The Role of Blame Attribution in Post-Concussion Syndrome Morbidity: A Retrospective Analysis of Patients at a Subspecialty Clinic

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S11.3-S12
Author(s):  
Graeme Battigelli ◽  
Mohammed Wasif Hussain
Keyword(s):  
Risk Factors ◽  
Psychiatric Symptoms ◽  
Initial Presentation ◽  
Headache Frequency ◽  
Post Injury ◽  
Blame Attribution ◽  
Psychological Risk Factors ◽  
Post Concussion Syndrome ◽  
External Group ◽  
Psychological Risk

ObjectiveTo compare the presentation of Post-Concussion Syndrome (PCS) based on whom the patient blames for the initial concussion.BackgroundPsychological risk factors, such as pre-injury psychiatric disease and ongoing litigation, are associated with worsened PCS. We investigated whether blame attribution is another one of these psychological risk factors.Design/Methods111 new patients presenting with PCS at a Canadian subspecialty concussion clinic were seen over 2 years. 91 patients (56 females, 35 males) were included. 20 patients were excluded for inability to define specific causative event (n = 13), underlying structural lesion (n = 1) or evidence of intracranial bleed (n = 6). Patients were separated into three groups: those attributing external blame (n = 70) those describing the incident as accidental (n = 20) and those attributing internal blame (n = 1). Patient observations included: subjective percentage of recovery (SPR), presence and severity of both headaches and psychiatric symptoms, and duration of symptoms at initial presentation. Psychiatric symptoms were graded 0–3 (0-absence, 1-mild, 2-moderate, 3-severe). Headache frequency was graded 0–4 (0-absence, 1-rare, 2-episodic, 3-chronic, 4-persistent).ResultsMore patients belonged to the External group compared to Accidental or Internal groups (p < 0.0001). Mean SPR in the Accidental group was 73% as compared to 44% in External (p < 0.0001). Mean headache frequency was 1.7 for Accidental and 2.64 for External (p = 0.001) Mean severity of psychiatric symptoms was 0.55 in Accidental and 2.24 in External (p < 0.0001). 77% of patients in the External group were diagnosed with post-injury PTSD, with 0% diagnosed in the Accidental group (p < 0.0001). Post-injury depression and anxiety each occurred 3 times more frequently in the External group compared to Accidental (p < 0.0001). Mean symptom duration at initial presentation was 10.2 months in Accidental and 22.49 months in External (p = 0.001). The External and Accidental groups did not differ significantly in age (p = 0.938), number of concussions (p = 0.72), gender (p = 0.908), or preexisting psychiatric illness (p = 0.735).ConclusionsThis study suggests blame attribution may be an important factor in determining patients at risk of a more severe and prolonged course of PCS.

scholarly journals Psychological Risk Factors for Posttraumatic Stress Disorder in Workers After Toxic Chemical Spill in Gumi, South Korea

2018 ◽  
Vol 66 (8) ◽  
pp. 393-402 ◽  
Author(s):  
Ji Young Song ◽  
Kyoung-Sook Jeong ◽  
Kyeong-sook Choi ◽  
Min-gi Kim ◽  
Yeon-Soon Ahn
Keyword(s):  
Risk Factors ◽  
Posttraumatic Stress Disorder ◽  
South Korea ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Psychiatric Symptoms ◽  
Industrial Complex ◽  
Event Scale ◽  
Psychological Risk Factors ◽  
Psychological Risk

The extent and severity of the psychological effects following chemical release disasters have not been widely reported. The aim of this study was to examine the prevalence of hydrogen fluoride (HF)–related posttraumatic stress disorder (PTSD) and to identify associated psychological risk factors. On September 2012, an estimated 8 to 12 tons of HF gas, which dissolves in air moisture to form droplets of corrosive hydrofluoric acid, escaped from an industrial complex in Gumi, South Korea. Ten months later, structured questionnaires that included items from the Impacts of Event Scale (revised Korean version) as well as questions about demographic and psychological risk factors related to PTSD were distributed to workers in the affected area. The prevalence rate of PTSD was 5.7%. The odds of PTSD in non-alcohol-dependent workers (odds ratio [OR] = 3.10, 95% confidence interval [CI] = [1.27, 7.60]) was significantly higher than in alcohol-independent workers. The OR for PTSD in workers with anxiety (OR = 7.63, 95% CI = [2.10, 27.71) was significantly higher than the OR workers without anxiety. The odds of PTSD in workers with high perceived stress scale (PSS) scores (OR = 8.72, 95 % CI = [2.29, 33.16]) was significantly higher than for workers with low PSS. Alcohol dependence, psychiatric symptoms at the time of the event, anxiety, and high PSS were associated with HF-related PTSD. Long-term employee assistance programs are needed to assist occupational health nurses and clinicians to reduce PTSD after industrial disasters.

scholarly journals Sociodemographic and Psychological Risk Factors for Anxiety and Depression: Findings from the Covid-19 Health and Adherence Research in Scotland on Mental Health (CHARIS-MH) Cross-sectional Survey

2021 ◽  
Author(s):  
Gill Hubbard ◽  
Chantal den Daas ◽  
Marie Johnston ◽  
Diane Dixon
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Social Support ◽  
Illness Representations ◽  
Gender Effects ◽  
Anxiety And Depression ◽  
Perceived Threat ◽  
Cross Sectional ◽  
Psychological Risk Factors ◽  
Psychological Risk

Abstract Background Investigations about mental health report prevalence rates with fewer studies investigating psychological and social factors influencing mental health during the Covid-19 pandemic. Study aims: (1) identify sociodemographic groups of the adult population at risk of anxiety and depression and (2) determine if the following social and psychological risk factors for poor mental health moderated these direct sociodemographic effects: loneliness, social support, threat perception, illness representations. Methods Cross-sectional nationally representative telephone survey in Scotland in June 2020. If available, validated instruments were used, for example, Patient Health Questionnaire (PHQ-4) to measure anxiety and depression. Simple linear regressions followed by examination of moderation effect. Results A total of 1006 participants; median age 53 years, 61.4% female, from all levels of area deprivation (i.e., 3.8% in the most deprived decile and 15.6% in the most affluent decile). Analyses show associations of anxiety and depression with sociodemographic (age, gender, deprivation), social (social support, loneliness) and psychological factors (perceived threat and illness representations). Mental health was poorer in younger adults, women and people living in the most deprived areas. Age effects were exacerbated by loneliness and illness representations, gender effects by loneliness and illness representations and deprivation effects by loneliness, social support, illness representations and perceived threat. In each case, the moderating variables amplified the detrimental effects of the sociodemographic factors. Conclusions These findings confirm the results of pre-Covid-19 pandemic studies about associations between sociodemographics and mental health. Loneliness, lack of social support and thoughts about Covid-19 exacerbated these effects and offer pointers for pre-emptive action.

Chronic low back pain and the transdiagnostic process: How do cognitive and emotional dysregulations contribute to the intensity of risk factors and pain?

2017 ◽  
Vol 17 (1) ◽  
pp. 309-315 ◽  
Author(s):  
Margaux Le Borgne ◽  
Abdel Halim Boudoukha ◽  
Audrey Petit ◽  
Yves Roquelaure
Keyword(s):  
Risk Factors ◽  
Low Back Pain ◽  
Back Pain ◽  
Multiple Regression ◽  
Chronic Low Back Pain ◽  
Emotional Regulation ◽  
Low Back ◽  
Psychological Risk Factors ◽  
Somatosensory Amplification ◽  
Psychological Risk

AbstractBackground and aimsBased on a transdiagnostic approach, this study assesses the impact of cognitive and emotional processes (difficulties in emotional regulation, impulsiveness, rumination and somatosensory amplification) on the psychological risk factors of chronic low-back pain.MethodsThe study was carried out with 256 patients with chronic low-back pain. All the variables were assessed through a booklet of 10 validated questionnaires. Multiple regression analysis and moderation analysis were performed.ResultsPredictors included in multiple regression models explain 3%-42% (adjusted R2) of the variance in psychological risk factors. Moreover, analyses reveal a significant moderator effect of somatosensory amplification on the link between fear-avoidance beliefs linked to work and pain intensity (F(3;250) = 12.33; p = .00), of somatosensory amplification and brooding on the link between depression and functional repercussions (FR) on everyday life (F(3;252) = 13.36; p = .000; F(1;252) = 12.42; p = .00), of the reflection dimension of rumination on the link between the helplessness dimension of catastrophizing and FRs on sociability (F(3;252) = 37.02; p = .00). There is also a moderation analysis with a significant trend concerning the lack of emotional awareness and the difficulties in controlling impulsive behaviours.ConclusionsOur results indicate an important role of some dimensions of difficulties in emotional regulation, somatosensory amplification and rumination in the increase in negative affects and dysfunctional beliefs, and in the links between those psychological risk factors and pain/disability.ImplicationsThis study identifies some cognitive and emotional dysregulations substantially involved in work-related chronic pain. This contribute to put in place psychotherapeutic protocols to tackle these deficits and dysregulations in a relevant way.

scholarly journals Evaluation of Psychological Risk Factors: Prospective Prediction of Psychopathology during Basic Training

1999 ◽  
Vol 164 (7) ◽  
pp. 509-513 ◽  
Author(s):  
Darin R. Lerew ◽  
Norman B. Schmidt ◽  
Robert J. Jackson
Keyword(s):  
Risk Factors ◽  
Basic Training ◽  
Psychological Risk Factors ◽  
Psychological Risk
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