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Wright E, Elliott TR, Kwok OM, Zhang Q, Spooner M. Resilience and distress among young adults with chronic health conditions: A longitudinal study. Br J Health Psychol 2023; 28:1036-1051. [PMID: 37186348 DOI: 10.1111/bjhp.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/26/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To test the beneficial associations of a resilient personality prototype among emerging adults with chronic health conditions (CHC) over an 8-year period. DESIGN Longitudinal, prospective observation study. METHODS Data obtained from emerging adults in the Add Health project with a CHC and completed study measures at two time points (286 men, 459 women) were examined. Cluster analysis was used to identify a resilient personality prototype at the first time point, as defined in the Block model of personality. Differences between those with a resilient and non-resilient prototype were examined. A structural equation model (SEM) tested the association of a resilience prototype with positive affect, perceived control and family relationships in predicting distress over time. RESULTS A resilient personality profile was identified (n = 256). These individuals reported higher positive affect, greater perceived control and less distress at both measurement occasions than those without this profile (n = 489). Women reported more distress than men. SEM revealed the relationship of a resilient prototype to distress was explained by its beneficial association with positive affect and perceived control at the first assessment, and through its beneficial association with perceived control 8 years later. Gender independently predicted distress. CONCLUSIONS A resilient personality prototype appears to operate through its beneficial association with perceived control to prospectively predict distress reported by emerging adults with CHC. The self-regulatory properties theoretically associated with a resilient personality prototype may function through perceptions of control which, in turn, prevent prolonged experiences of distress. Clinical implications are considered.
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Affiliation(s)
- Erika Wright
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
| | - Timothy R Elliott
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
| | - Oi-Man Kwok
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
| | - Qiyue Zhang
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
| | - Mikaela Spooner
- Department of Educational Psychology, Texas A&M University, College Station, Texas, USA
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Kase T, Ueno Y, Endo S. Association of sense of coherence and resilience with distress and infection prevention behaviors during the coronavirus disease pandemic. CURRENT PSYCHOLOGY 2023; 43:1-10. [PMID: 36819752 PMCID: PMC9916494 DOI: 10.1007/s12144-023-04359-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 02/12/2023]
Abstract
This cross-sectional study investigated the relationships between the sense of coherence (SOC) and resilience and between distress and infection prevention behaviors during the early phase of the coronavirus disease (COVID-19) pandemic. The study recruited 1,484 participants (male: 686, female: 798; mean age = 45.1 years, SD = 8.3 years) to complete the SOC-L9 scale, the Adolescent Resilience Scale, Kessler Psychological Distress Scale, and the measurement scale of practices of infection prevention behaviors against COVID-19, originally developed by the study in addition to other control variables. Hierarchical multiple regression analysis demonstrated that greater SOC was associated with less distress during the COVID-19 pandemic, even after resilience was controlled for. Additionally, logistic regression analysis revealed that greater resilience was associated with the majority of greater COVID-19 related infection prevention behaviors (IPBs). These results suggest that SOC and resilience were related to degree of distress during the COVID-19 pandemic, such that those with higher resilience tended to engage in IPB. Furthermore, differences in the association of both factors with distress and IPB may indicate a few points of discrimination between SOC and resilience, which include similar concepts.
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Affiliation(s)
- Takayoshi Kase
- College of Psychological Sciences, University of Human Environments, 9–12, Dogohimata, Matsuyama-shi, Ehime 790–0825 Japan
| | - Yuki Ueno
- The University of Tokyo, Tokyo, Japan
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Merritt VC, Crocker LD, Sakamoto MS, Chanfreau-Coffinier C, Delano-Wood L. Psychiatric symptoms influence social support in VA Million Veteran Program enrollees screening positive for traumatic brain injury. Soc Sci Med 2022; 312:115372. [PMID: 36162363 DOI: 10.1016/j.socscimed.2022.115372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/18/2022] [Accepted: 09/12/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To examine measures of social support and associations with neurobehavioral, psychiatric, and cognitive symptoms in Veterans who underwent the Veterans Health Administration's Traumatic Brain Injury (TBI) Screening and Evaluation Program. SETTING Nationally representative sample of U.S. Veterans enrolled in the Veterans Affairs Million Veteran Program. PARTICIPANTS Veterans (N = 9,837) were classified into the following three diagnostic groups based on results from the TBI Screening and Evaluation Program: (1) negative TBI screen (Screen-; n = 6,523), (2) positive TBI screen but no TBI diagnosis (Screen+/TBI-; n = 1,308), or (3) positive TBI screen and TBI diagnosis (Screen+/TBI+; n = 2,006). DESIGN Epidemiological cross-sectional study. MAIN MEASURES Medical Outcomes Study Social Support Survey Instrument (MOS-SSSI), with subscales representing emotional, tangible, and affectionate support and positive social interaction; Neurobehavioral Symptom Inventory (NSI); PTSD Checklist (PCL); Patient Health Questionnaire-4 (PHQ-4); and Medical Outcomes Study Cognitive Functioning-Revised Scale (MOS-Cog-R). RESULTS ANCOVAs showed significant associations between diagnostic group and all aspects of social support. Pairwise comparisons revealed that Veterans in the two Screen+ groups (Screen+/TBI+ and Screen+/TBI-) reported comparable levels of social support, but that both Screen+ groups reported significantly lower levels of social support compared to the Screen- group. Among the Screen+ groups, adjusted linear regression models controlling for age, sex, and race/ethnicity showed significant associations between social support indices and all symptom measures, such that lower levels of social support were associated with more severe neurobehavioral and psychiatric symptoms and worse cognitive functioning. Finally, mediation analyses showed that psychiatric symptoms mediated the association between TBI screen group and social support. CONCLUSIONS Our results are clinically informative and suggest (1) that the relationship between TBI screen status and social support is influenced by psychiatric symptoms and (2) that implementing distress reduction techniques before social support interventions may be most beneficial for Veterans screening positive for TBI.
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Affiliation(s)
- Victoria C Merritt
- Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, United States; Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States; Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, United States.
| | - Laura D Crocker
- Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, United States; Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, United States
| | - McKenna S Sakamoto
- Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, United States
| | - Catherine Chanfreau-Coffinier
- VA Informatics and Computing Infrastructure (VINCI), VA Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Lisa Delano-Wood
- Research & Psychology Services, VA San Diego Healthcare System (VASDHS), San Diego, CA, United States; Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States; Center of Excellence for Stress and Mental Health, VASDHS, San Diego, CA, United States
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Resilience Improves the Quality of Life and Subjective Happiness of Physiotherapists during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148720. [PMID: 35886573 PMCID: PMC9317447 DOI: 10.3390/ijerph19148720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/09/2022] [Accepted: 07/14/2022] [Indexed: 02/04/2023]
Abstract
Resilience is an individual characteristic that protects mental health. However, its impact on the lives of Brazilian physiotherapists during COVID-19 is not known. This study aimed to analyze whether resilience modulates the perceived quality of life (QoL) and subjective happiness (SH) of physiotherapists who work with COVID-19 patients, compared with those who do not. A cross-sectional study was conducted between 22 August and 22 October 2020. Physiotherapists working in critical and non-critical hospital sectors were invited to participate in the study. The participants completed sociodemographic questionnaires and were graded on the 14-item Resilience Scale, 36-item Short-Form Health Survey (SF-36), and the Subjective Happiness Scale. In total, 519 physiotherapists were enrolled in the study. Physiotherapists with low resilience who worked with COVID-19 patients reported lower scores on the SF-36 subscales (except for social functioning) and the Subjective Happiness Scale, compared with those with high resilience who did not work with COVID-19 patients. These responses were modulated by age, sex, absence from work, receipt of personal protective equipment, host leadership, and practice and maintenance of regular physical activity. In conclusion, physiotherapists with low resilience who worked with COVID-19 patients presented lower perceptions of QoL and SH, compared with the other study participants.
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Kreitzer N, Jain S, Young JS, Sun X, Stein MB, McCrea MA, Levin HS, Giacino JT, Markowitz AJ, Manley GT, Nelson LD. Comparing the Quality of Life after Brain Injury-Overall Scale and Satisfaction with Life Scale as Outcome Measures for Traumatic Brain Injury Research. J Neurotrauma 2021; 38:3352-3363. [PMID: 34435894 DOI: 10.1089/neu.2020.7546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
It is important to measure quality of life (QoL) after traumatic brain injury (TBI), yet limited studies have compared QoL inventories. In 2579 TBI patients, orthopedic trauma controls, and healthy friend control participants, we compared the Quality of Life After Brain Injury-Overall Scale (QOLIBRI-OS), developed for TBI patients, to the Satisfaction with Life Scale (SWLS), an index of generic life satisfaction. We tested the hypothesis that group differences (TBI and orthopedic trauma vs. healthy friend controls) would be larger for the QOLIBRI-OS than the SWLS and that the QOLIBRI-OS would manifest more substantial changes over time in the injured groups, demonstrating more relevance of the QOLIBRI-OS to traumatic injury recovery. (1) We compared the group differences (TBI vs. orthopedic trauma control vs. friend control) in QoL as indexed by the SWLS versus the QOLIBRI-OS and (2) characterized changes across time in these two inventories across 1 year in these three groups. Our secondary objective was to characterize the relationship between TBI severity and QoL. As compared with healthy friend controls, the QOLIBRI reflected greater reductions in QoL than the SWLS for both the TBI group (all time points) and the orthopedic trauma control group (2 weeks and 3 months). The QOLIBRI-OS better captured expected improvements in QoL during the injury recovery course in injured groups than the SWLS, which demonstrated smaller changes over time. TBI severity was not consistently or robustly associated with self-reported QoL. The findings imply that, as compared with the SWLS, the QOLIBRI-OS appears to identify QoL issues more specifically relevant to traumatically injured patients and may be a more appropriate primary QoL outcome measure for research focused on the sequelae of traumatic injuries.
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Affiliation(s)
- Natalie Kreitzer
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Sonia Jain
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - Jacob S Young
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Xiaoying Sun
- Biostatistics Research Center, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - Murray B Stein
- Departments of Psychiatry and Family Medicine & Public Health, University of California, San Diego, San Diego, California, USA
| | - Michael A McCrea
- Departments of Neurosurgery & Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Harvey S Levin
- Department of Physical Medicine and Rehabilitation, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA
| | - Joseph T Giacino
- Department of Physical Medicine and Rehabilitation, Harvard Medical School and Spaulding Rehabilitation Hospital, Charlestown, Massachusetts, USA
| | - Amy J Markowitz
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Geoffrey T Manley
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Lindsay D Nelson
- Departments of Neurosurgery & Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Elliott TR, Perrin PB, Bell AS, Powers MB, Warren AM. Resilience, coping, and distress among healthcare service personnel during the COVID-19 pandemic. BMC Psychiatry 2021; 21:489. [PMID: 34615501 PMCID: PMC8493044 DOI: 10.1186/s12888-021-03506-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/23/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has a detrimental effect on the health and well-being of health care workers (HCWs). The extent to which HCWs may differ in their experience of depression and anxiety is unclear, and longitudinal studies are lacking. The present study examined theorized differences in distress between resilient and non-resilient HCWs over time, as reported in a national online survey. We also examined possible differences in distress as a function of sex and doctoral-level status. METHODS A national sample responded to an online survey data that included the study measures. Of the HCWs who responded, 666 had useable data at the two time points. A longitudinal structural equation model tested an a priori model that specified the relationship of a resilient personality prototype to self-reported resilience, coping, depression and anxiety at both measurement occasions. Additional invariance models examined possible differences by sex and doctoral-level status. RESULTS The final model explained 46.4% of the variance in psychological distress at Time 1 and 69.1% at Time 2. A non-resilient personality prototype predicted greater depression and anxiety. A resilient personality prototype was predictive of and operated through self-reported resilience and less disengaged coping to effect lower distress. No effects were found for active coping, however. The final model was generally invariant by sex and HCWs status. Additional analyses revealed that non-doctoral level HCWs had significantly higher depression and anxiety than doctoral-level HCWs on both occasions. CONCLUSIONS HCWs differ in their susceptibility to distress imposed by COVID-19. Those who are particularly vulnerable may have characteristics that contribute to a lower sense of confidence and efficacy in stressful situations, and more likely to rely on ineffective, disengaged coping behaviors that can exacerbate stress levels. Individual interventions and institutional policies may be implemented to support HCWs at risk.
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Affiliation(s)
- Timothy R. Elliott
- grid.264756.40000 0004 4687 2082Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225 USA
| | - Paul B. Perrin
- grid.224260.00000 0004 0458 8737Department of Psychology, Virginia Commonwealth University, Richmond, Virginia USA
| | - Anne-Stuart Bell
- grid.264756.40000 0004 4687 2082Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225 USA
| | - Mark B. Powers
- grid.411588.10000 0001 2167 9807Baylor University Medical Center, Dallas, TX USA
| | - Ann Marie Warren
- grid.411588.10000 0001 2167 9807Baylor Scott & White Research Institute, Baylor University Medical Center, Dallas, TX USA
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Assonov D. Two-Step Resilience-Oriented Intervention for Veterans with Traumatic Brain Injury: A Pilot Randomized Controlled Trial. CLINICAL NEUROPSYCHIATRY 2021; 18:247-259. [PMID: 34984068 PMCID: PMC8696289 DOI: 10.36131/cnfioritieditore20210503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The present randomized parallel two-arm pilot study aimed to compare the efficacy of two-step resilience-oriented intervention with treatment as usual in veterans with mild to moderate traumatic brain injury. METHOD Two-step Resilience-Oriented Intervention (TROI) is a brief psychological intervention that targets cognitive (step 1) and emotional (step 2) factors of resilience and consists of six 1-hour sessions. Overall, 70 Ukrainian veterans serviced in Anti-Terrorist Operation / Joint Forces Operation were randomly assigned to an intervention group (TROI group) or a control group that underwent treatment as usual (TAU group). For pre- (T1) and post-treatment (T2) assessment the Connor-Davidson Resilience Scale (CD-RISC), Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment Scale (MoCA), Neurobehavioral Symptom Inventory (NSI), Posttraumatic Stress Disorder Checklist 5 (PCL-5), Chaban Quality of Life Scale (CQLS), Positive and Negative Affect Scale (PANAS) were used. RESULTS Multivariable linear regression with the treatment group, gender, baseline cognitive performance level and TBI severity as the independent variables revealed statistically significant improvements in the TROI group in resilience (CD-RISC), cognitive performance (MoCA), postconcussive symptoms (NSI), posttraumatic symptoms (PCL-5), positive affect (PANAS) and quality of life (CQLS) comparing to such in TAU group. We found no statistically significant differences between groups in depression, anxiety (HADS) and negative affect (PANAS) outcomes. Additionally, Wilcoxon signed-rank test revealed that participants who completed two-step resilience-oriented intervention had significantly improved scores for all outcomes compared to the baseline (p < 0.05). CONCLUSIONS In summary, we can tentatively conclude that adding TROI to the standard treatment measures may improve the resilience and sustainable symptoms in veterans with TBI when compared with standard treatment. Targeting cognitive and emotional factors like problem-solving, decision-making, positive thinking can promote resilience in veterans with TBI and be useful in facilitating recovery from injury. Results of this pilot study are promising, but the intervention needs to be studied in a larger trial.
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Affiliation(s)
- Dmytro Assonov
- Department of Medical Psychology, Psychosomatic Medicine and Psychotherapy, Bogomolets National Medical University, Kyiv, Ukraine,Corresponding author Dmytro Assonov, E-mail:
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Barczak-Scarboro NE, Cole WR, DeLellis SM, Means GE, Kane SF, Lynch JH, Mihalik JP. Mental Health Symptoms Are Associated With Mild Traumatic Brain Injury History in Active Special Operations Forces (SOF) Combat and Combat Support Soldiers. Mil Med 2020; 185:e1946-e1953. [PMID: 32676649 DOI: 10.1093/milmed/usaa167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Special Operations Forces (SOF) combat arms and combat support Soldiers are at risk for impaired mental health, such as mood- and stress-related disorders, due to operational and training demands. Additionally, these individuals experience high risk for sustaining mild traumatic brain injury (mTBI). These mTBIs have also been linked to negative psychological outcomes, such as anxiety and depressive symptoms. Studying mental illnesses and their related symptoms alone does not fully address mental health, which may be better understood by 2 separate but overlapping continua measuring both mental illness and subjective well-being (ie, emotional, psychological, and social well-being). Due to the lack of research in this area, current mental health symptoms in active SOF combat Soldiers in relation to mTBI warrants investigation. MATERIALS AND METHODS In this study, 113 SOF combat and combat support Soldiers completed self-report psychological and mTBI history measures during an in-person laboratory setting. These psychometric measures included (1) psychological distress (Brief Symptom Inventory 18), (2) anxiety (Generalized Anxiety Disorder 7-item), (3) posttraumatic stress (PTSD Checklist for DSM-5), (4) somatization (Patient Health Questionnaire-15), and (5) subjective well-being (Mental Health Continuum Short Form). RESULTS On average, SOF combat Soldiers endorsed moderate well-being and low psychological distress, somatization, posttraumatic stress, and anxiety. Most SOF combat Soldiers had sustained 1 or more mTBI. We observed mTBI history had significant effects on each dependent variable in the expected directions. History of more mTBIs, controlling for age, was associated with lower subjective well-being as well as higher psychological distress, somatization, posttraumatic stress, and anxiety symptoms. CONCLUSION Although SOF combat Soldiers reported relatively adaptive mental health symptoms across participants, there was considerable variance in the measures reported. Some of the variance in mental health symptoms was accounted for by mTBI history while controlling for age, with reporting higher numbers of lifetime mTBIs and older age being associated with worse mental health symptoms. Longitudinal investigations into these associations and their impact on Soldier performance is warranted.
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Affiliation(s)
- Nikki E Barczak-Scarboro
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 2201 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC 27599.,Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Bondurant Hall, Campus Box 7120, Chapel Hill, NC 27599
| | - Wesley R Cole
- Intrepid Spirit Center, Womack Army Medical Center, 3908 Longstreet Road, Building #3-403, Fort Bragg, NC 28310
| | - Stephen M DeLellis
- Defense Medical Strategies, LLC, 136 Timberlake Drive, Fayetteville, NC 28314
| | - Gary E Means
- United States Army Special Operations Command, E-2929 Desert Storm Drive, Fort Bragg, NC 28310
| | - Shawn F Kane
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 2201 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC 27599.,Department of Family Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, Chapel Hill, NC 27514
| | - James H Lynch
- United States Army Special Operations Command, E-2929 Desert Storm Drive, Fort Bragg, NC 28310
| | - Jason P Mihalik
- Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, 2201 Stallings-Evans Sports Medicine Center, Campus Box 8700, Chapel Hill, NC 27599.,Human Movement Science Curriculum, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Bondurant Hall, Campus Box 7120, Chapel Hill, NC 27599
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Clinical Predictors of 3- and 6-Month Outcome for Mild Traumatic Brain Injury Patients with a Negative Head CT Scan in the Emergency Department: A TRACK-TBI Pilot Study. Brain Sci 2020; 10:brainsci10050269. [PMID: 32369967 PMCID: PMC7287871 DOI: 10.3390/brainsci10050269] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/08/2020] [Accepted: 04/28/2020] [Indexed: 01/25/2023] Open
Abstract
A considerable subset of mild traumatic brain injury (mTBI) patients fail to return to baseline functional status at or beyond 3 months postinjury. Identifying at-risk patients for poor outcome in the emergency department (ED) may improve surveillance strategies and referral to care. Subjects with mTBI (Glasgow Coma Scale 13–15) and negative ED initial head CT < 24 h of injury, completing 3- or 6-month functional outcome (Glasgow Outcome Scale-Extended; GOSE), were extracted from the prospective, multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. Outcomes were dichotomized to full recovery (GOSE = 8) vs. functional deficits (GOSE < 8). Univariate predictors with p < 0.10 were considered for multivariable regression. Adjusted odds ratios (AOR) were reported for outcome predictors. Significance was assessed at p < 0.05. Subjects who completed GOSE at 3- and 6-month were 211 (GOSE < 8: 60%) and 185 (GOSE < 8: 65%). Risk factors for 6-month GOSE < 8 included less education (AOR = 0.85 per-year increase, 95% CI: (0.74–0.98)), prior psychiatric history (AOR = 3.75 (1.73–8.12)), Asian/minority race (American Indian/Alaskan/Hawaiian/Pacific Islander) (AOR = 23.99 (2.93–196.84)), and Hispanic ethnicity (AOR = 3.48 (1.29–9.37)). Risk factors for 3-month GOSE < 8 were similar with the addition of injury by assault predicting poorer outcome (AOR = 3.53 (1.17–10.63)). In mTBI patients seen in urban trauma center EDs with negative CT, education, injury by assault, Asian/minority race, and prior psychiatric history emerged as risk factors for prolonged disability.
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Rice VJ, Schroeder PJ, Cassenti DN, Boykin GL. The Effect of Traumatic Brain Injury (TBI) on Cognitive Performance in a Sample of Active Duty U.S. Military Service Members. Mil Med 2020; 185:184-189. [DOI: 10.1093/milmed/usz202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Traumatic brain injury (TBI) is considered a signature injury from the fighting in Iraq and Afghanistan. Since the year 2000, over 370,000 U.S. active duty service members have been diagnosed with TBI. Although prior research has shown that even mild forms of TBI are associated with impaired cognitive performance, it is not clear which facets of cognition (computation, memory, reasoning, etc.) are impacted by injury.
Method
In the present study, we compared active duty military volunteers (n = 88) with and without TBI on six measures of cognition using the Automated Neuropsychological Assessment Metric software.
Results
Healthy volunteers exhibited significantly faster response times on the matching-to-sample, mathematical processing, and second round of simple reaction time tasks and had higher throughput scores on the mathematical processing and the second round of the simple reaction time tasks (P < 0.05).
Conclusion
In this population, cognitive impairments associated with TBI influenced performance requiring working memory and basic neural processing (speed/efficiency).
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Affiliation(s)
- Valerie J Rice
- Army Research Laboratory—Real-World Soldier Quantification Branch, Army Medical Department, Field Office 3162 McIndoe Rd., Building 1152, Suite #1 Fort Sam Houston, San Antonio, TX 78234-7322
| | - Paul J Schroeder
- DCS Corp, 6909 Metro Park Drive, Suite 500, Alexandria, VA 22310
| | - Daniel N Cassenti
- Army Research Laboratory, Bldg 459, Aberdeen Proving Ground, MD 21005
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Adaptation and validation of the self-report version of the scale for measuring quality of life in people with acquired brain injury (CAVIDACE). Qual Life Res 2019; 29:1107-1121. [DOI: 10.1007/s11136-019-02386-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2019] [Indexed: 01/25/2023]
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Szkody E, Mckinney C. Social Support Versus Emotion Regulation: Mediators of Attachment and Psychological Problems After Social Exclusion. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2019. [DOI: 10.1521/jscp.2019.38.10.882] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: Secure parental attachment improves the perception of available social support and the socialization of emotion regulation strategies. Research has suggested that both perceived social support and emotion regulation help individuals reappraise stressful situations as less stressful. Individuals under stress are at an increased risk for psychological problems. Method: The current study examined whether social support, emotion regulation, and psychological inflexibility mediated the relation between parental attachment and psychological problems after a social exclusion task. Results: Results indicated that secure parental attachment was associated with an increased ability to up-regulate emotions and with an increase in the perception of available social support. Secure attachment to either parent was indirectly associated with psychological problems reported after social exclusion. Discussion: Indirect effects were found only for pathways from attachment through emotion regulation strategies, which suggests that emotion regulation may be a driving factor between attachment to parental figures and stress induced psychological problems. Further results, limitations, and implications were discussed.
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Crabtree MA, Meyer EC, Kimbrel NA, DeBeer BB, Kruse MI, Gulliver SB, Telch M, Morissette SB. Factor Structure and Initial Validation of a Brief Measure of Perceived Emotional and Physical Distress Tolerance in Post-9/11 US Veterans. MILITARY PSYCHOLOGY 2019; 31:10.1080/08995605.2019.1637210. [PMID: 31660019 PMCID: PMC6816279 DOI: 10.1080/08995605.2019.1637210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/24/2019] [Indexed: 12/24/2022]
Abstract
Distress tolerance (i.e., perceived or actual capacity to tolerate aversive internal states) has received considerable research attention as a transdiagnostic risk-factor underlying the development and maintenance of psychopathology. Lower levels of emotional distress tolerance have been linked to psychopathology (e.g. Posttraumatic Stress Disorder) within Military populations; however, the association of physical distress tolerance to psychopathology in this population has been under-researched. This research gap may be due in part to a paucity of comprehensive, temporally stable and brief measures of distress tolerance that have been validated within Military populations, which may hinder further examination and refinement of the construct. Addressing this problem, the current study evaluates the psychometric properties of a novel and brief measure of emotional and physical distress tolerance in a sample of United States post-9/11 Veterans. Participants were 307 Veterans (Mage= 38.9, 67.7% male) who completed the 10-item Distress Tolerance Inventory at baseline and annual follow-up. Exploratory structural equation modeling was used to examine the optimal latent factor structure and longitudinal invariance of the DTI measurement model, along with correlational analyses to examine the convergent properties of the DTI subscales. The DTI reflected a longitudinally invariant two-factor structure (emotional and physical distress tolerance), with excellent internal consistency and preliminary evidence of convergent validity. Thus, the DTI represents a brief, reliable and temporally stable measure of physical and emotional distress tolerance.
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Affiliation(s)
| | - Eric C Meyer
- VA VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System
- Texas A&M University Health Science Center, College of Medicine
- Warriors Research Institute, Baylor Scott & White Health
| | - Nathan A Kimbrel
- Durham Veterans Affairs Health Care System
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center
- Duke University School of Medicine
| | - Bryann B DeBeer
- VA VISN 17 Center of Excellence for Research on Returning War Veterans at Central Texas Veterans Health Care System
- Warriors Research Institute, Baylor Scott & White Health
| | - Marc I Kruse
- Austin Fire Department & Austin-Travis County Emergency Medical Services
| | - Suzy B Gulliver
- Texas A&M University Health Science Center, College of Medicine
- Warriors Research Institute, Baylor Scott & White Health
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Meyer EC, Kotte A, Kimbrel NA, DeBeer BB, Elliott TR, Gulliver SB, Morissette SB. Predictors of lower-than-expected posttraumatic symptom severity in war veterans: The influence of personality, self-reported trait resilience, and psychological flexibility. Behav Res Ther 2019; 113:1-8. [DOI: 10.1016/j.brat.2018.12.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 11/21/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022]
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