Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.38
K. Durfee, S. Jennings, M. Womble, S. Amalfe, R. Elbin
Document changes in state anxiety over the course of recovery from concussion and examine the effect of persisting state anxiety on concussion clinical outcomes. Patients (ages 15–51 yrs) seeking care for a sport or non-sport-related concussion within 1–7 days post-injury were included in this study. Participants completed a self-report measure of state anxiety (STAI) at each clinical visit. Differences in STAI scores from visit 1 and visit 2 were calculated and used to categorize patients into a PERSIST (scores stayed the same or got worse) and an IMPROVE group (scores improved). Changes in STAI scores across two clinical visits were examined with a paired samples t-test, and a series of independent samples t-tests and chi-square analyses were used to examine between-group differences in clinical outcomes (symptom score, neurocognitive scores, vestibular/ocular motor symptoms and impairment, and recovery time). 187 participants (M = 22.37, SD = 10.67 yrs, 65% female) completed study measures at 4.25 (SD = 1.68) (visit 1) and 13.20 (SD = 28.65) (visit 2) post-injury. STAI scores significantly differed between first (M = 20.99, SD = 6.05) and second visit (M = 17.41, SD = 6.21, p < 0.001). The PERSIST group (n = 41, M = 25.90, SD = 20.03) had significantly higher total symptom scores at visit 2 compared to those in the IMPROVE group (n = 122, M = 16.23, SD = 16.17, p = 0.002). There were no significant differences in other clinical outcomes between those with and without persisting state anxiety. State anxiety changes throughout concussion recovery and individuals with persisting state anxiety exhibit higher symptom scores at visit 2. Assessment, reassurance and recognition of anxiety is important for overall symptom recovery.
{"title":"A - 38 Examining Persisting State Anxiety and Concussion Clinical Outcomes across Concussion Recovery","authors":"K. Durfee, S. Jennings, M. Womble, S. Amalfe, R. Elbin","doi":"10.1093/arclin/acae052.38","DOIUrl":"https://doi.org/10.1093/arclin/acae052.38","url":null,"abstract":"\u0000 \u0000 \u0000 Document changes in state anxiety over the course of recovery from concussion and examine the effect of persisting state anxiety on concussion clinical outcomes.\u0000 \u0000 \u0000 \u0000 Patients (ages 15–51 yrs) seeking care for a sport or non-sport-related concussion within 1–7 days post-injury were included in this study. Participants completed a self-report measure of state anxiety (STAI) at each clinical visit. Differences in STAI scores from visit 1 and visit 2 were calculated and used to categorize patients into a PERSIST (scores stayed the same or got worse) and an IMPROVE group (scores improved). Changes in STAI scores across two clinical visits were examined with a paired samples t-test, and a series of independent samples t-tests and chi-square analyses were used to examine between-group differences in clinical outcomes (symptom score, neurocognitive scores, vestibular/ocular motor symptoms and impairment, and recovery time).\u0000 \u0000 \u0000 \u0000 187 participants (M = 22.37, SD = 10.67 yrs, 65% female) completed study measures at 4.25 (SD = 1.68) (visit 1) and 13.20 (SD = 28.65) (visit 2) post-injury. STAI scores significantly differed between first (M = 20.99, SD = 6.05) and second visit (M = 17.41, SD = 6.21, p < 0.001). The PERSIST group (n = 41, M = 25.90, SD = 20.03) had significantly higher total symptom scores at visit 2 compared to those in the IMPROVE group (n = 122, M = 16.23, SD = 16.17, p = 0.002). There were no significant differences in other clinical outcomes between those with and without persisting state anxiety.\u0000 \u0000 \u0000 \u0000 State anxiety changes throughout concussion recovery and individuals with persisting state anxiety exhibit higher symptom scores at visit 2. Assessment, reassurance and recognition of anxiety is important for overall symptom recovery.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.37
Bradyn Quinn Ree-Fedun, J. Hansen, C. David, R. White, M. Mrazik
Examine the prevalence of mental health difficulties in university student-athletes during baseline concussion assessment. Two hundred and forty-three university athletes (male = 163, female = 80) completed the. Sideline Concussion Assessment Tool, 3rd Edition (SCAT3) Symptom Evaluation scale and the Brief Symptom Inventory (BSI-18) self-report questionnaire at baseline evaluation across two consecutive seasons. The BSI-18 measured psychological distress using 5-point rating scales to calculate three emotional scales (Somatization, Depression, Anxiety) and one total scale (Global Severity Index). The four psychological symptoms from the SCAT3 Symptom Evaluation scale (more emotional, irritability, sadness, and nervous or anxious) were selected to calculate a total psychological symptom score out of 24. Existing normative data informed the SCAT3 symptom severity, including classifications of mild (1–2), moderate (3–4), and severe (5–6). Descriptive statistics indicated that 7.5% of athletes reported depressive symptoms and. 9.5% reported anxious symptoms on the BSI-18. The SCAT3 psychological symptoms score showed that 6.5% of athletes were within the mild range. Significant correlations existed between the SCAT3 total psychological symptom score and the BSI’s Anxiety, Depression, Somatization, and Global Severity Index scales (p < 0.01). A small but significant number of collegiate athletes reported experiencing psychological symptoms during baseline concussion evaluation. These results indicate that the psychological symptoms of the SCAT’s Symptom Evaluation scale may help identify players with more significant mental health concerns who will likely benefit from mental health support.
{"title":"A - 37 Baseline Mental Health Functioning in University Student Athletes.","authors":"Bradyn Quinn Ree-Fedun, J. Hansen, C. David, R. White, M. Mrazik","doi":"10.1093/arclin/acae052.37","DOIUrl":"https://doi.org/10.1093/arclin/acae052.37","url":null,"abstract":"\u0000 \u0000 \u0000 Examine the prevalence of mental health difficulties in university student-athletes during baseline concussion assessment.\u0000 \u0000 \u0000 \u0000 Two hundred and forty-three university athletes (male = 163, female = 80) completed the.\u0000 Sideline Concussion Assessment Tool, 3rd Edition (SCAT3) Symptom Evaluation scale and the Brief Symptom Inventory (BSI-18) self-report questionnaire at baseline evaluation across two consecutive seasons. The BSI-18 measured psychological distress using 5-point rating scales to calculate three emotional scales (Somatization, Depression, Anxiety) and one total scale (Global Severity Index). The four psychological symptoms from the SCAT3 Symptom Evaluation scale (more emotional, irritability, sadness, and nervous or anxious) were selected to calculate a total psychological symptom score out of 24. Existing normative data informed the SCAT3 symptom severity, including classifications of mild (1–2), moderate (3–4), and severe (5–6).\u0000 \u0000 \u0000 \u0000 Descriptive statistics indicated that 7.5% of athletes reported depressive symptoms and.\u0000 9.5% reported anxious symptoms on the BSI-18. The SCAT3 psychological symptoms score showed that 6.5% of athletes were within the mild range. Significant correlations existed between the SCAT3 total psychological symptom score and the BSI’s Anxiety, Depression, Somatization, and Global Severity Index scales (p < 0.01).\u0000 \u0000 \u0000 \u0000 A small but significant number of collegiate athletes reported experiencing psychological symptoms during baseline concussion evaluation. These results indicate that the psychological symptoms of the SCAT’s Symptom Evaluation scale may help identify players with more significant mental health concerns who will likely benefit from mental health support.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.29
A. Datoc, A. S. Mathew, S. Boucher, D. M. Choi, C. Ellis, J. P. Abt
Medical care for transgender youth requires a tailored approach to address their specific healthcare needs. The purpose of this study was to compare concussion patient characteristics between a population of youth who identified as transgender and their cisgender peers. Data were extracted from medical records (neurodevelopmental/psychiatric history, mechanism of injury, time between injury/evaluation, time between evaluation/recovery, and initial PCSS score) of 10 female patients selected using a stratified random sampling method (Mage = 15.0¬ ± 2.9 years) and five patients who identified as transgender with female sex assigned at birth (Mage = 14.4¬ ± 1.5 years). All patients presented to a specialty concussion clinic in 2020–2023. Patients who identified as transgender were significantly more likely to have a history of anxiety (X2[1] = 8.57, p = 0.003) and depression (X2[1] = 10.91, p < 0.001). Recovery time was significantly longer in those who identified as transgender (Mtrans = 36¬ ± 20.6 days; Mcis = 18.9¬ ± 8.6 days; p = 0.03). Days since injury to initial visit (Mtrans = 6.4¬ ± 2.4 days; Mcis = 3.8¬ ± 3.5 days; p = 0.16) and PCSS score (Mtrans = 46.8¬ ± 16.5; Mcis = 38¬ ± 26.6; p = 0.56) did not differ between groups. The average recovery time for this sample of transgender youth was significantly longer than their cisgender peers. Transgender youth also reported higher rates of anxiety and depression, which are well-known to impact concussion recovery. Sensitivity to psychological distress and mental health history is crucial for overall medical care and is supported when assessing and treating concussion in transgender youth. The effects of gender transition-related treatments (i.e., hormone therapy), discomfort in gender-segregated spaces, gender dysphoria, and other minority stressors warrant further research and should also be considered in concussion care of transgender patients.
{"title":"A - 29 Clinical Considerations for Concussion Care for Transgender Youth","authors":"A. Datoc, A. S. Mathew, S. Boucher, D. M. Choi, C. Ellis, J. P. Abt","doi":"10.1093/arclin/acae052.29","DOIUrl":"https://doi.org/10.1093/arclin/acae052.29","url":null,"abstract":"\u0000 \u0000 \u0000 Medical care for transgender youth requires a tailored approach to address their specific healthcare needs. The purpose of this study was to compare concussion patient characteristics between a population of youth who identified as transgender and their cisgender peers.\u0000 \u0000 \u0000 \u0000 Data were extracted from medical records (neurodevelopmental/psychiatric history, mechanism of injury, time between injury/evaluation, time between evaluation/recovery, and initial PCSS score) of 10 female patients selected using a stratified random sampling method (Mage = 15.0¬ ± 2.9 years) and five patients who identified as transgender with female sex assigned at birth (Mage = 14.4¬ ± 1.5 years). All patients presented to a specialty concussion clinic in 2020–2023.\u0000 \u0000 \u0000 \u0000 Patients who identified as transgender were significantly more likely to have a history of anxiety (X2[1] = 8.57, p = 0.003) and depression (X2[1] = 10.91, p < 0.001). Recovery time was significantly longer in those who identified as transgender (Mtrans = 36¬ ± 20.6 days; Mcis = 18.9¬ ± 8.6 days; p = 0.03). Days since injury to initial visit (Mtrans = 6.4¬ ± 2.4 days; Mcis = 3.8¬ ± 3.5 days; p = 0.16) and PCSS score (Mtrans = 46.8¬ ± 16.5; Mcis = 38¬ ± 26.6; p = 0.56) did not differ between groups.\u0000 \u0000 \u0000 \u0000 The average recovery time for this sample of transgender youth was significantly longer than their cisgender peers. Transgender youth also reported higher rates of anxiety and depression, which are well-known to impact concussion recovery. Sensitivity to psychological distress and mental health history is crucial for overall medical care and is supported when assessing and treating concussion in transgender youth. The effects of gender transition-related treatments (i.e., hormone therapy), discomfort in gender-segregated spaces, gender dysphoria, and other minority stressors warrant further research and should also be considered in concussion care of transgender patients.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.53
G. Rigney, J. Dugan, A. Bishay, S. Jonzzon, J. Jo, K. Williams, S. Zuckerman, D. Terry
This study assessed whether age of first exposure (AFE) to football was associated with later-life psychiatric and neurobehavioral symptoms, cognitive difficulties, and general health problems in a cohort of former amateur football players. A cross-sectional survey study of men with a history of amateur football exposure was conducted using the ResearchMatch online platform. Independent variables included demographics, number of lifetime concussions, AFE to football (dichotomized as AFE < 12 years vs. AFE ≥ 12 years), and total years of football participation. Main outcomes included current depressive (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorders-7), cognitive (British Columbia Cognitive Complaints Inventory), and neurobehavioral symptoms (Neurobehavioral Symptom Inventory). T-tests (AFE < 12 vs. AFE ≥ 12) and multivariable regressions assessed for associations between AFE and outcome variables, adjusting for age, number of prior concussions, and years of football exposure. A total of 107 male participants (mean age = 60.6 ± 15.1 years) reported an average of 4.2 ± 2.7 years of exposure to amateur football, with 41 participants reporting AFE < 12 (38.3%). In multivariable analyses, AFE < 12 was not a significant predictor of depressive (B = 0.51, SE = 1.25, p = 0.682), anxiety (B = 0.09, SE = 0.95, p = 0.926), cognitive (B = -0.65, SE = 0.77, p = 0.403), or neurobehavioral symptom scores (B = -0.56, SE = 2.93, p = 0.850). However, having more prior concussions were associated with worse depressive (B = 0.44, SE = 0.10, p < 0.001), anxiety (B = 0.33, SE = 0.07, p < 0.001), cognitive (B = 0.26, SE = 0.06, p < 0.001), and neurobehavioral symptoms (B = 1.04, SE = 0.23, p < 0.001). AFE to football was not associated with adverse psychiatric, cognitive, or neurobehavioral difficulties. However, these outcomes were associated with a greater number of lifetime concussions.
{"title":"A - 53 Age of First Exposure to Football and Later-Life Health Issues in Community-Dwelling Adults","authors":"G. Rigney, J. Dugan, A. Bishay, S. Jonzzon, J. Jo, K. Williams, S. Zuckerman, D. Terry","doi":"10.1093/arclin/acae052.53","DOIUrl":"https://doi.org/10.1093/arclin/acae052.53","url":null,"abstract":"\u0000 \u0000 \u0000 This study assessed whether age of first exposure (AFE) to football was associated with later-life psychiatric and neurobehavioral symptoms, cognitive difficulties, and general health problems in a cohort of former amateur football players.\u0000 \u0000 \u0000 \u0000 A cross-sectional survey study of men with a history of amateur football exposure was conducted using the ResearchMatch online platform. Independent variables included demographics, number of lifetime concussions, AFE to football (dichotomized as AFE < 12 years vs. AFE ≥ 12 years), and total years of football participation. Main outcomes included current depressive (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorders-7), cognitive (British Columbia Cognitive Complaints Inventory), and neurobehavioral symptoms (Neurobehavioral Symptom Inventory). T-tests (AFE < 12 vs. AFE ≥ 12) and multivariable regressions assessed for associations between AFE and outcome variables, adjusting for age, number of prior concussions, and years of football exposure.\u0000 \u0000 \u0000 \u0000 A total of 107 male participants (mean age = 60.6 ± 15.1 years) reported an average of 4.2 ± 2.7 years of exposure to amateur football, with 41 participants reporting AFE < 12 (38.3%). In multivariable analyses, AFE < 12 was not a significant predictor of depressive (B = 0.51, SE = 1.25, p = 0.682), anxiety (B = 0.09, SE = 0.95, p = 0.926), cognitive (B = -0.65, SE = 0.77, p = 0.403), or neurobehavioral symptom scores (B = -0.56, SE = 2.93, p = 0.850). However, having more prior concussions were associated with worse depressive (B = 0.44, SE = 0.10, p < 0.001), anxiety (B = 0.33, SE = 0.07, p < 0.001), cognitive (B = 0.26, SE = 0.06, p < 0.001), and neurobehavioral symptoms (B = 1.04, SE = 0.23, p < 0.001).\u0000 \u0000 \u0000 \u0000 AFE to football was not associated with adverse psychiatric, cognitive, or neurobehavioral difficulties. However, these outcomes were associated with a greater number of lifetime concussions.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.22
K. Slicer, C. Stafford, R. Bennett
The purpose of this pilot study is to find out the current state of baseline neurocognitive testing for athletes across multiple ages and organizations, by gathering information from professionals in the field. 16 sports neuropsychologists completed a one-time anonymous online survey that contained questions regarding concussion baseline testing practices and opinions. 15 sports neuropsychologists answered “yes”to conducting baseline testing, with one responding “no.”Of those, 10 reported working with professional athletes, 8 with college athletes, 8 with adolescents aged 13–17, and 5 with children aged 8–12. All 15 sports neuropsychologists reported using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), in accordance with other measures such as the VOMS, sway, force platform, SCAT, and traditional paper and pencil measures, among other assessments. Baseline testing took place in the sports medicine clinic, at the sports facility, at the university, private office, or research lab. A majority of the sports neuropsychologists reported that testing was supervised by themselves, an athletic trainer, student trainee, and/or clinic staff. A portion (20%) of the sports neuropsychologists indicated they were not satisfied with their current method of baseline testing. One neuropsychologist reported that they currently conduct remote baseline testing and a minority of the respondents stated they would consider remote testing. There was a consensus on the use of the ImPACT as the main baseline neurocognitive measure, among other assessments. This study should be expanded to include a larger sample size and variety of sports professionals to better understand the current state of sport concussion assessment.
{"title":"A - 22 Baseline testing for athletes: where are we now and where are we going?","authors":"K. Slicer, C. Stafford, R. Bennett","doi":"10.1093/arclin/acae052.22","DOIUrl":"https://doi.org/10.1093/arclin/acae052.22","url":null,"abstract":"\u0000 \u0000 \u0000 The purpose of this pilot study is to find out the current state of baseline neurocognitive testing for athletes across multiple ages and organizations, by gathering information from professionals in the field.\u0000 \u0000 \u0000 \u0000 16 sports neuropsychologists completed a one-time anonymous online survey that contained questions regarding concussion baseline testing practices and opinions.\u0000 \u0000 \u0000 \u0000 15 sports neuropsychologists answered “yes”to conducting baseline testing, with one responding “no.”Of those, 10 reported working with professional athletes, 8 with college athletes, 8 with adolescents aged 13–17, and 5 with children aged 8–12. All 15 sports neuropsychologists reported using the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), in accordance with other measures such as the VOMS, sway, force platform, SCAT, and traditional paper and pencil measures, among other assessments. Baseline testing took place in the sports medicine clinic, at the sports facility, at the university, private office, or research lab. A majority of the sports neuropsychologists reported that testing was supervised by themselves, an athletic trainer, student trainee, and/or clinic staff. A portion (20%) of the sports neuropsychologists indicated they were not satisfied with their current method of baseline testing. One neuropsychologist reported that they currently conduct remote baseline testing and a minority of the respondents stated they would consider remote testing.\u0000 \u0000 \u0000 \u0000 There was a consensus on the use of the ImPACT as the main baseline neurocognitive measure, among other assessments. This study should be expanded to include a larger sample size and variety of sports professionals to better understand the current state of sport concussion assessment.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.20
Lilian A. Klein, A. J. Zynda, M. Loftin, A. J. Tracey, A. Pollard-McGrandy, Haley Clark, E. R. Davis, T. Covassin
Vestibular and oculomotor assessments are fundamental tools to identify concussions. However, research is unclear on which vestibular and oculomotor assessment or combination of assessments best detect concussions. The purpose of this study was to assess the discriminant ability of the Vestibular/Ocular Motor Screening (VOMS), Balance Error Scoring System (BESS), modified BESS (mBESS), and High-Level Mobility Assessment Tool (HiMAT) to identify college-aged individuals with concussion from controls. A prospective study of college-aged individuals (18–30 years) diagnosed with concussion within 5 days of enrollment was conducted. Demographics, injury information, VOMS, BESS/mBESS, and HiMAT were completed at the initial visit. Logistic regressions (LR) and receiver operating characteristic (ROC) analyses of the area-under-the-curve (AUC) determined the ability of the VOMS, BESS/mBESS, and HiMAT to identify concussion from control. A total of 214 participants (mean age = 20.4¬ ± 2.5 years, 52.8% female) were enrolled, with 137 (64.0%) concussions and 77 (36.0%) controls. The VOMS total (AUC = 0.93, 95%CI = 0.90–0.97, p < 0.001) and HiMAT total (AUC = 0.79, 95%CI = 0.65–0.93, p < 0.001) significantly identified concussion from control, while the BESS (AUC = 0.58, 95%CI = 0.50–0.67, p = 0.05) and mBESS (AUC = 0.55, 95%CI = 0.47–0.64, p = 0.23) did not. A 2-factor model with combined VOMS and HiMAT totals did not improve identification (AUC = 0.92, 95%CI = 0.85–1.00, p < 0.001). The VOMS total score demonstrated outstanding discriminant ability, HiMAT total score demonstrated adequate discriminant ability, and BESS/mBESS total errors demonstrated unacceptable discriminant ability in identifying concussions from controls. Our findings suggest that the VOMS remains a preferred vestibular and oculomotor functioning assessment for identifying concussion. Furthermore, incorporating objective assessments with the VOMS, such as HiMAT, does not improve diagnostic yield.
{"title":"A - 20 Identifying Concussion in College-Aged Individuals Using a Multimodal Assessment of Vestibular and Oculomotor Function","authors":"Lilian A. Klein, A. J. Zynda, M. Loftin, A. J. Tracey, A. Pollard-McGrandy, Haley Clark, E. R. Davis, T. Covassin","doi":"10.1093/arclin/acae052.20","DOIUrl":"https://doi.org/10.1093/arclin/acae052.20","url":null,"abstract":"\u0000 \u0000 \u0000 Vestibular and oculomotor assessments are fundamental tools to identify concussions. However, research is unclear on which vestibular and oculomotor assessment or combination of assessments best detect concussions. The purpose of this study was to assess the discriminant ability of the Vestibular/Ocular Motor Screening (VOMS), Balance Error Scoring System (BESS), modified BESS (mBESS), and High-Level Mobility Assessment Tool (HiMAT) to identify college-aged individuals with concussion from controls.\u0000 \u0000 \u0000 \u0000 A prospective study of college-aged individuals (18–30 years) diagnosed with concussion within 5 days of enrollment was conducted. Demographics, injury information, VOMS, BESS/mBESS, and HiMAT were completed at the initial visit. Logistic regressions (LR) and receiver operating characteristic (ROC) analyses of the area-under-the-curve (AUC) determined the ability of the VOMS, BESS/mBESS, and HiMAT to identify concussion from control. A total of 214 participants (mean age = 20.4¬ ± 2.5 years, 52.8% female) were enrolled, with 137 (64.0%) concussions and 77 (36.0%) controls.\u0000 \u0000 \u0000 \u0000 The VOMS total (AUC = 0.93, 95%CI = 0.90–0.97, p < 0.001) and HiMAT total (AUC = 0.79, 95%CI = 0.65–0.93, p < 0.001) significantly identified concussion from control, while the BESS (AUC = 0.58, 95%CI = 0.50–0.67, p = 0.05) and mBESS (AUC = 0.55, 95%CI = 0.47–0.64, p = 0.23) did not. A 2-factor model with combined VOMS and HiMAT totals did not improve identification (AUC = 0.92, 95%CI = 0.85–1.00, p < 0.001).\u0000 \u0000 \u0000 \u0000 The VOMS total score demonstrated outstanding discriminant ability, HiMAT total score demonstrated adequate discriminant ability, and BESS/mBESS total errors demonstrated unacceptable discriminant ability in identifying concussions from controls. Our findings suggest that the VOMS remains a preferred vestibular and oculomotor functioning assessment for identifying concussion. Furthermore, incorporating objective assessments with the VOMS, such as HiMAT, does not improve diagnostic yield.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.40
H. Bouchard, L. Weis, D. Vasquez, T. Caze
Sports-related concussions are the most common setting for adolescents to sustain a concussion. Delayed access to care is a risk factor for recovery and youth athletes have limited access to early intervention often due to lack of athletic trainer coverage. The purpose of this study was to evaluate the effect of early access on sports-related concussions in youth hockey players. Participants (n = 67) included youth athletes from hockey organizations who partnered with a local specialty concussion clinic. Athletes presented to clinic for care (median = 2 days) after sustaining a concussion. We examined whether the number of days since injury to initial exam (DSI) significantly predicted recovery time while controlling for common injury modifiers, such as symptom severity, anxiety sensitivity, and age. Recovery was measured in number of days since injury to the date of medical clearance. Multivariate general linear analyses indicated that DSI (M = 4.96, SD = 8.90), significantly predicted the number of recovery days (M = 12.85, SD = 9.47), with each day earlier to initial exam predicting almost one day faster recovery (B = 0.92; p < 0.001; ηp2 = 0.813). Variables of age (M = 13.78, SD = 2.59), anxiety sensitivity (M = 8.91, SD = 9.69), and concussion severity (M = 19.22, SD = 8.90), were not predictive recovery. Early access resulted in faster medical clearance. This sample of youth hockey players do not have access to an athletic trainer to provide early intervention. Our results suggest that the ability to have early intervention through a specialty concussion clinic partnership resulted in faster recovery, highlighting the importance of continuing to explore and cultivate these relationships with youth sports.
{"title":"A - 40 The Impact of Early Access on Sports-Related Concussions in Youth Hockey Players","authors":"H. Bouchard, L. Weis, D. Vasquez, T. Caze","doi":"10.1093/arclin/acae052.40","DOIUrl":"https://doi.org/10.1093/arclin/acae052.40","url":null,"abstract":"\u0000 \u0000 \u0000 Sports-related concussions are the most common setting for adolescents to sustain a concussion. Delayed access to care is a risk factor for recovery and youth athletes have limited access to early intervention often due to lack of athletic trainer coverage. The purpose of this study was to evaluate the effect of early access on sports-related concussions in youth hockey players.\u0000 \u0000 \u0000 \u0000 Participants (n = 67) included youth athletes from hockey organizations who partnered with a local specialty concussion clinic. Athletes presented to clinic for care (median = 2 days) after sustaining a concussion. We examined whether the number of days since injury to initial exam (DSI) significantly predicted recovery time while controlling for common injury modifiers, such as symptom severity, anxiety sensitivity, and age. Recovery was measured in number of days since injury to the date of medical clearance.\u0000 \u0000 \u0000 \u0000 Multivariate general linear analyses indicated that DSI (M = 4.96, SD = 8.90), significantly predicted the number of recovery days (M = 12.85, SD = 9.47), with each day earlier to initial exam predicting almost one day faster recovery (B = 0.92; p < 0.001; Œ∑p2 = 0.813). Variables of age (M = 13.78, SD = 2.59), anxiety sensitivity (M = 8.91, SD = 9.69), and concussion severity (M = 19.22, SD = 8.90), were not predictive recovery.\u0000 \u0000 \u0000 \u0000 Early access resulted in faster medical clearance. This sample of youth hockey players do not have access to an athletic trainer to provide early intervention. Our results suggest that the ability to have early intervention through a specialty concussion clinic partnership resulted in faster recovery, highlighting the importance of continuing to explore and cultivate these relationships with youth sports.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141671947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.11
F. Nelson, E. Clise, A. Logalbo
This study represents the second phase in testing a self-report anxiety questionnaire and self-report vestibular symptom questionnaire, including its subscales, as potential competing predictive factors of protracted concussion recovery times among collegiate athletes. The Vertigo Symptom Scale-Short Form (VSS-SF) and Generalized Anxiety Disorder-7 (GAD-7) were administered to 31 collegiate athletes (18 females, 13 males, ages 18–23) at baseline and post-injury. Participant data was grouped by number of days until symptom resolution post-concussion (1–10 days [N = 18], 11+ days [N = 13]). VSS-SF, VSS-SF-Autonomic-Anxiety (VSS-SF-A), VSS-SF-Vestibular-Balance (VSS-SF-V), and GAD-7 scores were calculated via scoring guidelines. Results from an independent-samples t-test demonstrated that post-injury VSS-SF-A scores were significantly higher among athletes with 11+ recovery days (M = 3.08, SD = 3.71) compared to those with 1–10 recovery days (M = 1.06, SD = 2.65); t(29) = 1.78, p = 0.043, Cohen’s d = 0.65. Similar t-tests for post-injury VSS-SF-V (11+ [M = 5.23, SD = 6.41], 1–10 [M = 3.17, SD = 3.67]) and GAD-7 (11+ [M = 4.08, SD = 4.84], 1–10 [M = 2.50, SD = 2.23]) scores were not significant; t(29) = 1.14, p = 0.132, t(29) = 1.22, p = 0.116. A linear regression revealed that post-injury VSS-SF-A scores significantly predicted recovery time and explained 14.1% of the variance (b = 0.88, R2 = 0.14, p = 0.037). Post-injury VSS-SF-V and GAD-7 scores were not significant predictors. Results suggest that post-injury VSS-SF-A scores can aid in identifying athletes that may be at risk for longer recovery times. Additionally, post-concussive autonomic anxiety appears to have a greater influence on athletes’recovery time, as compared to generalized anxiety symptoms. Interventions directed towards reducing and/or coping with autonomic anxiety symptoms may be particularly important for supporting post-concussive recovery.
{"title":"A - 11 Autonomic Anxiety vs Generalized Anxiety: Predictive Recovery Time in Sport-Related Concussions among Collegiate Athletes","authors":"F. Nelson, E. Clise, A. Logalbo","doi":"10.1093/arclin/acae052.11","DOIUrl":"https://doi.org/10.1093/arclin/acae052.11","url":null,"abstract":"\u0000 \u0000 \u0000 This study represents the second phase in testing a self-report anxiety questionnaire and self-report vestibular symptom questionnaire, including its subscales, as potential competing predictive factors of protracted concussion recovery times among collegiate athletes.\u0000 \u0000 \u0000 \u0000 The Vertigo Symptom Scale-Short Form (VSS-SF) and Generalized Anxiety Disorder-7 (GAD-7) were administered to 31 collegiate athletes (18 females, 13 males, ages 18–23) at baseline and post-injury. Participant data was grouped by number of days until symptom resolution post-concussion (1–10 days [N = 18], 11+ days [N = 13]). VSS-SF, VSS-SF-Autonomic-Anxiety (VSS-SF-A), VSS-SF-Vestibular-Balance (VSS-SF-V), and GAD-7 scores were calculated via scoring guidelines.\u0000 \u0000 \u0000 \u0000 Results from an independent-samples t-test demonstrated that post-injury VSS-SF-A scores were significantly higher among athletes with 11+ recovery days (M = 3.08, SD = 3.71) compared to those with 1–10 recovery days (M = 1.06, SD = 2.65); t(29) = 1.78, p = 0.043, Cohen’s d = 0.65. Similar t-tests for post-injury VSS-SF-V (11+ [M = 5.23, SD = 6.41], 1–10 [M = 3.17, SD = 3.67]) and GAD-7 (11+ [M = 4.08, SD = 4.84], 1–10 [M = 2.50, SD = 2.23]) scores were not significant; t(29) = 1.14, p = 0.132, t(29) = 1.22, p = 0.116. A linear regression revealed that post-injury VSS-SF-A scores significantly predicted recovery time and explained 14.1% of the variance (b = 0.88, R2 = 0.14, p = 0.037). Post-injury VSS-SF-V and GAD-7 scores were not significant predictors.\u0000 \u0000 \u0000 \u0000 Results suggest that post-injury VSS-SF-A scores can aid in identifying athletes that may be at risk for longer recovery times. Additionally, post-concussive autonomic anxiety appears to have a greater influence on athletes’recovery time, as compared to generalized anxiety symptoms. Interventions directed towards reducing and/or coping with autonomic anxiety symptoms may be particularly important for supporting post-concussive recovery.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.18
J. E. Maietta, D. A. Terry, D. R. Lakisa, G. L. Iverson, A. J. Gardner
The Sport Concussion Assessment Tool-5th Edition (SCAT5) is a standardized assessment that is administered to athletes at preseason and after suspected concussion. We provide normative reference values for men’s professional National Rugby League (NRL) players. Baseline SCAT5 scores were obtained from 1005 NRL players during the 2018 and 2019 seasons (Mage = 25.9). Players self-identified whether they considered their cultural heritage or ethnicity to be “Pasifika (Pacific Islander) or Māori” (n = 243; 24.2%) or “Indigenous Australian” (n = 82; 8.2%). Those who identified as being from any other race, ethnicity, or cultural heritage were combined into a single group (n = 680; 67.7%). We provide normative values for the Standardized Assessment of Concussion (SAC), Symptom Evaluation (i.e., symptom severity and symptom number), and the Modified Balance Error Scoring System (mBESS). There were no significant differences between the cultural heritage or ethnicity groups for SAC total scores, symptom severity or number, or mBESS errors (p’s > 0.05). The median SAC score was 27 (IQR = 25–28), median symptom severity was 0 (IQR = 0–2), median symptom number was 0 (IQR = 0–1), and median mBESS error score was 3 (IQR = 1–5). SAC scores of <23 and mBESS errors >7 were uncommon in the sample while SAC scores of 26–30 and mBESS scores of 0–4 were considered within normal expectations (WNE). Reporting >4/22 symptoms and > 6/132 severity was uncommon while 0–1 symptoms and 0–1 symptom severity was WNE. Normative reference values for the SCAT5 are provided for a sample of elite professional men’s rugby league players from Australia.
{"title":"A - 18 Sport Concussion Assessment Tool-5th Edition (SCAT5) Normative Reference Values for Professional Men’s Rugby League Players","authors":"J. E. Maietta, D. A. Terry, D. R. Lakisa, G. L. Iverson, A. J. Gardner","doi":"10.1093/arclin/acae052.18","DOIUrl":"https://doi.org/10.1093/arclin/acae052.18","url":null,"abstract":"\u0000 \u0000 \u0000 The Sport Concussion Assessment Tool-5th Edition (SCAT5) is a standardized assessment that is administered to athletes at preseason and after suspected concussion. We provide normative reference values for men’s professional National Rugby League (NRL) players.\u0000 \u0000 \u0000 \u0000 Baseline SCAT5 scores were obtained from 1005 NRL players during the 2018 and 2019 seasons (Mage = 25.9). Players self-identified whether they considered their cultural heritage or ethnicity to be “Pasifika (Pacific Islander) or Māori” (n = 243; 24.2%) or “Indigenous Australian” (n = 82; 8.2%). Those who identified as being from any other race, ethnicity, or cultural heritage were combined into a single group (n = 680; 67.7%). We provide normative values for the Standardized Assessment of Concussion (SAC), Symptom Evaluation (i.e., symptom severity and symptom number), and the Modified Balance Error Scoring System (mBESS).\u0000 \u0000 \u0000 \u0000 There were no significant differences between the cultural heritage or ethnicity groups for SAC total scores, symptom severity or number, or mBESS errors (p’s > 0.05). The median SAC score was 27 (IQR = 25–28), median symptom severity was 0 (IQR = 0–2), median symptom number was 0 (IQR = 0–1), and median mBESS error score was 3 (IQR = 1–5). SAC scores of <23 and mBESS errors >7 were uncommon in the sample while SAC scores of 26–30 and mBESS scores of 0–4 were considered within normal expectations (WNE). Reporting >4/22 symptoms and > 6/132 severity was uncommon while 0–1 symptoms and 0–1 symptom severity was WNE.\u0000 \u0000 \u0000 \u0000 Normative reference values for the SCAT5 are provided for a sample of elite professional men’s rugby league players from Australia.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141672631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-06DOI: 10.1093/arclin/acae052.23
M. Ellis-Stockley, J. Adler, B. Forbes, K. Summers, T. Tupou, H. Eve, R. Hirst
Sports participation in youth has demonstrated better core executive function (EF) abilities compared to those who do not participate (Contreras-Osorio et al., 2021). However, previous research has not observed a pattern of improvement across all EF abilities (M√∂hring et al., 2022), indicating EF development in childhood is not linear (Anderson, 2002). The present study compared baseline scores of cognitive flexibility, working memory, and inhibition at two timepoints among youth athletes. Data from the Delis-Kaplan Executive Function System Trail Making Letter-Number Sequencing (cognitive flexibility), Wechsler Intelligence Scale for Children Fourth Edition Working Memory Index, and Golden Stroop Color-Word Inhibition test were analyzed in a sample of youth athletes (n = 32), aged 8–16 years. Mean age difference between time 1 and 2 was 1.86 years. Paired-samples t-test examined the difference in core EF scores at two timepoints. Performance on a measure of inhibition significantly improved over time (p = 0.02; effect size [d] = 0.43). Performances on measures of working memory and cognitive flexibility did not significantly differ over time (p = 0.16 and p = 0.61, respectively). Healthy youth athletes performed significantly better only on a measure of inhibition at baseline two than baseline one, suggesting clinicians should anticipate variation in scores when re-examining core EF abilities after two years. Further, clinicians should exercise caution when interpreting variation in baseline scores because it could be due to sports participation. Future research should investigate whether inhibition continues to improve overtime and whether significant changes are observed in other core EFs.
与不参加体育运动的青少年相比，参加体育运动的青少年具有更好的核心执行功能（EF）能力（Contreras-Osorio 等人，2021 年）。然而，以往的研究并没有观察到所有执行功能能力的提高模式（M√∂hring 等人，2022 年），这表明儿童时期的执行功能发展并不是线性的（Anderson，2002 年）。本研究比较了青少年运动员在两个时间点的认知灵活性、工作记忆和抑制能力的基线得分。 研究分析了 8-16 岁青少年运动员（32 人）的德利斯-卡普兰执行功能系统（Delis-Kaplan Executive Function System Trail Making Letter-Number Sequencing）（认知灵活性）、韦氏儿童智力量表第四版工作记忆指数（Wechsler Intelligence Scale for Children Fourth Edition Working Memory Index）和金-斯特罗普颜色-文字抑制测试（Golden Stroop Color-Word Inhibition Test）的数据。时间 1 和时间 2 之间的平均年龄差为 1.86 岁。对两个时间点的核心 EF 分数差异进行了配对样本 t 检验。 随着时间的推移，抑制测量的成绩有了明显的提高（p = 0.02；效应大小 [d] = 0.43）。工作记忆和认知灵活性方面的表现随时间的推移没有明显差异（p = 0.16 和 p = 0.61）。 健康的青少年运动员仅在抑制能力的测量上，基线二的表现明显优于基线一，这表明临床医生在两年后重新检查核心EF能力时，应预计到分数的变化。此外，临床医生在解释基线分数的变化时应谨慎，因为这可能是由于运动参与造成的。未来的研究应调查抑制能力是否会随着时间的推移而不断提高，以及其他核心 EF 是否会发生显著变化。
{"title":"A - 23 Interpretation Consideration: Serial Baseline Performances on Core Executive Function Measures in Healthy Youth Athletes","authors":"M. Ellis-Stockley, J. Adler, B. Forbes, K. Summers, T. Tupou, H. Eve, R. Hirst","doi":"10.1093/arclin/acae052.23","DOIUrl":"https://doi.org/10.1093/arclin/acae052.23","url":null,"abstract":"\u0000 \u0000 \u0000 Sports participation in youth has demonstrated better core executive function (EF) abilities compared to those who do not participate (Contreras-Osorio et al., 2021). However, previous research has not observed a pattern of improvement across all EF abilities (M√∂hring et al., 2022), indicating EF development in childhood is not linear (Anderson, 2002). The present study compared baseline scores of cognitive flexibility, working memory, and inhibition at two timepoints among youth athletes.\u0000 \u0000 \u0000 \u0000 Data from the Delis-Kaplan Executive Function System Trail Making Letter-Number Sequencing (cognitive flexibility), Wechsler Intelligence Scale for Children Fourth Edition Working Memory Index, and Golden Stroop Color-Word Inhibition test were analyzed in a sample of youth athletes (n = 32), aged 8–16 years. Mean age difference between time 1 and 2 was 1.86 years. Paired-samples t-test examined the difference in core EF scores at two timepoints.\u0000 \u0000 \u0000 \u0000 Performance on a measure of inhibition significantly improved over time (p = 0.02; effect size [d] = 0.43). Performances on measures of working memory and cognitive flexibility did not significantly differ over time (p = 0.16 and p = 0.61, respectively).\u0000 \u0000 \u0000 \u0000 Healthy youth athletes performed significantly better only on a measure of inhibition at baseline two than baseline one, suggesting clinicians should anticipate variation in scores when re-examining core EF abilities after two years. Further, clinicians should exercise caution when interpreting variation in baseline scores because it could be due to sports participation. Future research should investigate whether inhibition continues to improve overtime and whether significant changes are observed in other core EFs.\u0000","PeriodicalId":8176,"journal":{"name":"Archives of Clinical Neuropsychology","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：