collegiate athletes screening positive and negative for depression. Method: Participants included 113 (91 male) ...college athletes, who were assessed at baseline and following diagnosis of sport-related concussion (SRC). The Beck Depression Inventory-Fast Screen was used as a screener for depression. Athletes were categorized as either depressed (≥4) or nondepressed (<4) following injury and compared on composites for memory and attention-processing speed. Groups were also compared on reliable change index scores from baseline, as well as on proportion of impaired scores. Results: Depressed athletes performed significantly worse than did nondepressed athletes on the Memory Composite (p = .04, d = .51) but not on the Attention-Processing Speed Composite score (p = .15, d = .46). Chi-square tests indicated that, compared with nondepressed athletes, a significantly higher number of depressed athletes showed reliable decreases on the following test indices: Verbal Memory Composite of the Immediate Post-Concussion Assessment and Cognitive Testing (p = .03, φ = .21), Brief Visuospatial Memory Test-Revised Total (p = .02, φ = .22), and Hopkins Verbal Learning Test-Revised Total (p = .05, φ = .19). Chi-square test indicated that, compared with nondepressed athletes, a significantly higher proportion of depressed athletes met criteria for impairment (p = .02, φ = .23). Conclusion: Whether examining the data at the intraindividual or group level, there are memory deficits associated with the combination of an SRC and depression. The results highlight the importance of screening for depression to provide a more complete picture of an individual's functioning postconcussion.
General Scientific Summary
The prevalence of sport-related concussion (SRC), especially among adolescents and college-aged students, is an increasing public health concern. Certain sequalae, such as mood difficulties, might contribute to prolonged and/or complicated recovery. Understanding the impact of an SRC, and concurrently clinically relevant depression, on an athlete's functioning is of importance to clinicians treating athletes postconcussion.
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