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Childs A, Bertisch H, Talis E, Ricker JH, Rath JF. Development of an MMPI reference group for outpatients with persisting symptoms following mild TBI. Brain Inj 2022; 36:1357-1363. [PMID: 36324279 PMCID: PMC9772179 DOI: 10.1080/02699052.2022.2140834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To develop an MMPI-2-RF reference group for persistently symptomatic patients with mTBI in order to aid interpretation and better evaluate atypical scale elevations. METHOD Using the Q Local MMPI-2-RF Comparison Group Generator (CGG), 200 valid MMPI-2-RF profiles were aggregated for mTBI outpatients with persisting symptoms 2-24 months post injury. RESULTS Compared to established MMPI general population norms, individuals with persisting symptoms demonstrated elevations on several scales, primarily in cognitive and somatic domains. T scores > 60 and standard deviations > 10 were observed for the F-r (Infrequent Responses), Fs (Infrequent Somatic Responses), FBS-r (Symptom Validity), RBS (Response Bias Scale), RC1 (Somatic Complaints), MLS (Malaise), HPC (Head Pain Complaints), NUC (Neurological Complaints), and COG (Cognitive Complaints) scales. All other scales were consistent with established norms for the general population. CONCLUSION This study is the first to establish an empirically derived MMPI reference group for individuals with persisting symptoms following mTBI. By comparing MMPI profiles of patients with mTBI against this reference group, clinicians may be better able to identify abnormal symptomatology. Evaluating profiles within this context may allow for more accurate case conceptualization and targeted treatment recommendations for those patients who demonstrate disproportionate symptomatology outside the range of the mTBI reference group.
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Affiliation(s)
- Amanda Childs
- Department of Rehabilitation Medicine, Rusk Rehabilitation, NYU Langone Health, New York, New York, USA
| | - Hilary Bertisch
- Department of Psychiatry, Now at Northwell Health, Zucker Hillside Hospital, Glen Oaks, New York, USA
| | - Elina Talis
- Department of Rehabilitation Medicine, Rusk Rehabilitation, NYU Langone Health, New York, New York, USA
| | - Joseph H. Ricker
- Department of Rehabilitation Medicine, Rusk Rehabilitation, NYU Langone Health, New York, New York, USA
| | - Joseph F. Rath
- Department of Rehabilitation Medicine, Rusk Rehabilitation, NYU Langone Health, New York, New York, USA
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Malpas CB, Wang AD, Leong M, Johnstone B, Rayner G, Kalincik T, Kwan P, O'Brien TJ, Velakoulis D. Abbreviated assessment of psychopathology in patients with suspected seizure disorders. Epilepsy Behav 2019; 100:106530. [PMID: 31665694 DOI: 10.1016/j.yebeh.2019.106530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/11/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE Psychopathology is common in patients undergoing investigation for seizure-related disorders. Psychometric examination using self-report instruments, such as the Symptom Checklist 90 - Revised (SCL-90-R), can assist diagnosis. The SCL-90-R, however, is a lengthy instrument and might not be tolerated by all patients. We assessed several abbreviated forms of the SCL-90-R in patients undergoing video encephalographic monitoring (VEM). METHOD Six hundred eighty-seven patients completed the SCL-90-R, and scores were computed for the full SCL-90-R and five abbreviated forms. Correlations and mean differences were computed between different forms. Classification accuracy was assessed via receiver operating characteristic (ROC) curves, and measurements models were examined using confirmatory factor analysis (CFA). RESULTS All abbreviated forms were strongly correlated with the SCL-90-R for general psychopathology (r = 0.93-0.99), depression (r = 0.89-0.95), anxiety (r = 0.97-0.98), psychosis (r = 0.95-0.99), and obsessive-compulsive symptoms (r = 0.97). Classification performance was similar across forms for depression and anxiety, with high negative predictive values (0.90-0.94) and lower positive predictive values (0.34-0.38). Classification performance for psychotic and obsessive-compulsive disorders was poor. Differences were observed between the full SCL-90-R and its abbreviated forms across most domains (d = 0.00-0.65). The published measurement model was most strongly validated for the SCL-27, SCL-14, and the SCL-K-9. CONCLUSIONS These five SCL-90-R abbreviated forms show high convergent validity with the full version. In patients undergoing investigation for seizure-related disorders, the Brief Symptom Inventory full form (BSI) or short form (BSI-18) is most appropriate where screening for both depression and anxiety is required. The SCL-K-9 is appropriate when only a single measure of global psychological distress is required. None of the instruments were able to detect psychotic or obsessive-compulsive symptoms with great accuracy. Caution should be exercised when making direct comparisons across the different forms.
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Affiliation(s)
- Charles B Malpas
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia.
| | - Albert D Wang
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Michelle Leong
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Benjamin Johnstone
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia
| | - Genevieve Rayner
- Department of Medicine (Austin Health), The University of Melbourne, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Australia
| | - Tomas Kalincik
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia
| | - Patrick Kwan
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia
| | - Terence J O'Brien
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Australia; Department of Neurology, Royal Melbourne Hospital, Australia; Department of Neurology, Alfred Hospital, Australia; Department of Neurosciences, Monash University, Australia
| | - Dennis Velakoulis
- Department of Psychiatry, Royal Melbourne Hospital, Australia; Department of Psychiatry, The University of Melbourne, Australia
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Ruis C, van den Berg E, van Stralen HE, Huenges Wajer IM, Biessels GJ, Kappelle LJ, Postma A, van Zandvoort MJE. Symptom Checklist 90–Revised in neurological outpatients. J Clin Exp Neuropsychol 2014; 36:170-7. [DOI: 10.1080/13803395.2013.875519] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Falk AC, Von Wendt L, Söderkvist BK. The specificity of post-concussive symptoms in the pediatric population. J Child Health Care 2009; 13:227-38. [PMID: 19713406 DOI: 10.1177/1367493509336691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study compared patterns of reported symptoms between a mild head injury group and a group of children with abdominal complaints visiting an emergency department. Children (0-15 years) admitted to an emergency department during a three-month period with a history of head injury and a comparison group of children were included. Medical records at the time of injury were reviewed and follow-up questionnaires focused on presumed symptoms related to concussion at three months post-visit. The comparison group reported significantly more change in behaviour than the head injury group. However, for the older children, higher intensity of symptoms was reported by the comparison group compared to the head injury group. Initial differences in the amount and presence of symptoms between the two groups did not reflect the findings at three months; both groups reported symptoms or changes at three months after the event. Evaluating children aged under five, their symptoms and recovery patterns after a head injury is recommended.
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Affiliation(s)
- Ann-Charlotte Falk
- Department of Woman and Child Health, Neuropediatric Research Unit, Karolinska Institutet, Stockholm, Sweden.
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The Reliability and Validity of the Brief Symptom Inventory−18 in Persons With Traumatic Brain Injury. Arch Phys Med Rehabil 2008; 89:958-65. [DOI: 10.1016/j.apmr.2007.12.028] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2007] [Revised: 12/07/2007] [Accepted: 12/23/2007] [Indexed: 11/18/2022]
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Bruce AS, Arnett PA. Longitudinal Study of the Symptom Checklist 90-Revised in Multiple Sclerosis Patients. Clin Neuropsychol 2008; 22:46-59. [DOI: 10.1080/13854040601064518] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Chua KSG, Ng YS, Yap SGM, Bok CW. A Brief Review of Traumatic Brain Injury Rehabilitation. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2007. [DOI: 10.47102/annals-acadmedsg.v36n1p31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction: This article aims to provide an overview of the epidemiology, medical and rehabilitation issues, current evidence for traumatic brain injury (TBI) rehabilitation, recent advances and emerging practices. Special TBI population groups will also be addressed.
Materials and Methods: We included publications indexed in Medline and the Cochrane Database of Systemic Reviews from 1974 to 2006, relevant chapters in major rehabilitation texts and Physical Medicine and Rehabilitation Clinics of North America and accessed Internet publications.
Results: TBI has been implicated by the World Health Organisation to be a 21st century epidemic similar to malaria and HIV/AIDS, not restricted to the developed world. One third of patients may suffer severe TBI with long-term cognitive and behavioural disabilities. Injuries to the brain do not only damage the cerebrum but may give rise to a multisystem disorder due to associated injuries in 20% of cases, which can include complex neurological impairments, neuroendocrine and neuromedical complications. There is promising evidence of improved outcome and functional benefits with early induction into a transdisciplinary brain injury rehabilitation programme. However, TBI research is fraught with difficulties because of an intrinsically heterogeneous population due to age, injury severity and type, functional outcome measures and small samples. Recent advances in TBI rehabilitation include task-specific training of cognitive deficits, computer-aided cognitive remediation and visual-spatial and visual scanning techniques and body weight-supported treadmill training for motor deficits. In addition, special rehabilitation issues for mild TBI, TBI-related vegetative states, elderly and young TBI, ethical issues and local data will also be discussed.
Key words: Disability, Head injury, Impairment, Neurorehabilitation, Vegetative state
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Nacajauskaite O, Endziniene M, Jureniene K, Schrader H. The validity of post-concussion syndrome in children: a controlled historical cohort study. Brain Dev 2006; 28:507-14. [PMID: 16682158 DOI: 10.1016/j.braindev.2006.02.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2005] [Revised: 02/26/2006] [Accepted: 02/27/2006] [Indexed: 11/24/2022]
Abstract
The aim of this controlled historical cohort study was to assess the validity of post-concussion syndrome in children. We identified 301 children aged 4-15 years who had sustained an isolated brain concussion, and another group of 301 children who sustained any other mild body injury excluding the head. Parents from both groups filled in standardized questionnaires containing questions about the health condition of the children: headache, neck pain, dizziness, malaise, fatigability, exercise or noise intolerance, irritability, weepiness, sadness, anxiety, nocturnal enuresis, tics, sleep disorders, memory or learning difficulties, hyperactivity, seizures, attention disorder, buzzing in the ears, subjective parental concerns about the child's health condition, and parental concerns about their child having a brain disorder. The severity of the complaints was rated on the Visual Analogue Scale. After the final exclusion, 102 pairs strictly matched by sex, age, and the date of trauma were analyzed. The differences of parental complaints about the health condition of their children between case and control groups were statistically insignificant for all symptoms, except parental concerns about their child having brain damage which were significantly higher in the case group. The likelihood of parental concerns about the possibility of their child having brain damage was 2.7 times higher in the case group. Headache, learning difficulties, and sleep disorders were significant variables predicting the concerns. These results question the validity of the post-concussion syndrome in children.
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Affiliation(s)
- Olga Nacajauskaite
- Center of Pediatric Surgery, Vilnius University Children's Hospital, Santariskiu 7, Vilnius, Lithuania.
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