scholarly journals Pain Catastrophizing Correlates with Early Mild Traumatic Brain Injury Outcome

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Geneviève Chaput ◽  
Susanne P. Lajoie ◽  
Laura M. Naismith ◽  
Gilles Lavigne
Keyword(s):  
Traumatic Brain Injury ◽  
Chronic Pain ◽  
Psychological Distress ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Pain Catastrophizing ◽  
Self Report ◽  
Pain Severity ◽  
Cross Sectional ◽  
Postconcussion Symptoms

Background.Identifying which patients are most likely to be at risk of chronic pain and other postconcussion symptoms following mild traumatic brain injury (MTBI) is a difficult clinical challenge.Objectives.To examine the relationship between pain catastrophizing, defined as the exaggerated negative appraisal of a pain experience, and early MTBI outcome.Methods.This cross-sectional design included 58 patients diagnosed with a MTBI. In addition to medical chart review, postconcussion symptoms were assessed by self-report at 1 month (Time 1) and 8 weeks (Time 2) after MTBI. Pain severity, psychological distress, level of functionality, and pain catastrophizing were measured by self-report at Time 2.Results.The pain catastrophizing subscales of rumination, magnification, and helplessness were significantly correlated with pain severity (r=.31to.44), number of postconcussion symptoms reported (r=.35to.45), psychological distress (r=.57to.67), and level of functionality (r=-.43to-.29). Pain catastrophizing scores were significantly higher for patients deemed to be at high risk of postconcussion syndrome (6 or more symptoms reported at both Time 1 and Time 2).Conclusions.Higher levels of pain catastrophizing were related to adverse early MTBI outcomes. The early detection of pain catastrophizing may facilitate goal-oriented interventions to prevent or minimize the development of chronic pain and other postconcussion symptoms.

scholarly journals Predictors for Return to Work in Subjects with Mild Traumatic Brain Injury

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Eirik Vikane ◽  
Torgeir Hellstrøm ◽  
Cecilie Røe ◽  
Erik Bautz-Holter ◽  
Jörg Aßmus ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Psychological Distress ◽  
Brain Injury ◽  
Sick Leave ◽  
Return To Work ◽  
Mild Traumatic Brain Injury ◽  
Self Report ◽  
University Hospitals ◽  
Global Functioning ◽  
One Year

Objective. To predict return to work (RTW) at 12 months for patients who either were sick-listed or were at risk to be sick-listed with persistent postconcussion symptoms (PCS) at six to eight weeks after injury.Method. A prospective cohort study of 151 patients with mild traumatic brain injury (MTBI) admitted consecutively to outpatient clinics at two University Hospitals in Norway. The study was conducted as part of a randomised clinical trial. Injury characteristics were obtained from the medical records. Sick leave data from one year before to one year after MTBI were obtained from the Norwegian Labour and Welfare Service. Self-report questionnaires were used to obtain demographic and symptom profiles.Results. We observed a significant negative association between RTW at 12 months and psychological distress, global functioning, and being sick-listed at two months after MTBI, as well as having been sick-listed the last year before injury.Conclusion. Psychological distress, global functioning postinjury, and the sick leave trajectory of the subjects were negative predictors for RTW. These findings should be taken into consideration when evaluating future vocational rehabilitation models.

scholarly journals The “self” in pain: high levels of schema-enmeshment worsen fibromyalgia impact

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Myrella Paschali ◽  
Asimina Lazaridou ◽  
Eric S. Vilsmark ◽  
Jeungchan Lee ◽  
Michael Berry ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Catastrophizing ◽  
Well Being ◽  
Cross Sectional Study ◽  
The Self ◽  
Self Report ◽  
Pain Severity ◽  
Pictorial Representation ◽  
Cross Sectional ◽  
Mediation Analyses

Abstract Objective Chronic pain can have detrimental effects on quality of life and a profound impact on one’s identity. The Pictorial Representation of Illness- and Self-Measure (PRISM), is a visual tool designed to measure the self-illness separation (SIS) that represents the degree of schema-enmeshment (i.e., the degree to which the self-schema and the illness-schema come to overlap). Our aim was to investigate the relationship between schema-enmeshment and pain-related outcomes in patients with fibromyalgia. Methods In this cross-sectional study, 114 patients with fibromyalgia completed self-report assessments of pain catastrophizing, pain severity and interference, impact of symptoms, anxiety, and depression. SIS was assessed using an iPad version of PRISM. Mediation analyses evaluated the mediating role of schema-enmeshment on the association between pain catastrophizing and fibromyalgia impact. Results A higher degree of schema-enmeshment was associated with greater pain catastrophizing, pain severity and interference, impact of symptoms, and depression. Moreover, a mediation analysis revealed that schema-enmeshment significantly mediated the association between pain catastrophizing and fibromyalgia impact (p < 0.001). Conclusions Our results indicate that schema-enmeshment is associated with greater intrusiveness of chronic pain on everyday life, thereby posing significant limitations on the emotional and physical well-being of fibromyalgia patients. Schema-enmeshment also appears to partly account for the deleterious effect of pain catastrophizing on disease impact. The PRISM is a simple tool that may uniquely capture the extent to which chronic pain and illness infiltrates and affects one’s self-concept.

scholarly journals A-105 Post-Concussive Symptom Endorsement and Symptom Attribution Following Remote Mild Traumatic Brain Injury in Combat-Exposed Veterans

2020 ◽  
Vol 35 (6) ◽  
pp. 898-898
Author(s):  
Merritt V ◽  
Jurick S ◽  
Sakamoto M ◽  
Crocker L ◽  
Sullan M ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Sociodemographic Factors ◽  
Cross Sectional Study ◽  
Self Report ◽  
Cross Sectional ◽  
Psychiatric Distress ◽  
History Of ◽  
Symptom Attribution

Abstract Objective The purpose of this study was to examine rates of “post-concussive” symptom endorsement and symptom attribution in Veterans with a history of mild traumatic brain injury (mTBI). We also explored the relationship between symptom endorsement and symptom attribution and assessed correlates of each. Method This cross-sectional study included 48 combat-exposed Iraq/Afghanistan Veterans with remote history of mTBI. All Veterans completed clinical interviews and self-report questionnaires assessing sociodemographic factors, injury and combat-related variables, psychiatric distress, self-efficacy, and coping style. To assess symptom endorsement and symptom attribution, a modified version of the Neurobehavioral Symptom Inventory was administered. Results Results showed that the most commonly endorsed “post-concussive” symptoms were several non-specific symptoms, and the symptoms most frequently attributed to mTBI included forgetfulness, poor concentration, and headaches. Furthermore, although there were some overlapping correlates of both symptom endorsement and symptom attribution, unique variables were associated with each domain. Specifically, symptom endorsement was uniquely associated with measures of psychiatric distress, while symptom attribution was uniquely associated with having a history of loss of consciousness and a greater degree of combat exposure. Conclusions Taken together, results suggest that endorsement of symptoms may be significantly impacted by the presence of mental health comorbidities, but that perceptions or beliefs as to why symptoms are occurring are related more to mTBI and combat-related characteristics. Findings offer potential avenues for therapeutic intervention, emphasize the importance of psychoeducation, and highlight the need to consider using alternate terminology for these symptoms that promotes recovery and minimizes misattribution of symptoms.

scholarly journals Electrophysiological Markers of Visuospatial Attention Recovery after Mild Traumatic Brain Injury

2019 ◽  
Vol 9 (12) ◽  
pp. 343 ◽  
Author(s):  
Julie Bolduc-Teasdale ◽  
Pierre Jolicoeur ◽  
Michelle McKerral
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Short Term Memory ◽  
Information Processing Speed ◽  
Visual Short Term Memory ◽  
Trail Making ◽  
Postconcussion Symptoms ◽  
Map Search ◽  
And Control

Objective: Attentional problems are amongst the most commonly reported complaints following mild traumatic brain injury (mTBI), including difficulties orienting and disengaging attention, sustaining it over time, and dividing attentional resources across multiple simultaneous demands. The objective of this study was to track, using a single novel electrophysiological task, various components associated with the deployment of visuospatial selective attention. Methods: A paradigm was designed to evoke earlier visual evoked potentials (VEPs), as well as attention-related and visuocognitive ERPs. Data from 36 individuals with mTBI (19 subacute, 17 chronic) and 22 uninjured controls are presented. Postconcussion symptoms (PCS), anxiety (BAI), depression (BDI-II) and visual attention (TEA Map Search, DKEFS Trail Making Test) were also assessed. Results: Earlier VEPs (P1, N1), as well as processes related to visuospatial orientation (N2pc) and encoding in visual short-term memory (SPCN), appear comparable in mTBI and control participants. However, there appears to be a disruption in the spatiotemporal dynamics of attention (N2pc-Ptc, P2) in subacute mTBI, which recovers within six months. This is also reflected in altered neuropsychological performance (information processing speed, attentional shifting). Furthermore, orientation of attention (P3a) and working memory processes (P3b) are also affected and remain as such in the chronic post-mTBI period, in co-occurrence with persisting postconcussion symptomatology. Conclusions: This study adds original findings indicating that such a sensitive and rigorous ERP task implemented at diagnostic and follow-up levels could allow for the identification of subtle but complex brain activation and connectivity deficits that can occur following mTBI.

Symptoms of post-concussional syndrome are non-specifically related to mild traumatic brain injury in UK Armed Forces personnel on return from deployment in Iraq: an analysis of self-reported data

2008 ◽  
Vol 39 (8) ◽  
pp. 1379-1387 ◽  
Author(s):  
N. T. Fear ◽  
E. Jones ◽  
M. Groom ◽  
N. Greenberg ◽  
L. Hull ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Military Personnel ◽  
Symptom Severity ◽  
General Health Questionnaire ◽  
Armed Forces ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Reported Data

BackgroundMild traumatic brain injury (mTBI) is being claimed as the ‘signature’ injury of the Iraq war, and is believed to be the cause of long-term symptomatic ill health (post-concussional syndrome; PCS) in an unknown proportion of military personnel.MethodWe analysed cross-sectional data from a large, randomly selected cohort of UK military personnel deployed to Iraq (n=5869). Two markers of PCS were generated: ‘PCS symptoms’ (indicating the presence of mTBI-related symptoms: none, 1–2, 3+) and ‘PCS symptom severity’ (indicating the presence of mTBI-related symptoms at either a moderate or severe level of severity: none, 1–2, 3+).ResultsPCS symptoms and PCS symptom severity were associated with self-reported exposure to blast whilst in a combat zone. However, the same symptoms were also associated with other in-theatre exposures such as potential exposure to depleted uranium and aiding the wounded. Strong associations were apparent between having PCS symptoms and other health outcomes, in particular being a post-traumatic stress disorder or General Health Questionnaire case.ConclusionsPCS symptoms are common and some are related to exposures such as blast injury. However, this association is not specific, and the same symptom complex is also related to numerous other risk factors and exposures. Post-deployment screening for PCS and/or mTBI in the absence of contemporaneous recording of exposure is likely to be fraught with hazards.

scholarly journals The role of deficient pain modulatory systems in the development of persistent post-traumatic headaches following mild traumatic brain injury: an exploratory longitudinal study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kelly M. Naugle ◽  
Christopher Carey ◽  
Eric Evans ◽  
Jonathan Saxe ◽  
Ryan Overman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Pain Catastrophizing ◽  
Pain Modulation ◽  
Conditioned Pain Modulation ◽  
Mild Tbi ◽  
Inhibitory Capacity ◽  
Pressure Pain Thresholds ◽  
Post Traumatic

Abstract Background Post-traumatic headache (PTH) is one of the most common and long-lasting symptoms following mild traumatic brain injury (TBI). However, the pathological mechanisms underlying the development of persistent PTH remain poorly understood. The primary purpose of this prospective pilot study was to evaluate whether early pain modulatory profiles (sensitization and endogenous pain inhibitory capacity) and psychological factors after mild TBI predict the development of persistent PTH in mild TBI patients. Methods Adult mild TBI patients recruited from Level I Emergency Department Trauma Centers completed study sessions at 1–2 weeks, 1-month, and 4-months post mild TBI. Participants completed the following outcome measures during each session: conditioned pain modulation to measure endogenous pain inhibitory capacity, temporal summation of pain and pressure pain thresholds of the head to measure sensitization of the head, Pain Catastrophizing Scale, Center for Epidemiological Studies – Depression Scale, and a standardized headache survey. Participants were classified into persistent PTH (PPTH) and no-PPTH groups based on the 4-month data. Results The results revealed that mild TBI patients developing persistent PTH exhibited significantly diminished pain inhibitory capacity, and greater depression and pain catastrophizing following injury compared to those who do not develop persistent PTH. Furthermore, logistic regression indicated that headache pain intensity at 1–2 weeks and pain inhibitory capacity on the conditioned pain modulation test at 1–2 weeks predicted persistent PTH classification at 4 months post injury. Conclusions Overall, the results suggested that persistent PTH is characterized by dysfunctional alterations in endogenous pain modulatory function and psychological processes in the early stages following mild TBI, which likely exacerbate risk for the maintenance of PTH.

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