3 results
56 Investigating the Moderating Effect of Family Psychiatric History on the Association Between Concussion History and Elevated Symptom Endorsement
- Keeley E Hamill, Benjamin L Brett, Timothy B Meier
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 161-162
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Objective:
Prior research has found that a greater history of concussion is associated with subtle increases in symptom endorsement. Recent work indicates that a family history of psychiatric disorder is a potential risk factor for prolonged recovery following a single injury. While greater symptom endorsement is observed among those with a personal psychiatric history, the potential role of family psychiatric history in elevated symptom endorsement in the context of repeated concussion has not been investigated. Therefore, the objective of this work was to determine whether family psychiatric history moderates the association of concussion history and elevated symptom endorsement in active collegiate athletes.
Participants and Methods:A total of 176 (mean age = 21.19 ± 1.63; 116 male) collegiate athletes completed this study at the Medical College of Wisconsin. Participant’s family psychiatric history was collected through a modified Family History Screen (FHS) regarding the participant’s biological parents, siblings, and children, focusing on questions relating to major depressive disorder (MDD; 3 total questions) and general psychiatric history (5 total questions). Concussion history was assessed through a semi-structured interview using American College of Rehabilitation Medicine criteria for mild traumatic brain injury. Concussion symptoms were measured via the Sport Concussion Assessment Tool (SCAT-5) and psychological distress was assessed using the Brief Symptom Inventory-18 (BSI-18). General linear models tested the association of the number of prior concussions with log-transformed SCAT-5 and BSI-18 scores. Additional general linear models were fit to assess the effects of number of prior concussions, family psychiatric history (MDD family history and general family history, each coded as Yes/No), and the interaction of prior concussion and family psychiatric history on log-transformed SCAT-5 and BSI-18 scores. Sex was included as a covariate in all models.
Results:More prior concussions were significantly associated with greater symptom severity scores on the SCAT-5 (x2=26.87, p<0.001, unstandardized beta[B](standard error[SE])=0.25(0.05)) and BSI-18 (x2=20.94, p<0.00, B(SE)=0.19(0.04)). For the models investigating the effects of family psychiatric history, neither the main effect of MDD family history nor the MDD family history by prior concussion interaction were significant for either the SCAT-5 (ps>0.05) or BSI-18 (ps>0.05). Similarly, for the general history model, neither the main effect of general family psychiatric history nor the interaction of general family psychiatric history and number of prior concussions were significant for either the SCAT-5 (ps>0.05) or BSI-18 (ps>0.05). For both the MDD family history and general psychiatric family history models, the number of prior concussions remained positively associated with subjective symptoms on both the SCAT-5 (X2=20.10, p<0.001, and x2=23.50, p<0.001) and BSI-18 (x2=16.46, p<0.001, and x2=20.68, p<0.001).
Conclusions:The results of the current study provide further evidence for a relationship between elevated sub-clinical symptom endorsement and the number of prior concussions in active, collegiate athletes. The results do not, however, support the hypothesis that the association between prior concussion and an athletes’ level of symptom endorsement are moderated by the family psychiatric history. Additional research is needed to determine what factors predispose some individuals to the adverse chronic effects of repeated concussion.
55 The Association of Prior Concussion and Subjective Sleep Quality in Young Adult Athletes
- Kearnin M Van Bortel, Benjamin L Brett, Timothy B Meier
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 160-161
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Objective:
There is rising concern over the potential cumulative and long-lasting effects of prior concussions in active and retired athletes. Previous studies suggest that there is an inverse relationship between concussion (or mild traumatic brain injury) and sleep, with increasing evidence of individuals reporting chronically disrupted sleep following remote concussion. The extent to which these effects are cumulative across repeat concussions is unknown. This project aimed to investigate the association between the number of prior concussions and subjective sleep quality in otherwise healthy collegiate-aged athletes. Furthermore, we investigated which aspects of sleep are most associated with prior concussion.
Participants and Methods:A total of 176 collegiate-aged athletes (Mage = 21.19, SD = 1.63; 65.9% men) completed off-season clinical visits, at least 6 months since their most recent concussion. Semi-structured interviews captured detailed sport and head injury history across the lifespan. The number of prior concussions for each participant was retrospectively assessed based on American Congress of Rehabilitation Medicine criteria. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A general linear model tested the relationship between number of prior concussions and global PSQI score (i.e., overall sleep quality). Logistic regression models were fit to investigate the association of the number of prior concussions with individual subcomponents of the PSQI (i.e., quality, latency, duration, efficiency, disturbances, use of sleep medications, and daily dysfunction), which were binarized based on their distribution. Sex and total number of years of exposure to contact sports were included as covariates for all models.
Results:The number of prior concussions was significantly associated with worse overall sleep quality as assessed by the global PSQI score, F(3,172)=6.92, p= <0.001, unstandardized beta[B](standard error[SE])=0.54(0.14). Investigation of sub-components showed that the number of prior concussions was significantly associated with multiple PSQI subcomponents, including: poorer sleep quality, odds ratio [OR]=1.35, 95% CI [1.05, 1.74], p=0.02; longer sleep latency, OR=1.35, 95% CI [1.08, 1.68], p=0.008; more sleep disturbances, OR=1.56, 95% CI [1.15, 2.12], p=0.004; and more sleep-related daily dysfunction, OR=1.46, 95% CI [1.16, 1.83], p=0.001. The number of prior concussions was not significantly associated with sleep duration, sleep efficiency, or the use of sleep medication (ps>0.05). There were no years of exposure effects (ps>0.05). Select sex-related effects on sleep quality were observed. Specifically, women reported significantly worse global sleep scores, F(3,172)=6.92, p=0.048, B(SE)=-0.99(0.50), and women reported significantly more sleep disturbances, B(SE)=1.47(0.70), p=0.04, OR=4.34 (95% CI [1.11, 16.98].
Conclusions:These results suggest a potential dose-effect of concussion history on poorer sleep quality ratings in otherwise healthy athletes. Specific facets of sleep that were adversely associated with prior concussion included sleep quality, latency, disturbances, and daily dysfunction, highlighting potential areas for sleep-related clinical interventions. Given the adverse effects of chronic sleep disturbance on mental health, future studies are needed to determine the role of concussion-related sleep problems in the adverse psychological outcomes observed in some athletes with multiple prior concussions.
Test–Retest Reliability of a Semi-Structured Interview to Aid in Pediatric Traumatic Brain Injury Diagnosis
- Danielle C. Hergert, Veronik Sicard, David D. Stephenson, Sharvani Pabbathi Reddy, Cidney R. Robertson-Benta, Andrew B. Dodd, Edward J. Bedrick, Gerard A. Gioia, Timothy B. Meier, Nicholas A. Shaff, Davin K. Quinn, Richard A. Campbell, John P. Phillips, Andrei A. Vakhtin, Robert E. Sapien, Andrew R. Mayer
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- Journal:
- Journal of the International Neuropsychological Society / Volume 28 / Issue 7 / August 2022
- Published online by Cambridge University Press:
- 11 August 2021, pp. 687-699
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Objective:
Retrospective self-report is typically used for diagnosing previous pediatric traumatic brain injury (TBI). A new semi-structured interview instrument (New Mexico Assessment of Pediatric TBI; NewMAP TBI) investigated test–retest reliability for TBI characteristics in both the TBI that qualified for study inclusion and for lifetime history of TBI.
Method:One-hundred and eight-four mTBI (aged 8–18), 156 matched healthy controls (HC), and their parents completed the NewMAP TBI within 11 days (subacute; SA) and 4 months (early chronic; EC) of injury, with a subset returning at 1 year (late chronic; LC).
Results:The test–retest reliability of common TBI characteristics [loss of consciousness (LOC), post-traumatic amnesia (PTA), retrograde amnesia, confusion/disorientation] and post-concussion symptoms (PCS) were examined across study visits. Aside from PTA, binary reporting (present/absent) for all TBI characteristics exhibited acceptable (≥0.60) test–retest reliability for both Qualifying and Remote TBIs across all three visits. In contrast, reliability for continuous data (exact duration) was generally unacceptable, with LOC and PCS meeting acceptable criteria at only half of the assessments. Transforming continuous self-report ratings into discrete categories based on injury severity resulted in acceptable reliability. Reliability was not strongly affected by the parent completing the NewMAP TBI.
Conclusions:Categorical reporting of TBI characteristics in children and adolescents can aid clinicians in retrospectively obtaining reliable estimates of TBI severity up to a year post-injury. However, test–retest reliability is strongly impacted by the initial data distribution, selected statistical methods, and potentially by patient difficulty in distinguishing among conceptually similar medical concepts (i.e., PTA vs. confusion).