Abstract:Preinjury somatization symptoms contribute to reported postconcussive symptom recovery via their influence on acute postconcussive symptoms. The findings highlight the relevance of premorbid psychological factors in postconcussive recovery, even in a healthy athlete sample relatively free of psychopathology or medical comorbidities. Future research should elucidate the neurobiopsychosocial mechanisms that explain the role of this individual difference variable in outcome following concussive injury.
“…With this in mind, it is interesting that the general factor also correlated robustly with several pre-injury clinical variables, including pre-injury baseline somatic and distress symptoms. This finding is consistent with a wealth of evidence indicating a direct link between pre-injury emotional functioning and response to concussion which in turn points to the need for more investigation into the mechanisms by which pre-injury risk and resilience factors influence patients’ responses to injury and courses of recovery (Broshek, De Marco, & Freeman, 2015; Nelson, Tarima, et al, 2016; Root et al, 2016). …”
The SCAT3 contains items that appear unidimensional, suggesting that it is appropriate to quantify concussion symptoms with total scores. However, evidence of multidimensionality was revealed using bifactor modeling. Additional work is needed to clarify the nature of factors identified by this model, explicate their clinical and research utility, and determine to what degree the model applies to other stages of injury recovery and patient subgroups. (JINS, 2018, 24, 793-804).
“…With this in mind, it is interesting that the general factor also correlated robustly with several pre-injury clinical variables, including pre-injury baseline somatic and distress symptoms. This finding is consistent with a wealth of evidence indicating a direct link between pre-injury emotional functioning and response to concussion which in turn points to the need for more investigation into the mechanisms by which pre-injury risk and resilience factors influence patients’ responses to injury and courses of recovery (Broshek, De Marco, & Freeman, 2015; Nelson, Tarima, et al, 2016; Root et al, 2016). …”
The SCAT3 contains items that appear unidimensional, suggesting that it is appropriate to quantify concussion symptoms with total scores. However, evidence of multidimensionality was revealed using bifactor modeling. Additional work is needed to clarify the nature of factors identified by this model, explicate their clinical and research utility, and determine to what degree the model applies to other stages of injury recovery and patient subgroups. (JINS, 2018, 24, 793-804).
“…Furthermore, these findings do not rule out the possibility that acute neuropsychological data could be informative for prognostic purposes in mTBI or other patient populations (Dischinger, Ryb, Kufera, & Auman, 2009; McCrea et al, 2013; Meehan, Mannix, Monuteaux, Stein, & Bachur, 2014; Nelson, Tarima, et al, 2016). At the present time, however, the findings suggest that clinicians can continue to apply standard clinical criteria to assess patients for mTBI; neurocognitive assessment may provide supporting data on patients’ presenting concerns but is not useful for diagnostic purposes.…”
The CNTs evaluated, developed and widely used to assess sport-related concussion, did not yield significant differences between patients with mTBI versus other injuries. Symptom scores better differentiated groups than CNTs, with effect sizes weaker than those reported in sport-related concussion studies. Nonspecific injury factors, and other characteristics common in ED settings, likely affect CNT performance across trauma patients as a whole and thereby diminish the validity of CNTs for assessing mTBI in this patient population. (JINS, 2017, 23, 293-303).
ObjectiveA systematic review of factors that might be associated with, or influence, clinical recovery from sport-related concussion. Clinical recovery was defined functionally as a return to normal activities, including school and sports, following injury.DesignSystematic review.Data sourcesPubMed, PsycINFO, MEDLINE, CINAHL, Cochrane Library, EMBASE, SPORTDiscus, Scopus and Web of Science.Eligibility criteria for selecting studiesStudies published by June of 2016 that addressed clinical recovery from concussion.ResultsA total of 7617 articles were identified using the search strategy, and 101 articles were included. There are major methodological differences across the studies. Many different clinical outcomes were measured, such as symptoms, cognition, balance, return to school and return to sports, although symptom outcomes were the most frequently measured. The most consistent predictor of slower recovery from concussion is the severity of a person’s acute and subacute symptoms. The development of subacute problems with headaches or depression is likely a risk factor for persistent symptoms lasting greater than a month. Those with a preinjury history of mental health problems appear to be at greater risk for having persistent symptoms. Those with attention deficit hyperactivity disorder (ADHD) or learning disabilities do not appear to be at substantially greater risk. There is some evidence that the teenage years, particularly high school, might be the most vulnerable time period for having persistent symptoms—with greater risk for girls than boys.ConclusionThe literature on clinical recovery from sport-related concussion has grown dramatically, is mostly mixed, but some factors have emerged as being related to outcome.
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