Self-efficacy theory asserts that personal mastery expectations are the primary determinants of behavioral change. Further, it is suggested that individual differences in past experiences and attribution of success to skill or chance result in different levels of generalized self-efficacy expectations. To measure these generalized expectancies, a Self-efficacy Scale was developed. A factor analysis yielded two subscales: a General Self-efficacy subscale (17 items) and a Social Self-efficacy subscale (6 items). Confirmation of several predicted conceptual relationships between the Self-efficacy subscales and other personality measures (i.e., Locus of Control, Personal Control, Social Desirability, Ego Strength, Interpersonal Competence, and Self-esteem) provided evidence of construct validity. Positive relationships between the Self-efficacy Scale and vocational, educational, and military success established criterion validity. Future research and clinical uses of the scale were discussed.

Amantadine accelerated the pace of functional recovery during active treatment in patients with post-traumatic disorders of consciousness. (Funded by the National Institute on Disability and Rehabilitation Research; ClinicalTrials.gov number, NCT00970944.).

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Neuropsychological recovery after TBI is not uniform across individuals and neuropsychological domains. For a subset of persons with moderate to severe TBI, neuropsychological recovery may continue several years after injury with substantial recovery. For other persons, measurable impairment remains 5 years after injury. Improvement was most apparent on measures of cognitive speed, visuoconstruction, and verbal memory.

Self-efficacy theory asserts that self-efficacy expectancies exert powerful influences on behavior and behavioral change. The Self-efficacy Scale was developed to assess generalized expectations of self-efficacy. Previous research provided preliminary evidence of the validity and reliability of the two subscales of the Self-efficacy Scale. The present study investigated several predicted conceptual relationships between the Self-efficacy subscales and other personality measures, i.e., MMPI, Rathus Assertiveness Schedule, and Bem Sex-role Inventory. Results supported the interpretation of the Self-efficacy Scale as a valid measure of expectation of personal ability to initiate and persist in behavior. Positive expectancies of self-efficacy were associated with enhanced personal adjustment.

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IMPORTANCE Traumatic brain injury (TBI) has been associated with adverse mental health outcomes, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), but little is known about factors that modify risk for these psychiatric sequelae, particularly in the civilian sector.OBJECTIVE To ascertain prevalence of and risk factors for PTSD and MDD among patients evaluated in the emergency department for mild TBI (mTBI). DESIGN, SETTING, AND PARTICIPANTS Prospective longitudinal cohort study (February 2014 to May 2018). Posttraumatic stress disorder and MDD symptoms were assessed using the PTSD Checklist for DSM-5 and the Patient Health Questionnaire-9 Item. Risk factors evaluated included preinjury and injury characteristics. Propensity score weights-adjusted multivariable logistic regression models were performed to assess associations with PTSD and MDD. A total of 1155 patients with mTBI (Glasgow Coma Scale score, 13-15) and 230 patients with nonhead orthopedic trauma injuries 17 years and older seen in 11 US hospitals with level 1 trauma centers were included in this study. MAIN OUTCOMES AND MEASURES Probable PTSD (PTSD Checklist for DSM-5 score, Ն33) and MDD (Patient Health Questionnaire-9 Item score, Ն15) at 3, 6, and 12 months postinjury. RESULTS Participants were 1155 patients (752 men [65.1%]; mean [SD] age, 40.5 [17.2] years) with mTBI and 230 patients (155 men [67.4%]; mean [SD] age, 40.4 [15.6] years) with nonhead orthopedic trauma injuries. Weights-adjusted prevalence of PTSD and/or MDD in the mTBI vs orthopedic trauma comparison groups at 3 months was 20.0% (SE, 1.4%) vs 8.7% (SE, 2.2%) (P < .001) and at 6 months was 21.2% (SE, 1.5%) vs 12.1% (SE, 3.2%) (P = .03). Risk factors for probable PTSD at 6 months after mTBI included less education (adjusted odds ratio, 0.89; 95% CI, 0.82-0.97 per year), being black (adjusted odds ratio, 5.11; 95% CI, 2.89-9.05), self-reported psychiatric history (adjusted odds ratio, 3.57; 95% CI, 2.09-6.09), and injury resulting from assault or other violence (adjusted odds ratio, 3.43; 95% CI, 1.56-7.54). Risk factors for probable MDD after mTBI were similar with the exception that cause of injury was not associated with increased risk. CONCLUSIONS AND RELEVANCEAfter mTBI, some individuals, on the basis of education, race/ethnicity, history of mental health problems, and cause of injury were at substantially increased risk of PTSD and/or MDD. These findings should influence recognition of at-risk individuals and inform efforts at surveillance, follow-up, and intervention.