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Jovanović V. The Depression Anxiety Stress Scales for Youth (DASS-Y): evidence of validity and cross-national and gender measurement invariance. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02561-0. [PMID: 39141105 DOI: 10.1007/s00787-024-02561-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 08/07/2024] [Indexed: 08/15/2024]
Abstract
The Depression Anxiety Stress Scales for Youth (DASS-Y) is a recently developed measure of unpleasant emotional experiences for children and adolescents; however, the evidence for its validity is still limited. The present study evaluated the evidence for the structural, convergent, and incremental validity of the DASS-Y on a sample of Serbian adolescents aged 15-19 years (N = 421; 48% female, mean age = 16.86). Measurement invariance across gender and two countries (Serbia and Australia) was also tested. The findings supported the bifactor exploratory structural equation modeling (bifactor-ESEM) representation of the DASS-Y, which includes the General factor of negative affect/emotional distress, and three specific factors of Depression, Anxiety, and Stress. The DASS-Y factors showed evidence of incremental validity in predicting global externalizing symptoms and demonstrated convergent validity in relation to measures of global internalizing and externalizing symptoms as well as subjective well-being. The bifactor-ESEM model of the DASS-Y was found to be invariant across gender and two countries. The present study findings highlight the importance of distinguishing between general and specific components of unpleasant emotional states.
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Affiliation(s)
- Veljko Jovanović
- Department of Psychology, Faculty of Philosophy, University of Novi Sad, Dr Zorana Đinđića 2, Novi Sad, 21 000, Serbia.
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2
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Botchway-Commey E, Ryan NP, Anderson V, Catroppa C. Exploring emotional distress symptom clusters in young adults with childhood traumatic brain injury. Neuropsychol Rehabil 2024:1-25. [PMID: 39031777 DOI: 10.1080/09602011.2024.2375803] [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: 07/02/2023] [Accepted: 06/28/2024] [Indexed: 07/22/2024]
Abstract
BACKGROUND Depression, anxiety, and stress are persistent and co-occurring symptoms in survivors of childhood traumatic brain injury (TBI), and often impact on health-related quality of life (HRQoL). This paper explored emotional distress symptom clusters and associated factors in young adults with childhood TBI. METHODS We included 54 young adults who sustained mild (n = 14), moderate (n = 27), and severe (n = 13) childhood TBI, at 20 years post-injury. The Depression Anxiety Stress Scale was administered. Cluster group membership was identified using two-step clustering and hierarchical clustering methods, and associated factors were assessed with multiple regression models. RESULTS Two symptom cluster groups were identified, including a No Distress (n = 66%) and an Elevated Distress (n = 33%) group, with the latter showing significantly higher symptoms of depression, anxiety, and stress (all p < .001). Elevated Distress group membership was linked to tobacco use and poor sleep quality, while poor HRQoL was associated with younger age at injury and Elevated Distress group membership. CONCLUSIONS Using cluster methodology, we showed that one-third of young adults with childhood TBI had elevated emotional distress symptoms. This underscores the complex emotional profile of this subgroup and the need for assessment, analysis, and treatment methods that target a range of symptoms rather than relying on single-diagnostic protocols. ABBREVIATIONS ANOVA: Analysis of Variance; CT: Computed Tomography; DASS: Depression Anxiety Stress Scale; GCS: Glasgow Coma Scale; HREC: Human Research Ethics Committee; HRQoL: Health-Related Quality of Life; IBM: International Business Machines Corporation; MRI: Magnetic Resonance Imaging; PTA: Post-Traumatic Amnesia; QoL: Quality of Life; QOLIBRI: Quality of Life after Brain Injury Scale; REDCap: Research Electronic Data Capture; SES: Socioeconomic Status; SPSS: Statistical Package for the Social Sciences; TBI: Traumatic Brain Injury.
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Affiliation(s)
- Edith Botchway-Commey
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Nicholas P Ryan
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
- Cognitive Neuroscience Unit, Deakin University, Geelong, Australia
| | - Vicki Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Psychology, Royal Children's Hospital, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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Chuah SL, Whiting DL, Gates TM, Simpson GK. Factors Associated with Device, Internet and Videoconferencing Use Amongst Individuals with Moderate-to-Severe Traumatic Brain Injury. Healthcare (Basel) 2024; 12:1371. [PMID: 39057514 PMCID: PMC11275634 DOI: 10.3390/healthcare12141371] [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] [Received: 06/07/2024] [Revised: 06/30/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024] Open
Abstract
Videoconferencing (VC) has the potential to improve access to quality healthcare for individuals with traumatic brain injury (TBI) who require intensive and ongoing rehabilitation post-injury. Gaps in information and communication technology (ICT) use, access, and skills, however, may undermine equitable participation in remotely delivered healthcare and rehabilitation. This cross-sectional study sought to identify which demographic, injury-related, and psychological factors are associated with gaps in digital inclusion amongst individuals with a TBI. Between March 2020 and December 2023, 186 adults with a moderate-to-severe TBI who were aged 18-65 years and were within five years post-injury completed a range of self-report measures. The results demonstrated that most individuals with a moderate-to-severe TBI reported high levels of technology skills and access and used the internet from multiple devices daily. While injury severity was unrelated to technology use, this finding may reflect an overestimation of technology use amongst individuals with the most severe injuries, who were excluded from the study. Several demographic and psychological factors were found to predict VC readiness and are presented within a model to guide clinicians considering client suitability for VC rehabilitation. The current findings indicate that the use of VC in clinical settings following a moderate-to-severe TBI is feasible and suggest that individuals with a TBI may benefit from the greater provision of remotely delivered healthcare than is currently offered.
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Affiliation(s)
- Sarah L Chuah
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW 2170, Australia
| | - Diane L Whiting
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW 2170, Australia
- School of Psychology, University of Wollongong, Wollongong, NSW 2500, Australia
| | - Thomas M Gates
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW 2170, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW 2170, Australia
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, Sydney, NSW 2065, Australia
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O'Loghlen J, Geraghty T, Kendall M, Nielsen M, Jones R, McLennan V, Watter K, Ownsworth T. Perceived vocational support needs and return-to-work outcomes in the first 12-months post-discharge in individuals with acquired brain injury and spinal cord injury: A retrospective cohort study. Work 2024; 77:275-293. [PMID: 37638466 DOI: 10.3233/wor-230090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Return-to-work (RTW) is often viewed as an important outcome following acquired brain injury (ABI) and spinal cord injury (SCI), although not all individuals have vocational goals and many experience barriers to RTW. OBJECTIVE This study investigated the relationship between RTW and psychosocial functioning at 12-months post-discharge after ABI and SCI and examined patterns of RTW according to perceived need for and receipt of vocational support. METHODS A file audit was conducted for 69 participants with ABI (n = 44) and SCI (n = 25). Data on employment status and perceived vocational support at 3- and 12-months post-discharge, home and community participation, psychological distress, and health-related quality of life were extracted. RESULTS Individuals in paid employment at 12-months post-discharge (22%, n = 15) reported significantly better psychosocial functioning at this timepoint compared to those not employed (78%; n = 54). For those not employed, three subgroups were identified: 1) Did not perceive the need for or receive vocational support (50%; n = 27); 2) Perceived vocational support needs were unmet (19%; n = 10); and 3) Perceived and received vocational support (31%; n = 17). Psychological distress was highest for those who perceived and received vocational support but were not employed. CONCLUSION RTW was associated with better psychosocial functioning after acquired neurological injury. The findings highlight the need for clinicians to explore and revisit individuals' perceived need for and preferences for vocational support and monitor the psychological well-being of those with RTW goals that are not yet successful.
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Affiliation(s)
- Jessica O'Loghlen
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Timothy Geraghty
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Mandy Nielsen
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Rachel Jones
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Vanette McLennan
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kerrin Watter
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Division of Rehabilitation, Metro South Health Hospital and Health Service, Brisbane, Australia
| | - Tamara Ownsworth
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Torunsky NT, Knauz S, Vilares I, Marcoulides KM, Koutstaal W. What is the relationship between alexithymia and experiential avoidance? A latent analysis using three alexithymia questionnaires. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023; 214:112308. [PMID: 37637074 PMCID: PMC10455047 DOI: 10.1016/j.paid.2023.112308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Alexithymia is a clinically relevant personality trait characterized by poor emotional awareness and associated with several psychological and physical health concerns. Individuals with high alexithymia tend to engage in experiential avoidance and this may mediate psychological distress. However, little is known about what specific processes of experiential avoidance are involved, and the nature of the relation between alexithymia, experiential avoidance, and psychological distress remains unclear at a latent construct level. To examine this relationship at the latent construct level, a representative sample of 693 U.S. adults completed alexithymia (TAS-20, BVAQ, PAQ), general distress (DASS-21), multi-dimensional experiential avoidance (MEAQ), and general health (PROMIS-G-10) questionnaires. Structural equation modeling revealed that alexithymia significantly predicted experiential avoidance (β = 0.966, t = 82.383, p < .01), experiential avoidance significantly predicted general distress (β = 0.810, t = 2.017, p < .05), and experiential avoidance fully mediated the relationship between alexithymia and general distress (βindirect = -0.159, t = -0.398, p > .05). Correlations between alexithymia and experiential avoidance subfactors revealed a strong relationship to the repression and denial subfactor. Experiential avoidance is a promising target for clinical interventions, though longitudinal research is necessary to elucidate how the relationship between alexithymia and experiential avoidance unfolds over time.
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Affiliation(s)
| | - Sara Knauz
- Department of Psychology, University of Minnesota – Twin Cities, USA
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Meusel LA, Colella B, Ruttan L, Tartaglia MC, Green R. Preliminary efficacy and predictors of response to a remotely-delivered symptom self-management program for persistent symptoms after concussion. Brain Inj 2023; 37:1245-1252. [PMID: 37452884 DOI: 10.1080/02699052.2023.2230873] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND More than a quarter of adults with concussion endure prolonged symptoms of >3 months. We developed the Concussion Education Self-Management program to help people manage persisting symptoms. Here, we assess feasibility, preliminary efficacy, and correlates of response. METHODS N = 80 adults participated in the program; ages ranged from 18 to 65 years and time post-injury ranged from 6 months to 18 years. Weekly sessions, delivered remotely and in groups, comprised education and strategies for management of cognitive, emotional, and physical symptoms. Primary outcome: Confidence to self-manage symptoms. Secondary outcomes: Quality of life; mood/anxiety/stress. Predictors of response: Self-reported cognitive, emotional and physical symptoms at intake. RESULTS Pre- to post-program improvements were observed in confidence to self-manage, p < 0.03; quality of life, p < 0.001; depression, p < 0.001; anxiety, p < 0.001; and stress, p < 0.001. Considering confidence to self-manage, those with fewer cognitive and physical symptoms benefitted more (p's < 0.0005 and p < 0.01, respectively). DISCUSSION This program shows promise for improving self-management of prolonged symptoms. Those with high symptom burden may need extra sessions to benefit. This is a cost-effective and scalable program that can reach people regardless of geographic location or impediments to travel.
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Affiliation(s)
- Liesel-Ann Meusel
- Toronto Rehab, University Centre, University Health Network, Toronto, Canada
| | - Brenda Colella
- Toronto Rehab, University Centre, University Health Network, Toronto, Canada
| | - Lesley Ruttan
- Toronto Rehab, University Centre, University Health Network, Toronto, Canada
| | | | - Robin Green
- Toronto Rehab, University Centre, University Health Network, Toronto, Canada
- Psychiatry, University of Toronto, Toronto, Canada
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Carmichael J, Spitz G, Gould KR, Johnston L, Samiotis A, Ponsford J. Bifactor analysis of the Hospital Anxiety and Depression Scale (HADS) in individuals with traumatic brain injury. Sci Rep 2023; 13:8017. [PMID: 37198250 DOI: 10.1038/s41598-023-35017-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023] Open
Abstract
Anxiety and depression symptoms are commonly experienced after traumatic brain injury (TBI). However, studies validating measures of anxiety and depression for this population are scarce. Using novel indices derived from symmetrical bifactor modeling, we evaluated whether the Hospital Anxiety and Depression Scale (HADS) reliably differentiated anxiety and depression in 874 adults with moderate-severe TBI. The results showed that there was a dominant general distress factor accounting for 84% of the systematic variance in HADS total scores. The specific anxiety and depression factors accounted for little residual variance in the respective subscale scores (12% and 20%, respectively), and overall, minimal bias was found in using the HADS as a unidimensional measure. Further, in a subsample of 184 participants, the HADS subscales did not clearly discriminate between formal anxiety and depressive disorders diagnosed via clinical interview. Results were consistent when accounting for degree of disability, non-English speaking background, and time post-injury. In conclusion, variance in HADS scores after TBI predominately reflects a single underlying latent variable. Clinicians and researchers should exercise caution in interpreting the individual HADS subscales and instead consider using the total score as a more valid, transdiagnostic measure of general distress in individuals with TBI.
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Affiliation(s)
- Jai Carmichael
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia.
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia.
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
- Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Kate Rachel Gould
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Lisa Johnston
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
| | - Alexia Samiotis
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
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Rose AE, Cullen B, Crawford S, Evans JJ. A systematic review of mood and depression measures in people with severe cognitive and communication impairments following acquired brain injury. Clin Rehabil 2023; 37:679-700. [PMID: 36380679 PMCID: PMC10041571 DOI: 10.1177/02692155221139023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM A systematic review to identify which mood and depression measures are valid for use with people with severe cognitive and communication impairments following severe acquired brain injury. METHOD A systematic search of Cochrane, Web of Science, Ovid, and EBSCOhost was performed in March 2020, July 2021, and September 2022. The search focused on self-report and observer-rated assessment tools used to assess mood, depression, and/or distress in those described as having a severe acquired brain injury. Psychometric properties were extracted using the Consensus-based standards for the selection of health measurement instruments (COSMIN) risk of bias checklist. Qualitative synthesis was performed on extracted patient data. RESULTS Nineteen papers detailing the psychometric properties of 25 measures were included, involving 2,914 participants. Nine papers provided details confirming the severity of participants' cognitive and communication impairments. The remaining papers described including severely injured participants but provided limited details so that precise level of severity could not be confirmed. Only one paper showed evidence of adequate psychometric properties and included those with severe cognitive impairments in a study of two observer-rated measures, the Stroke Aphasia Depression Questionnaire (10 items) and the Aphasia Depression Rating Scale. CONCLUSIONS Due to the exclusion of individuals with severe cognitive and communication consequences following brain injury, no studies using self-report measures showed adequate validity evidence to recommend their use in this population. A small study using two observer-rated scales included those with severe cognitive impairments and showed satisfactory evidence that these measures can be validly used with this population.
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Affiliation(s)
- Alexandra E Rose
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Department of Psychology, 59386Royal Hospital for Neuro-disability, London, UK
| | - Breda Cullen
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Sarah Crawford
- Department of Psychology, 59386Royal Hospital for Neuro-disability, London, UK
| | - Jonathan J Evans
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Yap AU, Lee DZR. Use of the Depression Anxiety Stress Scale-21 in young people with temporomandibular disorders: Reliability and dimensionality. Cranio 2023:1-9. [PMID: 36593731 DOI: 10.1080/08869634.2022.2158259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The reliability and dimensionality of the Depression Anxiety Stress Scale-21 (DASS-21) were explored in adolescents/young adults with temporomandibular disorders (TMDs). METHODS TMD presence was established with the Fonseca Anamnestic Index. Reliability of the DASS-21 for participants with (WT) and without (NT) TMDs was assessed by the Cronbach alpha test, while dimensionality was examined using exploratory factor analysis. RESULTS Data from 400 participants (mean age 18.8 ± 1.5 years; 52.2% women) comprising 47.0% with and 53.0% without TMDs were evaluated. Total-DASS and the 3 subscales showed acceptable to high internal consistencies for the WT and NT groups, with alphas of 0.78-0.94 and 0.66-0.92, respectively. Although 3 factors contributed to about half the variance for both groups, scalar and item discrepancies in the primary anxiety-stress factor existed. CONCLUSION The DASS-21 has good reliability but may comprise only 2 dimensions, specifically anxiety-stress and depression, instead of the 3 originally asserted.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Center Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
- Department of Prosthodontics, Trisakti University, Jakarta, Indonesia
| | - Darren Zong Ru Lee
- School of Health & Social Sciences, Nanyang Polytechnic, Singapore, Singapore
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Trbovich AM, Preszler J, Emami K, Cohen P, Eagle S, Collins MW, Kontos AP. Is Overparenting Associated with Adolescent/Young Adult Emotional Functioning and Clinical Outcomes Following Concussion? Child Psychiatry Hum Dev 2022; 53:1231-1239. [PMID: 34136979 DOI: 10.1007/s10578-021-01204-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
Overparenting (O-P), or "helicopter" parenting, has warranted increased attention across the past decade. It is characterized as being overly involved, protective, and low on granting autonomy, and is associated with deleterious psychosocial outcomes outside of the concussion literature. This study examined the association of overparenting and patient emotional distress and clinical outcomes (i.e., symptoms, neurocognitive test scores, recovery time) post-concussion. Adolescents/young adult concussion patients (injury < 30 days) and parents (N = 101 child-parent dyads) participated. Patient participants completed measures of depression, anxiety, stress, and concussion clinical outcomes while parents concurrently completed an overparenting measure. Results of a general linear model found that overparenting was associated with higher anxiety and stress report of the child. Overparenting had a significant positive correlation with concussion recovery, although of a small magnitude. Emotional distress level, but not overparenting, was moderately associated with worse performance on clinical outcomes, including neurocognitive testing, vestibular/ocular motor dysfunction, and concussion symptom severity.
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Affiliation(s)
- Alicia M Trbovich
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, University of Pittsburgh, 3200 S. Water St. Pittsburgh, Pittsburgh, PA, 15203, USA.
| | - Jonathan Preszler
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, University of Pittsburgh, 3200 S. Water St. Pittsburgh, Pittsburgh, PA, 15203, USA
| | - Kouros Emami
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, University of Pittsburgh, 3200 S. Water St. Pittsburgh, Pittsburgh, PA, 15203, USA
| | - Paul Cohen
- WakeMed Concussion Program, WakeMed Health and Hospitals, 3000 New Bern Ave, Raleigh, NC, 27610, USA
| | - Shawn Eagle
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, University of Pittsburgh, 3200 S. Water St. Pittsburgh, Pittsburgh, PA, 15203, USA
| | - Michael W Collins
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, University of Pittsburgh, 3200 S. Water St. Pittsburgh, Pittsburgh, PA, 15203, USA
| | - Anthony P Kontos
- Department of Orthopaedic Surgery, University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion Program, University of Pittsburgh, 3200 S. Water St. Pittsburgh, Pittsburgh, PA, 15203, USA
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Ernst N, Eagle S, Trbovich A, Kissinger-Knox A, Bitzer H, Kontos AP. Lower post-injury psychological resilience is associated with increased recovery time and symptom burden following sport-related concussion. APPLIED NEUROPSYCHOLOGY. CHILD 2022; 11:781-788. [PMID: 34410842 DOI: 10.1080/21622965.2021.1964966] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to compare athletes with high and low resilience scores on concussion outcomes, and identify significant predictors associated with protracted recovery (>30 days). Forty-five adolescent and young adult athletes (28 males; aged 15.13 ± 2.74; range of 11-22) were diagnosed with an SRC within 14 days of injury (M = 4.9 days) and grouped as high or low resilience based on score on the Connor-Davidson Resilience Scale-10 (CD-RISC-10). Primary dependent measures included days to full clearance, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Depression Anxiety and Stress Scale-21 (DASS-21), and Vestibular/Ocular Motor Screening (VOMS). The low resilience group (n = 22) had a longer recovery (36.0 ± 27.6 vs 17.8 ± 11.2 days), endorsed more mood symptoms (PCSS Affective cluster; 3.8 ± 0.8 vs 0.9 ± 0.7), and were more likely to have VOMS scores above cut off (p = 0.01-0.02), compared to those with high psychological resilience (n = 23). Logistic regression found low resilience scores was the only significant predictor for protracted recovery among injury characteristics and risk factors. Psychological resilience is a critical factor associated with recovery time following sport-related concussions. Low resilience was also associated with other poor clinical outcomes, greater subjective symptom report, more severe vestibular dysfunction, and elevated levels of mood symptoms following injury.
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Affiliation(s)
- Nathan Ernst
- Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, WV, USA
| | - Shawn Eagle
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alicia Trbovich
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | | | - Hannah Bitzer
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anthony P Kontos
- Department of Orthopedics, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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12
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Nguyen JVK, McKay A, Ponsford J, Davies K, Makdissi M, Drummond SPA, Reyes J, Willmott C. Interdisciplinary Rehabilitation for Concussion Recovery (i-RECOveR): protocol of an investigator-blinded, randomised, case series with multiple baseline design to evaluate the feasibility and preliminary efficacy of a 12-week treatment for persistent post-concussion symptoms. Pilot Feasibility Stud 2022; 8:198. [PMID: 36064489 PMCID: PMC9441831 DOI: 10.1186/s40814-022-01153-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 08/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Up to 25% of concussed individuals experience persistent post-concussion symptoms (PPCSs) which may interfere with the return to pre-injury activities and cause significant stress. Given that multiple etiological factors are thought to contribute to PPCSs, an interdisciplinary approach is recommended. This pilot study aims to primarily investigate the feasibility of a novel interdisciplinary treatment for PPCSs. Given this intervention is novel, uncertainty exists in terms of potential recruitment and retention rates, adverse events, and treatment adherence and fidelity. These factors will be explored to inform the feasibility of a phase-2 randomised controlled trial. Preliminary efficacy of this intervention will also be explored. METHODS Fifteen individuals with mild traumatic brain injury and PPCSs will receive up to 12 weeks of interdisciplinary treatments including psychology, physiotherapy, and medical interventions. Primary feasibility outcomes including data on recruitment and retention rates and treatment adherence will be explored descriptively. The cognitive therapy rating scale will be used to assess treatment fidelity. A single-case series with multiple baseline design will be used to explore preliminary efficacy. Participants will be randomly assigned to baseline phases of 2, 4, or 6 weeks. Regarding patient-centred secondary outcomes, the Rivermead Post-Concussion Symptoms Questionnaire will be assessed three times a week during baseline and treatment phases. Secondary outcomes also include measures of mood, sleep and fatigue, physical functioning, return to activity, and health-related quality of life. Patient-centred outcomes will be assessed at baseline, pretreatment, post-treatment, and one- and three-month follow-up. Thematic analysis of participant experiences will be explored through qualitative interviews. DISCUSSION Results from this trial will inform the feasibility and preliminary efficacy of this interdisciplinary concussion intervention and whether proceeding to a future definitive phase-2 randomised controlled trial is worthwhile. Understanding the end-user perspective of the treatment will also enable modifications to the treatment protocol for future trials to best suit the needs of individuals with PPCSs after mTBI. Outcomes from this trial can be directly translated into community rehabilitation programmes. TRIAL REGISTRATION ANZCTR, ACTRN12620001111965. Registered 27 October 2020, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379118.
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Affiliation(s)
- Jack V K Nguyen
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, GPO Box 1449, Melbourne, VIC, 3001, Australia
| | - Adam McKay
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, GPO Box 1449, Melbourne, VIC, 3001, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Jennie Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, GPO Box 1449, Melbourne, VIC, 3001, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Katie Davies
- Neurological Rehabilitation Group, Melbourne, Australia
| | - Michael Makdissi
- Olympic Park Sports Medicine Centre, Melbourne, Australia.,Australian Football League, AFL House, 140 Harbour Esplanade, Docklands, Melbourne, VIC, 3008, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, GPO Box 1449, Melbourne, VIC, 3001, Australia
| | - Jonathan Reyes
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, GPO Box 1449, Melbourne, VIC, 3001, Australia.,Australian Football League, AFL House, 140 Harbour Esplanade, Docklands, Melbourne, VIC, 3008, Australia
| | - Catherine Willmott
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, GPO Box 1449, Melbourne, VIC, 3001, Australia. .,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia. .,Australian Football League, AFL House, 140 Harbour Esplanade, Docklands, Melbourne, VIC, 3008, Australia.
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13
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Paasila JM, Smith E, Daher M, Simpson GK. Reasons for living, positive psychological constructs and their relationship with suicide ideation in people with moderate to severe traumatic brain injury: A cross-sectional study. Neuropsychol Rehabil 2022; 32:2125-2146. [PMID: 35862622 DOI: 10.1080/09602011.2022.2100795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Positive psychological constructs such as reasons for living, self-esteem and resilience have previously been shown to act as protective psychological barriers against negative psychological outcomes, including suicide ideation in both clinical populations and the general population. This study aims to explore the positive psychological constructs of reasons for living, self-esteem, resilience and their relationship with suicide ideation and predictors of suicide ideation (depression, hopelessness) for N = 50 people who have a severe TBI and are currently receiving community rehabilitation at Liverpool Brain Injury Rehabilitation Unit (LBIRU), NSW. Results indicated good reliability for the use of the RFLI with people who have TBI, with the most frequently endorsed subscale (range 0-5) being "survival and coping beliefs" (4.7 ± 1.0) and the least frequently being "fear of suicide" (2.2 ± 1.1). The shortened version of the RFLI (BRFLI) also displayed good reliability. Positive psychological constructs (reasons for living, resilience, self-esteem) were all significantly inversely associated with suicide and suicide predictors (depression, hopelessness). This study suggests that positive psychological constructs can act as a buffer against suicide ideation after moderate to severe TBI.
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Affiliation(s)
- Josephine M Paasila
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.,School of Psychology, Western Sydney University, Sydney, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Maysaa Daher
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.,John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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14
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Hicks AJ, Clay FJ, James AC, Hopwood M, Ponsford JL. Effectiveness of Pharmacotherapy for Depression after Adult Traumatic Brain Injury: an Umbrella Review. Neuropsychol Rev 2022; 33:393-431. [PMID: 35699850 PMCID: PMC10148771 DOI: 10.1007/s11065-022-09543-6] [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: 03/14/2021] [Accepted: 03/14/2022] [Indexed: 11/29/2022]
Abstract
Symptoms of depression are common following traumatic brain injury (TBI), impacting survivors' ability to return to work, participate in leisure activities, and placing strain on relationships. Depression symptoms post TBI are often managed with pharmacotherapy, however, there is little research evidence to guide clinical practice. There have been a number of recent systematic reviews examining pharmacotherapy for post TBI depression. The aim of this umbrella review was to synthesize systematic reviews and meta-analyses of the effectiveness of pharmacotherapy for the management of post TBI depression in adults. Eligible reviews examined any pharmacotherapy against any comparators, for the treatment of depression in adults who had sustained TBI. Seven databases were searched, with additional searching of online journals, Research Gate, Google Scholar and the TRIP Medical Database to identify published and unpublished systematic reviews and meta-analyses in English up to May 2020. A systematic review of primary studies available between March 2018 and May 2020 was also conducted. Evidence quality was assessed using Joanna Briggs Institute Critical Appraisal Instruments. The results are presented as a narrative synthesis. Twenty-two systematic reviews were identified, of which ten reviews contained a meta-analysis. No new primary studies were identified in the systematic review. There was insufficient high quality and methodologically rigorous evidence to recommend prescribing any specific drug or drug class for post TBI depression. The findings do show, however, that depression post TBI is responsive to pharmacotherapy in at least some individuals. Recommendations for primary studies, systematic reviews and advice for prescribers is provided. Review Registration PROSPERO (CRD42020184915).
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Affiliation(s)
- Amelia J Hicks
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Ground Floor, 185-187 Hoddle St, Richmond, Melbourne, VIC, 3121, Australia.
| | - Fiona J Clay
- Department of Forensic Medicine, Monash University, Southbank, Australia
| | - Amelia C James
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Ground Floor, 185-187 Hoddle St, Richmond, Melbourne, VIC, 3121, Australia
| | - Malcolm Hopwood
- Department of Psychiatry, University of Melbourne, Melbourne, Australia.,Professorial Psychiatry Unit, Albert Road Clinic, Department of Psychiatry, University of Melbourne, 31 Albert Road, Melbourne, Australia
| | - Jennie L Ponsford
- Monash-Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Ground Floor, 185-187 Hoddle St, Richmond, Melbourne, VIC, 3121, Australia
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15
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Brito-Costa S, Jonason PK, Tosi M, Antunes R, Silva S, Castro F. Opinions and options about COVID-19: Personality correlates and sex differences in two European countries. PLoS One 2022; 17:e0268193. [PMID: 35657914 PMCID: PMC9165842 DOI: 10.1371/journal.pone.0268193] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/24/2022] [Indexed: 12/04/2022] Open
Abstract
In the initial months of the COVID-19 pandemic in 2020, we collected data (N = 1,420) from Portugal and Spain in relation to personality (i.e., Dark Triad traits, Big Five traits, religiousness, and negative affect) and attitudes related to COVID-19 about its origins, opinions on how to deal with it, and fear of it. The most pervasive patterns we found were: (1) neurotic-type dispositions were associated with stronger opinions about the origins of the virus and leave people to have more fear of the virus but also more trust in tested establishments to provide help. (2): religious people were less trusting of science, thought prayer was answer, and attributed the existence of the virus to an act of God. We also found that sex differences and country differences in attitudes towards COVID-19 were mediate by sex/country differences in personality traits like emotional stability, religiousness, and negative affect. For instance, women reported more fear of COVID-19 than men did, and this was verified by women’s greater tendency to have negative affect and low emotional stability relative to men. Results point to the central role of neuroticism in accounting for variance in broad-spectrum attitudes towards COVID-19.
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Affiliation(s)
- Sónia Brito-Costa
- Polytechnic Institute of Coimbra, Institute of Applied Research, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Human Potential Development Center (CDPH), Research Group in Social and Human Sciences, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Coimbra Education School, Coimbra, Portugal
- * E-mail:
| | - Peter Karl Jonason
- University of Padua, Padua, Italy
- University of Cardinal Stefan Wyszyński, Warszawa, Poland
| | | | - Rui Antunes
- Polytechnic Institute of Coimbra, Human Potential Development Center (CDPH), Research Group in Social and Human Sciences, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Coimbra Education School, Coimbra, Portugal
| | - Sofia Silva
- Polytechnic Institute of Coimbra, Human Potential Development Center (CDPH), Research Group in Social and Human Sciences, Coimbra, Portugal
- Polytechnic Institute of Coimbra, Coimbra Education School, Coimbra, Portugal
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16
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Rauwenhoff JCC, Bol Y, Peeters F, van den Hout AJHC, Geusgens CAV, van Heugten CM. Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases. Neuropsychol Rehabil 2022:1-31. [PMID: 35332849 DOI: 10.1080/09602011.2022.2053169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Patients with acquired brain injury (ABI) often experience symptoms of anxiety and depression. Until now, evidence-based treatment is scarce. This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with ABI. To evaluate the effect of ACT for people with ABI, a non-concurrent multiple baseline design across four cases was used. Participants were randomly assigned to a baseline period, followed by treatment and then follow-up phases. Anxiety and depressive symptoms were repeatedly measured. During six measurement moments over a year, participants filled in questionnaires measuring anxiety, depression, stress, participation, quality of life, and ACT-related processes. Randomization tests and NAP scores were used to calculate the level of change across phases. Clinically significant change was defined with the Reliable Change Index. Three out of four participants showed medium to large decreases in anxiety and depressive symptoms (NAP = 0.85 till 0.99). Furthermore, participants showed improvements regarding stress, cognitive fusion, and quality of life. There were no improvements regarding psychological flexibility, value-driven behaviour, or social participation. This study shows that ACT is possibly an effective treatment option for people experiencing ABI-related anxiety and depression symptoms. Replication with single case or large scale group studies is needed to confirm these findings.
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Affiliation(s)
- Johanne C C Rauwenhoff
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands
| | - Yvonne Bol
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Frenk Peeters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Anja J H C van den Hout
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Chantal A V Geusgens
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, Netherlands
| | - Caroline M van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Centre, Maastricht, Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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17
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Tanglai W, Chen CF, Rattanapan C, Laosee O. The effects of personality and attitude on risky driving behaviour among public van drivers: hierarchical modelling. Saf Health Work 2022; 13:187-191. [PMID: 35664902 PMCID: PMC9142736 DOI: 10.1016/j.shaw.2022.03.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 02/26/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022] Open
Abstract
Background Traffic injuries have become a significant public health problem in low- and middle-income countries. Several studies have examined the role of personality and attitude toward traffic safety in predicting driving behaviors in diverse types of drivers. Few studies have investigated risky behavior among public passenger van drivers. This study aims to identify the predictors of self-reported risky driving behavior among public van drivers. Method A total of 410 public van drivers were interviewed at terminal stations in Bangkok. Hierarchical regression models were applied to determine the effects of demographics, personality traits, and attitude on self-reported risky driving behaviors. Results The results indicated that drivers with a high education level, more working days, and high scores for normlessness and anger were more likely to report risky driving behaviors (p < 0.05). Conclusion The personality traits and attitude toward speeding account for aberrant self-reported risky driving behavior in passenger van drivers. This could be another empirical basis for evidence-based road safety interventions in the context of public transport.
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18
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Obeidat RF, Masri MA, Marzouq M. Factors Affecting Jordanian Women's Surgical Treatment Decisions for Early-Stage Breast Cancer. Asia Pac J Oncol Nurs 2021; 8:711-719. [PMID: 34790855 PMCID: PMC8522584 DOI: 10.4103/apjon.apjon-20105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 07/26/2021] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aimed to assess factors influencing surgical treatment decisions for early-stage breast cancer among Jordanian women. Methods: A descriptive correlational survey design was utilized to meet the study objective. A total of 180 Jordanian women diagnosed with unilateral early-stage breast cancer (Stages I–II) were recruited from the radiotherapy departments and outpatient surgical and breast cancer clinics at King Hussein Cancer Center (KHCC). Participants completed a structured questionnaire consisting of the Arabic version of the Depression Anxiety Stress Scale, Breast Surgery Beliefs and Expectations Scale, and the Arabic version of the Control Preference Scale. Results: The majority of the participants underwent mastectomy as a definitive surgical treatment (i.e. 67%). Only stage at diagnosis and having a second opinion about surgical treatment options were significantly associated with the type of surgical procedure women opted for. The overwhelming majority of the participants in both groups cited the items of “Minimize the chance of breast cancer coming back” and “Minimize the chance of dying of breast cancer” as very important in their decisions for surgical treatment of unilateral early-stage breast cancer. Women who cited the item “remove breast for peace of mind” as important/very important were more likely to opt for mastectomy than women who cited the item as not important. Conclusions: Mastectomy is the preferred surgical treatment option for the majority of Jordanian women diagnosed with unilateral early-stage breast cancer at KHCC.
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Affiliation(s)
| | - Mahmoud Al Masri
- Department of Surgery, King Hussein Cancer Center-KHCC, Amman, Jordan
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19
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Rauwenhoff J, Peeters F, Bol Y, Van Heugten C. Measuring psychological flexibility and cognitive defusion in individuals with acquired brain injury. Brain Inj 2021; 35:1301-1307. [PMID: 34487472 PMCID: PMC10791065 DOI: 10.1080/02699052.2021.1972155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Acceptance and Commitment Therapy (ACT) is used increasingly for individuals with psychological distress following acquired brain injury (ABI) in different countries. However, questionnaires measuring ACT-processes are often not validated for this patient group and need cross-cultural validation. This study investigated the psychometric properties of the Acceptance and Action Questionnaire for Acquired Brain Injury (AAQ-ABI; measuring psychological flexibility related to thoughts and feelings about ABI) and the Cognitive Fusion Questionnaire (CFQ-7; measuring cognitive defusion). MATERIALS AND METHODS Score distribution, reliability, and convergent validity of the AAQ-ABI and the CFQ-7 were examined in Dutch individuals with ABI. RESULTS Seventy-three patients with ABI were included. The AAQ-ABI showed good reliability (Cronbach's α = 0.87) and the CFQ-7 excellent reliability (Cronbach's α = 0.97). Both did not show a floor or ceiling effect, nor a skewed distribution. There were strong to moderate correlations between the questionnaires and measures of psychological flexibility, mood, quality of life, and value-driven behavior (AAQ-ABI: r = -0.70-0.81; CFQ-7 = -0.67-0.84). Inter-item total correlations indicate that the questions within each questionnaire measured the same construct (AAQ-ABI: r = 0.40-0.78; CFQ-7: r = 0.84-0.93). CONCLUSIONS The current study shows that the Dutch AAQ-ABI and CFQ-7 have acceptable to good psychometric properties when measuring psychological flexibility and cognitive defusion in patients with ABI.
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Affiliation(s)
- Johanne Rauwenhoff
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht University Medical Centre, Maastricht, The Netherlands
- Limburg Brain Injury Centre, Maastricht, The Netherlands
| | - Frenk Peeters
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Yvonne Bol
- Department of Clinical and Medical Psychology, Zuyderland Medical Centre, Sittard-Geleen/Heerlen, The Netherlands
| | - Caroline Van Heugten
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht University Medical Centre, Maastricht, The Netherlands
- Limburg Brain Injury Centre, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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20
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Faulkner JW, Snell DL, Theadom A, Mahon S, Barker-Collo S, Skirrow P. Psychological flexibility in mild traumatic brain injury: an evaluation of measures. Brain Inj 2021; 35:1103-1111. [PMID: 34334064 DOI: 10.1080/02699052.2021.1959062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PRIMARY OBJECTIVE In this study, we examined the psychometric properties of measures of psychological flexibility in a mild traumatic brain injury (mTBI) sample. METHOD AND PROCEDURES Adults who sustained a mTBI (n = 112) completed the Acceptance and Action Questionnaire - Acquired Brain Injury reactive avoidance subscale (AAQ-ABI (RA). Exploratory factor analysis and Rasch analysis were conducted to evaluate the facture structure, dimensionality, and differential item functioning. Construct validity was determined by correlating the AAQ-ABI (RA) with the Acceptance and Action Questionnaire-Revised (AAQ-II) and Fear Avoidance after Traumatic Brain Injury (FAB-TBI). MAIN OUTCOME AND RESULTS The AAQ-ABI (RA) was found to have strong internal consistency (Cronbach's α = 0.87). Consistent with previous findings, the AAQ-ABI (RA) had one distinct factor. Fit to the unidimensional Rasch model was adequate (χ2 (18) = 22.5, p = .21) with no evidence of differential item functioning across person factors examined. The AAQ-ABI (RA) also had expected relationships with theoretically relevant constructs. CONCLUSIONS The AAQ-ABI (RA) appears to be a psychometrically sound measure of psychological flexibility in mTBI.
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Affiliation(s)
- Josh W Faulkner
- School of Psychology, Massey University, Wellington, New Zealand
| | - Deborah L Snell
- University of Otago Christchurch, University of Otago, Christchurch
| | - Alice Theadom
- TBI Network, Auckland University of Technology, TBI Network, Auckland University of Technology, University of Technology, Northcote, Auckland
| | - Susan Mahon
- TBI Network, Auckland University of Technology, TBI Network, Auckland University of Technology, University of Technology, Northcote, Auckland
| | | | - Paul Skirrow
- University of Otago Wellington, University of Otago, Newtown, Wellington
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21
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Young J, Zoghi M, Khan F, Galea MP. The Effect of Transcranial Direct Current Stimulation on Chronic Neuropathic Pain in Patients with Multiple Sclerosis: Randomized Controlled Trial. PAIN MEDICINE 2021; 21:3451-3457. [PMID: 32594139 DOI: 10.1093/pm/pnaa128] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic neuropathic pain is a common symptom in multiple sclerosis (MS). This randomized controlled single-blinded study investigated whether a new protocol involving five days of transcranial direct current stimulation (tDCS) with an interval period would be effective to reduce pain using the visual analog scale (VAS). Other secondary outcomes included the Neuropathic Pain Scale (NPS), Depression Anxiety Stress Score (DASS), Short Form McGill Pain Questionnaire (SFMPQ), and Multiple Sclerosis Quality of Life 54 (MSQOL54). DESIGN A total of 30 participants were recruited for the study, with 15 participants randomized to a sham group or and 15 randomized to an active group. After a five-day course of a-tDCS, VAS and NPS scores were measured daily and then weekly after treatment up to four weeks after treatment. Secondary outcomes were measured pretreatment and then weekly up to four weeks. RESULTS After a five-day course of a-tDCS, VAS scores were significantly reduced compared with sham tDCS and remained significantly low up to week 2 post-treatment. There were no statistically significant mean changes in MSQOL54, SFMPQ, NPS, or DASS for the sham or treatment group before treatment or at four-week follow-up. CONCLUSIONS This study shows that repeated stimulation with a-tDCS for five days can reduce pain intensity for a prolonged period in patients with MS who have chronic neuropathic pain.
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Affiliation(s)
- Jamie Young
- RehabilitationDepartment, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.,Department of Medicine and Radiology, Integrated Critical Care, University of Melbourne, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Fary Khan
- RehabilitationDepartment, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Mary P Galea
- RehabilitationDepartment, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
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22
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Tuck NL, Khuvtsagaan B, Rashid U, Aamir T, Goucke R, Regjii B, Dorjbal EA, Lundeg G, Bean DJ. The Adaptation of Pain Assessment Tools from High-Income to Low- and Middle-Income Countries: Psychometric Properties of a Set of Chronic Pain Questionnaires in Mongolian and New Zealand Patient Samples. PAIN MEDICINE 2021; 22:948-960. [PMID: 33001213 DOI: 10.1093/pm/pnaa267] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Chronic pain is a leading cause of disability in low- and middle-income countries; however, pain assessment tools have generally been developed and validated in high-income countries. This study examines the psychometric properties of a set of translated pain (and distress) questionnaires in Mongolia and documents the characteristics of people seeking treatment for chronic pain in Mongolia, compared with those in New Zealand, which is representative of high-income countries. DESIGN Cross-sectional, observational. SETTING Hospital-based pain treatment centers in New Zealand and Mongolia. SUBJECTS People seeking treatment for chronic pain in Mongolia (N = 142) and New Zealand (N = 159). METHODS The Brief Pain Inventory, the Depression Anxiety Stress Scale-21, the Pain Catastrophizing Scale, and the Pain Self-Efficacy Questionnaire were translated into Mongolian and administered to patients attending a hospital-based pain service. Questionnaires that were completed by patients in New Zealand were used for comparisons. Internal reliability, convergent validity, and factor structure were assessed in both groups. RESULTS Patients in Mongolia were older and reported lower pain intensity, interference, and distress and higher pain self-efficacy than those in New Zealand. The translated questionnaires had good internal consistencies, and the relationships between pain variables were similar across both groups. The factor structure for the Pain Catastrophizing Scale was consistent across both groups, but this was not the case for the Brief Pain Inventory or the Depression Anxiety Stress Scale-21. CONCLUSIONS Findings indicate that some pain outcome measures may be appropriate for use in Mongolia and should be investigated in other low- and middle-income countries.
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Affiliation(s)
- Natalie L Tuck
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand.,The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.,The Waitematā District Health Board (WDHB) Chronic Pain Service, Department of Anesthesiology and Perioperative Medicine, Auckland, New Zealand
| | | | - Usman Rashid
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Tipu Aamir
- The Auckland Regional Pain Service, Auckland District Health Board, Auckland, New Zealand
| | - Roger Goucke
- Medical School University of Western Australia, Nedlands, Western Australia, Australia
| | | | | | - Ganbold Lundeg
- The Mongolian National University of Medical Sciences, Ulaanbatar, Mongolia
| | - Debbie J Bean
- The Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.,The Waitematā District Health Board (WDHB) Chronic Pain Service, Department of Anesthesiology and Perioperative Medicine, Auckland, New Zealand
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23
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Whiting DL, Simpson GK, Deane FP, Chuah SL, Maitz M, Weaver J. Protocol for a Phase Two, Parallel Three-Armed Non-inferiority Randomized Controlled Trial of Acceptance and Commitment Therapy (ACT-Adjust) Comparing Face-to-Face and Video Conferencing Delivery to Individuals With Traumatic Brain Injury Experiencing Psychological Distress. Front Psychol 2021; 12:652323. [PMID: 33763008 PMCID: PMC7982655 DOI: 10.3389/fpsyg.2021.652323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/10/2021] [Indexed: 11/13/2022] Open
Abstract
Background: People with traumatic brain injury (TBI) face a range of mental health challenges during the adjustment process post-injury, but access to treatment can be difficult, particularly for those who live in regional and remote regions. eHealth provides the potential to improve access to evidence-based psychological therapy for people with a severe TBI. The aim of the current study is to assess the efficacy of a psychological intervention delivered via video consulting to reduce psychological distress in people with TBI. Methods: This paper outlines the protocol for a multi-center, three-arm, parallel, non-inferiority randomized controlled trial (RCT) of an evidence-based manualized psychological intervention, ACT-Adjust. ACT-Adjust provides nine sessions for adults with a moderate to severe TBI experiencing clinical levels of psychological distress. Fifty-six participants referred from Brain Injury Rehabilitation Units across New South Wales (NSW) and the NSW icare scheme will be randomly allocated to three conditions; (1) video consulting (VC), (2) face-to-face (FtF) and, (3) a waitlist control (WL). Discussion: This is the first RCT to evaluate the efficacy of a psychological therapy (ACT-Adjust) delivered via video consulting for individuals with a moderate to severe TBI. Trial Registration: www.anzctr.org.au, Australian New Zealand Clinical Trials Registry ANZCTRN2619001602112.
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Affiliation(s)
- Diane L. Whiting
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Grahame K. Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
- John Walsh Centre for Rehabilitation Research, Sydney School of Medicine, University of Sydney, St Leonards, NSW, Australia
| | - Frank P. Deane
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Sarah L. Chuah
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Michelle Maitz
- Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Liverpool, NSW, Australia
| | - Jerre Weaver
- Mid-Western Brain Injury Rehabilitation Unit, Bathurst, NSW, Australia
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Khazaei M, Holder MD, Sirois FM, Oades LG, Gendron B. Development and Assessment of the Personal Emotional Capital Questionnaire for Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041856. [PMID: 33672904 PMCID: PMC7918152 DOI: 10.3390/ijerph18041856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 11/23/2022]
Abstract
(1) Background: The present study developed and evaluated a personal emotional capital questionnaire (PECQ) for adults that assessed 10 domains of personal emotional capital. (2) Method: Initially, 100 items were created and then administered to students attending Semnan University and Semnan University of Medical Sciences in Iran. Of the 700 questionnaires distributed, 527 were completed in full. Students were sampledusing the multi-stage random cluster method. Exploratory factor analyses, Cronbach’s alpha, and test–retest reliability were used to evaluate the scale. (3) Results: The ten components ofthe PECQ were confirmed. Test–retest correlations after 30 days were high, as was Cronbach’s alpha (0.94). Thecomponents highly correlatedwith overall emotional capital. The PECQ displayed convergent validity as it positively correlated with the Keyes’s Mental Health Continuum—Short Form and students’GPAs. The PECQ displayed divergent validity as it negatively correlated with measures of depression, anxiety and stress (Depression Anxiety and Stress Scale (DASS21)). Differences in overall PECQ scores and its components were examined for several variables including gender, age, marital and employment status, academic program, and field of study. PECQ scores were not sensitive to the order of administering questionnaires. (4) Conclusion: The results suggest that the PECQ is a valid and reliable measure of personal emotional capital and supports its use in adults.
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Affiliation(s)
- Morteza Khazaei
- Ministry of Education, Abadan 6317984844, Iran
- Correspondence: ; Tel.: +98-9163-3053-80
| | - Mark D. Holder
- Department of Psychology, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
| | - Fuschia M. Sirois
- Department of Psychology, University of Sheffield, Sheffield S1 2LT, UK;
| | - Lindsay G. Oades
- Centre for Positive Psychology, Melbourne Graduate School of Education, The University of Melbourne, Melbourne, VIC 3052, Australia;
| | - Benedicte Gendron
- Laboratoire Interdisciplinaire de Recherche en Didactique, Éducation et Formation, Paul Valéry University, 34000 Montpellier, France;
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Makara-Studzińska M, Tyburski E, Załuski M, Adamczyk K, Mesterhazy J, Mesterhazy A. Confirmatory Factor Analysis of Three Versions of the Depression Anxiety Stress Scale (DASS-42, DASS-21, and DASS-12) in Polish Adults. Front Psychiatry 2021; 12:770532. [PMID: 35058818 PMCID: PMC8764392 DOI: 10.3389/fpsyt.2021.770532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 11/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background: The Depression Anxiety Stress Scales (DASS) are designed to identify quickly and differentiate between the symptoms of depression and anxiety in the non-clinical population. Different versions (original and short) were validated in many cultures. Nevertheless, there are no data of factorial validity of the different versions of this scale in Polish culture. Thus, the aim of this study was to evaluate the factor structure using confirmatory factor analysis (CFA) and internal consistency of DASS-42 (original version) and two short versions (DASS-21 items and DASS-12 items) in the Polish population. Methods: The DASS-42 was administered to a non-clinical sample, broadly representative of the general Polish adult population (n = 1,021) in terms of demographic variables. The DASS-21 and DASS-12 version used in this study comprise seven and four items from each of the following corresponding three subscales of the Polish version of DASS-42. Results: There were two models that fitted best for DASS-42: (a) modified three correlated factors (depression, anxiety, and stress) with cross-loadings and (b) second order (general factor of psychological distress) and three factors with cross-loadings. There were also two models that fitted best for DASS-21 and DASS-12: (a) modified three correlated factors (depression, anxiety, and stress) and (b) second order (general factor of psychological distress) and three factors. Conclusions: All three versions of DASS appear to have an acceptable factorial structure. However, the shorter versions (DASS-21 and DASS-12) may be more feasible to use in general medical practice and also be less burdensome to participants.
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Affiliation(s)
- Marta Makara-Studzińska
- Department of Health Psychology, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Kraków, Poland
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Maciej Załuski
- Department of Health Psychology, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Kraków, Poland
| | - Katarzyna Adamczyk
- Department of Health Psychology, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Kraków, Poland
| | - Jacek Mesterhazy
- Department of Health Psychology, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Kraków, Poland
| | - Agnieszka Mesterhazy
- Department of Health Psychology, Institute of Nursing and Midwifery, Jagiellonian University Medical College, Kraków, Poland
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Talaat F, Ramadan I, Aly S, Hamdy E. Are multiple sclerosis patients and their caregivers more anxious and more committed to following the basic preventive measures during the COVID-19 pandemic? Mult Scler Relat Disord 2020; 46:102580. [PMID: 33296977 PMCID: PMC7550868 DOI: 10.1016/j.msard.2020.102580] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/26/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
MS patients were more anxious, depressed and stressed during the COVID-19 pandemic than their caregivers and the general population. Younger patients, those with high EDSS scores and those who believed that MS patients are at high risk for COVID-19 infection were more anxious. The patients’ knowledge about the factors that may affect the risk for COVID-19 infection was poor. Though they were more anxious, they were not more committed – in contrast to what would be expected - to follow the basic preventive measures for staying safe during the pandemic than the general population.
Background The novel coronavirus of 2019 (COVID-19), a pandemic of the kind not seen for a century, has caused global apprehension and distress. Objectives to evaluate whether the psychological state and behaviours of multiple sclerosis (MS) patients and their caregivers were different from the non-MS population or not during the pandemic. Methods A cross-sectional survey was conducted on 115 MS patients, 33 MS caregivers and 129 healthy controls. Depression anxiety stress score-21 (DASS-21) was used for evaluation of their psychological state. Results MS patients had significantly higher DASS-21 scores (51.48±29.62) than their caregivers (29.79±27.19) and non-MS population (32.91±23.39) (p = 0.005). Younger patients (r=-0.252, p<0.0001), those with high EDSS scores (r = 0.023, p = 0.013) and those who believed that MS patients are at high risk for COVID-19 infection (p = 0.009) had the highest anxiety scores. There was no difference between the three groups in the level of commitment to staying at home (p = 0.747), wearing facemask (p = 0.164), wearing gloves (0.225), avoiding crowd (p = 0.225) and frequent hand washing (p = 0.570). Anxious patients had more relapses (p = 0.002) and pseudorelapses (p = 0.008). Conclusion In this cohort, MS patients were more anxious, stressed and depressed during the COVID-19 pandemic than their caregivers and the non-MS population, but they were not more motivated to follow the basic preventive measures against infection.
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Affiliation(s)
- Farouk Talaat
- Department of Neurology, Faculty of Medicine, Alexandria University, Egypt
| | - Ismail Ramadan
- Department of Neurology, Faculty of Medicine, Alexandria University, Egypt
| | - Salma Aly
- Department of Community Medicine, Faculty of Medicine, Alexandria University, Egypt
| | - Eman Hamdy
- Department of Neurology, Faculty of Medicine, Alexandria University, Egypt.
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27
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Krejčí M, Psotta R, Hill M, Kajzar J, Jandová D, Hošek V. A short-term yoga-based intervention improves balance control, body composition, and some aspects of mental health in the elderly men. ACTA GYMNICA 2020. [DOI: 10.5507/ag.2020.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Vasterling JJ, Aslan M, Proctor SP, Ko J, Leviyah X, Concato J. Long-term negative emotional outcomes of warzone TBI. Clin Neuropsychol 2020; 34:1088-1104. [PMID: 32301397 DOI: 10.1080/13854046.2020.1749935] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Many veterans of the Iraq and Afghanistan Wars have experienced traumatic brain injury (TBI). Although prior work has examined associations between TBI and development of psychiatric syndromes, less is known about associations between TBI and component emotions constituting these syndromes, especially in the long term. The purpose of this study was to examine the long-term emotional consequences of deployment-related TBI. METHODS As part of VA Cooperative Studies Program #566, we assessed a sample of n = 456 US Army soldiers prior to an index deployment to Iraq, and again an average of 8.3 years (SD = 2.4 years) after their deployment for a long-term follow-up assessment. In this report, we used adjusted regression analyses to examine the relationship of deployment TBI to depression, anxiety, and stress symptom severity measured at the long-term follow-up assessment. A structured interview was used to determine TBI history; the Depression, Anxiety, and Stress Scale, 21-item version (DASS-21) was used to determine emotional status at the follow-up evaluation. RESULTS Warzone TBI events, particularly when greater than mild in severity, were independently associated with depression, anxiety, and stress severity at long-term follow-up, even after taking into account variance attributable to pre-deployment emotional distress and war-zone stress. Post-hoc analyses did not detect independent associations of either number of events or injury mechanism with outcomes. CONCLUSIONS These findings highlight the potentially enduring and multi-faceted emotional effects of deployment TBI, underscoring the need for early assessment of negative affectivity in warzone veterans reporting TBI.
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Affiliation(s)
- Jennifer J Vasterling
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.,National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Mihaela Aslan
- Clinical Epidemiology Research Center, VA Cooperative Studies Program, West Haven, CT, USA.,Department of Medicine, School of Medicine, Yale University, New Haven, CT, USA
| | - Susan P Proctor
- U.S. Army Research Institute of Environmental Medicine, Natick, MA, USA.,Research Service, VA Boston Healthcare System, Boston, MA, USA
| | - John Ko
- Clinical Epidemiology Research Center, VA Cooperative Studies Program, West Haven, CT, USA
| | - Xenia Leviyah
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - John Concato
- Department of Medicine, School of Medicine, Yale University, New Haven, CT, USA.,Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD, USA
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30
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Gertler P, Tate RL. Are single item mood scales (SIMS) valid for people with traumatic brain injury? Brain Inj 2020; 34:653-664. [DOI: 10.1080/02699052.2020.1733087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Paul Gertler
- John Walsh Centre for Rehabilitation Research, University of Sydney, St. Leonards, Australia
| | - Robyn L. Tate
- John Walsh Centre for Rehabilitation Research, University of Sydney, St. Leonards, Australia
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31
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Do self-report measures of alexithymia measure alexithymia or general psychological distress? A factor analytic examination across five samples. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2019.109721] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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32
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González-Rivera JA, Pagán-Torres OM, Pérez-Torres EM. Depression, Anxiety and Stress Scales (DASS-21): Construct Validity Problem in Hispanics. Eur J Investig Health Psychol Educ 2020; 10:375-389. [PMID: 34542491 PMCID: PMC8314236 DOI: 10.3390/ejihpe10010028] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/21/2019] [Accepted: 01/04/2020] [Indexed: 01/22/2023] Open
Abstract
The main purpose of this research was to examine the construct validity of the Depression, Anxiety and Stress Scales (DASS-21) in order to determine whether it is able to adequately discriminate between symptoms of depression and anxiety in the Hispanic population in Puerto Rico. This study has an instrumental design. A total of 1073 Hispanics participated in this psychometric study. The results showed that the DASS-21 has serious psychometric deficiencies, especially related to the construct validity, as well as convergent and discriminatory validity. In addition, it was shown that DASS-21 do not replicate the three-dimensional structure of the original instrument in the Hispanic community. Finally, it was confirmed that the DASS-21 have difficulty in properly identifying and discriminating between symptoms associated with depression and anxiety in a Hispanic population.
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Affiliation(s)
- Juan Aníbal González-Rivera
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00716, USA
| | - Orlando M Pagán-Torres
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00716, USA
| | - Emily M Pérez-Torres
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, 388 Zona Industrial Reparada 2, Ponce, PR 00716, USA
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33
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Renfrew ME, Morton DP, Morton JK, Hinze JS, Beamish PJ, Przybylko G, Craig BA. A Web- and Mobile App-Based Mental Health Promotion Intervention Comparing Email, Short Message Service, and Videoconferencing Support for a Healthy Cohort: Randomized Comparative Study. J Med Internet Res 2020; 22:e15592. [PMID: 31904578 PMCID: PMC6971514 DOI: 10.2196/15592] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/14/2019] [Accepted: 10/20/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The rapid increase in mental health disorders has prompted a call for greater focus on mental health promotion and primary prevention. Web- and mobile app-based interventions present a scalable opportunity. Little is known about the influence of human support on the outcomes of these interventions. OBJECTIVE This study aimed to compare the influence of 3 modes of human support on the outcomes (ie, mental health, vitality, depression, anxiety, stress, life satisfaction, and flourishing) of a 10-week, Web- and mobile app-based, lifestyle-focused mental health promotion intervention among a healthy adult cohort. METHODS Participants were recruited voluntarily using a combination of online and offline advertising. They were randomized, unblinded into 3 groups differentiated by human support mode: Group 1 (n=201): standard-fully automated emails (S); Group 2 (n=202): standard plus personalized SMS (S+pSMS); and Group 3 (n=202): standard plus weekly videoconferencing support (S+VCS), hosted by 1 trained facilitator. Participants accessed the intervention, including the questionnaire, on a Web-based learning management system or through a mobile app. The questionnaire, administered at pre- and postintervention, contained self-reported measures of mental well-being, including the "mental health" and "vitality" subscales from the Short Form Health Survey-36, Depression Anxiety and Stress Scale-21, Diener Satisfaction With Life Scale (SWLS), and Diener Flourishing Scale. RESULTS Of 605 potential participants, 458 (S: n=157, S+pSMS: n=163, and S+VCS: n=138) entered the study by completing registration and the preintervention questionnaire. At post intervention, 320 out of 458 participants (69.9%; S: n=103, S+pSMS: n=114, and S+VCS: n=103) completed the questionnaire. Significant within-group improvements were recorded from pre- to postintervention in all groups and in every outcome measure (P≤.001). No significant between-group differences were observed for outcomes in any measure: mental health (P=.77), vitality (P=.65), depression (P=.93), anxiety (P=.25), stress (P.57), SWLS (P=.65), and Flourishing Scale (P=.99). Adherence was not significantly different between groups for mean videos watched (P=.42) and practical activity engagement (P=.71). Participation in videoconference support sessions (VCSSs) was low; 37 out of 103 (35.9%) participants did not attend any VCSSs, and only 19 out of 103 (18.4%) attended 7 or more out of 10 sessions. Stratification within the S+VCS group revealed that those who attended 7 or more VCSSs experienced significantly greater improvements in the domains of mental health (P=.006; d=0.71), vitality (P=.005; d=0.73), depression (P=.04; d=0.54), and life satisfaction (P=.046; d=0.50) compared with participants who attended less than 7. CONCLUSIONS A Web- and mobile app-based mental health promotion intervention enhanced domains of mental well-being among a healthy cohort, irrespective of human support. Low attendance at VCSSs hindered the ability to make meaningful between-group comparisons. Supplementing the intervention with VCSSs might improve outcomes when attendance is optimized. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR): 12619001009101; http://www.anzctr.org.au/ACTRN12619001009101.aspx.
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Affiliation(s)
- Melanie Elise Renfrew
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
| | - Darren Peter Morton
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
| | - Jason Kyle Morton
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
| | - Jason Scott Hinze
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
| | - Peter James Beamish
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
| | - Geraldine Przybylko
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
| | - Bevan Adrian Craig
- Lifestyle and Health Research Centre, Avondale University College, Cooranbong, New South Wales, Australia
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The BrainACT study: acceptance and commitment therapy for depressive and anxiety symptoms following acquired brain injury: study protocol for a randomized controlled trial. Trials 2019; 20:773. [PMID: 31881916 PMCID: PMC6935100 DOI: 10.1186/s13063-019-3952-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/03/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Following an acquired brain injury, individuals frequently experience anxiety and/or depressive symptoms. However, current treatments for these symptoms are not very effective. A promising treatment is acceptance and commitment therapy (ACT), which is a third-wave behavioural therapy. The primary goal of this therapy is not to reduce symptoms, but to improve psychological flexibility and general well-being, which may be accompanied by a reduction in symptom severity. The aim of this study is to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people with acquired brain injury who experience anxiety and/or depressive symptoms. METHODS The study is a multicenter, randomized, controlled, two-arm parallel trial. In total, 94 patients who survive a stroke or traumatic brain injury will be randomized into an ACT or control (i.e. psycho-education and relaxation) intervention. The primary outcome measures are the Hospital Anxiety and Depression Scale and the Depression Anxiety Stress Scale. Outcomes will be assessed by trained assessors, blinded to treatment condition, pre-treatment, during treatment, post-treatment, and at 7 and 12 months. DISCUSSION This study will contribute to the existing knowledge on how to treat psychological distress following acquired brain injury. If effective, BrainACT could be implemented in clinical practice and potentially help a large number of patients with acquired brain injury. TRIAL REGISTRATION Dutch Trial Register, NL691, NTR 7111. Registered on 26 March 2018. https://www.trialregister.nl/trial/6916.
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Gertler P, Tate RL. Behavioural activation therapy to improve participation in adults with depression following brain injury: A single-case experimental design study. Neuropsychol Rehabil 2019; 31:369-391. [PMID: 31793383 DOI: 10.1080/09602011.2019.1696212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Following brain injury, the risk of depression increases. There are few studies of non-pharmacological interventions for this problem. Behavioural Activation (BA) could help because it has been demonstrated to be as effective as cognitive-behaviour therapy but is less cognitively demanding and more suitable for people with brain impairment. The current study evaluated BA using a multiple-baseline design across behaviours with replication. Three male participants with clinically significant depressive symptoms (two with traumatic brain injury aged 26 and 46, one who experienced strokes in infancy, aged 26) engaged in a 10-14-week trial of BA focusing on three activity domains: physical, social and functional activities. Participants completed an online form three times a day which recorded activity participation and responses to a single-item mood scale. There was little evidence in support of BA for increasing participation. There was also a lack of change in average mood, but some positive effects were found on measures of depression symptoms and quality of life in these participants. Various factors affected participation which might have been mitigated by extended treatment contact, greater use of prompts or electronic aids or the addition of other therapy modes.
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Affiliation(s)
- Paul Gertler
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Robyn L Tate
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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36
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O’Brien S, Metcalf K, Batchelor J. An examination of the heterogeneity of cognitive outcome following severe to extremely severe traumatic brain injury. Clin Neuropsychol 2019; 34:120-139. [DOI: 10.1080/13854046.2019.1598501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sarah O’Brien
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Kasey Metcalf
- Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia
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Lee J, Lee EH, Moon SH. Systematic review of the measurement properties of the Depression Anxiety Stress Scales-21 by applying updated COSMIN methodology. Qual Life Res 2019; 28:2325-2339. [PMID: 30937732 DOI: 10.1007/s11136-019-02177-x] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE The Depression Anxiety Stress Scales (DASS)-21 measures emotional symptoms of depression, anxiety, and stress, is relatively short, and is freely available in the public domain, which has resulted in it being applied to various clinical and non-clinical populations in many countries. The aim of this study was to systematically review the measurement properties of the DASS-21. METHODS The MEDLINE, Embase, and CINAHL databases were searched. The methodological quality of each identified study was assessed using the updated COSMIN Risk of Bias checklist. The quality of the measurement properties of the studies was rated using the updated criteria for good measurement properties. The quality of evidence was rated using a modified version of the GRADE approach. RESULTS This study included 48 studies in its review. The content validity of the DASS-21 demonstrated sufficient moderate-quality evidence. The instrument exhibited sufficient high-quality evidence for bifactor structural validity and internal consistency. The instrument also showed sufficient high-quality evidence for hypothesis testing of construct validity. Regarding criterion validity, only the DASS-21 Depression subscale demonstrated sufficient high-quality evidence. The measurement invariance across gender demonstrated inconsistent moderate-quality evidence. There was insufficient low-quality evidence for the reliability of each subscale. For responsiveness there was sufficient low-quality evidence for depression and stress subscales, and insufficient very-low-quality evidence for anxiety subscale. CONCLUSIONS The DASS-21 demonstrated sufficient high-quality evidence for bifactor structural validity, internal consistency (bifactor), criterion validity (Depression subscale), and hypothesis testing for construct validity. Further studies are required to assess the other measurement properties of the DASS-21.
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Affiliation(s)
- Jiyeon Lee
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, 164 World cup-ro, Yeongtong-Gu, Suwon, 16499, Republic of Korea.
| | - Seung Hei Moon
- Department of Nursing, Graduate School, Inha University, Incheon, Republic of Korea
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Whiting D, Deane F, McLeod H, Ciarrochi J, Simpson G. Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial. Neuropsychol Rehabil 2019; 30:1348-1371. [DOI: 10.1080/09602011.2019.1583582] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Diane Whiting
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, Australia
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Frank Deane
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Hamish McLeod
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Joseph Ciarrochi
- Institute of Positive Psychology & Education, Australian Catholic University, Strathfield, Australia
| | - Grahame Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
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Lee EH, Moon SH, Cho MS, Park ES, Kim SY, Han JS, Cheio JH. The 21-Item and 12-Item Versions of the Depression Anxiety Stress Scales: Psychometric Evaluation in a Korean Population. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 13:30-37. [PMID: 30503903 DOI: 10.1016/j.anr.2018.11.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/09/2018] [Accepted: 11/26/2018] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study aimed to evaluate the psychometric properties of the Depression Anxiety Stress Scales 21 and 12 in a Korean population. METHODS The Depression Anxiety Stress Scales were translated into Korean using a translation and back-translation technique, and the content validity was assessed by an expert panel. Participants were recruited from six community health centers (n = 431) and two community mental health centers (n = 50). A field test of the psychometric properties of the instruments was conducted using confirmatory factor analysis with bootstrap maximum likelihood estimation involving 1,000 samples, Pearson's analysis, t test, and Cronbach's α coefficient. RESULTS Confirmatory factor analysis of the Depression Anxiety Stress Scales 21 and 12 supported both three-factor and second-order three-factor models. The Scales 21 and 12 satisfied convergent validity with the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Perceived Stress Scale-10 and discriminant validity with the Rosenberg Self-Esteem Scale. The scores for the Depression Anxiety Stress Scales 21 and 12 were higher for the psychiatric group than for the nonpsychiatric group, confirming the presence of known-groups validity. The Depression Anxiety Stress Scales 21 and 12 exhibited moderate-to-strong correlations with the Negative Affect. Cronbach's α coefficients for the Depression Anxiety Stress Scales 21 and 12 were .93 and .90, respectively. CONCLUSION The Depression Anxiety Stress Scales 21 and 12 appear to be acceptable, reliable, and valid instruments. However, the shorter Depression Anxiety Stress Scales 12 may be more feasible to use in a busy practice and also be less burdensome to respondents.
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Affiliation(s)
- Eun-Hyun Lee
- Graduate School of Public Health, Ajou University, Suwon, Republic of Korea.
| | - Seung Hei Moon
- Department of Nursing, Graduate School, Inha University, Incheon, Republic of Korea
| | - Myung Sun Cho
- Anyang-si Community Mental Health Center, Anyang, Republic of Korea
| | - Eun Suk Park
- Gunpo-si Community Mental Health Center, Gunpo, Republic of Korea
| | - Soon Young Kim
- Gyeonggi Community Mental Health Center, Suwon, Republic of Korea
| | - Jin Sil Han
- Gimpo-si Community Mental Health Center, Gimpo, Republic of Korea
| | - Jung Hee Cheio
- Uiwang-si Community Mental Health Center, Uiwang, Republic of Korea
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Hurst FG, Ownsworth T, Beadle E, Shum DHK, Fleming J. Domain-specific deficits in self-awareness and relationship to psychosocial outcomes after severe traumatic brain injury. Disabil Rehabil 2018; 42:651-659. [DOI: 10.1080/09638288.2018.1504993] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Felicity G. Hurst
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Tamara Ownsworth
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Elizabeth Beadle
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - David H. K. Shum
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- Neuropsychology and Applied Cognitive Neuroscience Laboratory CAS Key Laboratory of Mental Health, Institute of Psychology Chinese Academy of Sciences, Griffith University, Beijing, China
| | - Jennifer Fleming
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
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