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Psychological Resilience as a Predictor of Persistent Post-Concussive Symptoms in Children With Single and Multiple Concussion

Published online by Cambridge University Press:  07 September 2018

Christianne Laliberté Durish*
Affiliation:
Department of Psychology, University of Calgary, Calgary, Alberta, Canada
Keith Owen Yeates
Affiliation:
Department of Psychology, University of Calgary, Calgary, Alberta, Canada
Brian L. Brooks
Affiliation:
Department of Psychology, University of Calgary, Calgary, Alberta, Canada
*
Correspondence and reprint requests to: Christianne Laliberté Durish, Department of Psychology, University of Calgary, 2500 University Drive N.W., Calgary, AB, T2N 1N4. E-mail: christianne.lalibert@ucalgary.ca

Abstract

Objectives: To evaluate the relationship of psychological resilience to persistent post-concussive symptoms (PCS) in children with a history of single or multiple concussions, as well as orthopedic injury (OI). Methods: Participants (N=75) were children, ages 8–18 years, who sustained a single concussion (n=24), multiple concussions (n=25), or an OI (n=26), recruited from a tertiary care children’s hospital. All participants sustained injuries at least 6 months before recruitment, with an average time since injury of 32.9 months. Self-reported psychological resilience was measured using the Connor-Davidson Resilience Scale, and both self- and parent-reported PCS were measured using the Post-Concussion Symptom Inventory. Hierarchical regression analyses examined psychological resilience as a predictor of PCS, both as a main effect and as a moderator of group differences. Results: Multiple concussions and low psychological resilience were both significant predictors of persistent PCS. Resilience was not a significant moderator of group differences in PCS. Conclusions: Sustaining multiple concussions may increase a child’s risk of persistent PCS; however, high psychological resilience may serve as a protective factor, regardless of the number or type of injuries sustained. These findings provide support for developing and testing interventions aimed at increasing psychological resilience as a potential means of improving outcomes for children suffering from persistent PCS after concussion. (JINS, 2018, 24, 759–768)

Type
Regular Research
Copyright
Copyright © The International Neuropsychological Society 2018 

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References

REFERENCES

Anthony, E.J. (1974). The syndrome of the psychologically invulnerable child. In E.J. Anthony & C. Koupernik (Eds.), The child in his family: Children at psychiatric risk (pp. 529545). New York: Wiley.Google Scholar
Association for the Advancement of Automotive Medicine (AAAM). (2008). Abbreviated Injury Scale 2005, Update 2008. Barrington, IL: Association for the Advancement of Automotive Medicine.Google Scholar
Babcock, L., Byczkowski, T., Wade, S.L., Ho, M., Mookerjee, S., & Bazarian, J.J. (2013). Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department. JAMA Pediatrics, 156(2), 161167.Google Scholar
Barker, T., Russo, S.A., Barker, G., Rice, M.A., Jeffrey, M.G., Broderick, G., &Craddock, T.J.A. (2017). A case matched study examining the reliability of using ImPACT to assess effects of multiple concussions. BMC Psychology, 5(1), 14.Google Scholar
Barlow, K.M., Crawford, S., Stevenson, A., Sandhu, S.S., Belanger, F., & Dewey, D. (2010). Epidemiology of postconcussion syndrome in pediatric mild traumatic brain injury. Pediatrics, 126, e374e381.Google Scholar
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society, Series B (Methodological), 57, 289300.Google Scholar
Bijur, P.E., Haslum, M., & Golding, J. (1996). Cognitive outcomes of multiple mild head injuries in children. Journal of Developmental & Behavioral Pediatrics, 17(3), 143148.Google Scholar
Brooks, B.L., Mannix, R., Maxwell, B., Zafonte, R., Berkner, P.D., & Iverson, G.L. (2016). Multiple past concussions in high school football players: Are there differences in cognitive functioning and symptom reporting? Journal of Sports Medicine, 44(12), 32433251.Google Scholar
Brooks, B.L., McKay, C.D., Mrazik, M., Barlow, K.M., Meeuwisse, W.H., & Emery, C.A. (2013). Subjective, but not objective, lingering effects of multiple past concussions in adolescents. Journal of Neurotrauma, 30, 14691475.Google Scholar
Cassidy, J.D., Carroll, L.J., Peloso, P.M., Borg, J., von Holst, H., Coronado, V.G. (2004). Incidence, risk factors and prevention of mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(Suppl), 2860.Google Scholar
Connor, K.M., & Davidson, J.R. (2003). Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depression and Anxiety, 18, 7682.Google Scholar
Fay, T.B., Yeates, K.O., Taylor, H.G., Bangert, C., Dietrich, A., Nuss, K.E., &Wright, J.M. (2010). Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury. Journal of the International Neuropsychological Society, 16(1), 94105.Google Scholar
Grool, A.M., Aglipay, M., Momoli, F., Meehan, W.P., Freedman, S.B., Yeates, K.O., . . . Pediatric Emergency Research Canada (PERC) Concussion Team. (2016). Association between early participation in physical activity following acute concussion and persistent postconcussive symptoms in children and adolescents. JAMA, 316(23), 25042514.Google Scholar
IBM Corp. (2016). IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.Google Scholar
Iverson, G.L., Brooks, B.L., Lovell, M.R., & Collins, M.W. (2006). No cumulative effects for one or two previous concussions. British Journal of Sports Medicine, 40(1), 7275.Google Scholar
Iverson, G.L., Gaetz, M., Lovell, M.R., & Collins, M.W. (2004). Cumulative effects of concussion in amateur athletes. Brain Injury, 18(5), 433443.Google Scholar
Iverson, G.L., Gardner, A.J., Terry, D.P., Ponsford, J.L., Sills, A.K., Broshek, D.K., &Solomon, G.S. (2017). Predictors of clinical recovery from concussion: A systematic review. British Journal of Sports Medicine, 51, 941948.Google Scholar
Johnston, M.C., Porteous, T., Crilly, M.A., Burton, C.D., Elliot, A., Iversen, L., &Black, C. (2015). Physical disease and resilient outcomes: A systematic review of resilience definitions and study methods. Psychosomatics, 56(2), 168180.Google Scholar
Laliberté Durish, C., Brooks, B.L., & Yeates, K.O. (2017). Convergent and divergent validity for a measure of psychological resilience in children with mild traumatic brain injury. Journal of the International Neuropsychological Society, 23(Suppl. 1), 294.Google Scholar
Langlois, J.A., Rutland-Brown, W., & Thomas, K.E. (2006). Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.Google Scholar
Losoi, H., Silverberg, N.D., Waljas, M., Turunen, S., Rosti-Otajarvi, E., Helminen, M., &Iverson, G.L. (2016). Recovery from mild traumatic brain injury in previously healthy adults. Journal of Neurotrauma, 33(8), 766776.Google Scholar
Losoi, H., Silverberg, N.D., Waljas, M., Turunen, S., Rosti-Otajarvi, E., Helminen, M., &Iverson, G.L. (2015). Resilience is associated with outcome from mild traumatic brain injury. Journal of Neurotrauma, 32, 942949.Google Scholar
Mannix, R., Iverson, G.L., Maxwell, B., Atkins, J.E., Zafonte, R., & Berkner, P.D. (2014). Multiple prior concussions are associated with symptoms in high school athletes. Annals of Clinical and Translational Neurology, 1(6), 433438.Google Scholar
McNally, K.A., Bangert, B., Dietrich, A., Nuss, K., Rusin, J., Wright, M., &Yeates, K.O. (2014). Injury versus non-injury factors as predictors of post-concussive symptoms following mild traumatic brain injury in children. Neuropsychology, 27(1), 1227.Google Scholar
Merritt, V.C., Lange, R.T., & French, L.M. (2015). Resilience and symptom reporting following mild traumatic brain injury in military service members. Brain Injury, 29(11), 13251336.Google Scholar
National Center for Injury Prevention and Control. (2003). Report to Congress on Mild Traumatic Brain Injury in the United States: Steps to Prevent a Serious Public Health Problem. Atlanta, GA: Centers for Disease Control and Prevention.Google Scholar
Podsakoff, P.M., MacKenzie, S.B., Lee, J.-Y., & Podsakoff, N.P. (2003). Common method biases in behavioural research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879903.Google Scholar
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Ayton, G., Nelmus, R., &Ng, K.T. (1999). Cognitive and behavioural outcome following mild traumatic head injury in children. Journal of Head Trauma Rehabilitation, 14(4), 360372.Google Scholar
Rieger, B.P., Lewandowski, L.J., Callahan, J.M., Spenceley, L., Truckenmiller, A., Gathke, R., &Miller, L.A. (2013). A prospective study of symptoms and neurocognitive outcomes in youth with concussion vs orthopaedic injuries. Brain Injury, 27(2), 169178.Google Scholar
Sady, M.D., Vaughan, C.G., & Gioia, G.A. (2014). Psychometric characteristics of the postconcussion symptom inventory in children and adolescents. Archives of Clinical Neuropsychology, 29, 348363.Google Scholar
Sherman, E.M.S., & Brooks, B.L., (2015a). Child and Adolescent Memory ProfileTM (ChAMP). Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Sherman, E.M.S., & Brooks, B.L., (2015b). Memory Validity ProfileTM (MVP). Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Sherman, E.M.S., & Brooks, B.L., (2017). Multidimensional Everyday Memory Ratings for YouthTM (MEMRY). Lutz, FL: Psychological Assessment Resources, Inc.Google Scholar
Steinhardt, M.A., & Dolbier, C. (2008). Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. Journal of American College Health, 445, 453456.Google Scholar
Sullivan, K.A., Edmed, S.L., Allan, A.C., Smith, S.S., & Karlsson, L.J.E. (2015). The role of psychological resilience and mTBI as predictors of postconcussional syndrome symptomatology. Rehabilitation Psychology, 60(2), 147154.Google Scholar
Taylor, H.G., Dietrich, A., Nuss, K., Wright, M., Rusin, J., Bangert, B., &Yeates, K.O. (2010). Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology, 24(2), 148159.Google Scholar
Thomsen, D.K., Mehlsen, M.Y., Christensen, S., & Zachariae, R. (2003). Rumination – relationship with negative mood and sleep quality. Personality and Individual Differences, 34(7), 12931301.Google Scholar
Van Dyk, T.R., Thompson, R.W., & Nelson, T.D. (2016). Daily bidirectional relationships between sleep and mental health symptoms in youth with emotional and behavioral problems. Journal of Pediatric Psychology, 41(9), 983992.Google Scholar
Werner, E. (1997). Vulnerable but invincible: High-risk children from birth to adulthood. Acta Paediatrica, 86, 103105.Google Scholar
Werner, E.E., & Smith, R.S. (1992). Overcoming the odds: High risk children from birth to adulthood. Ithaca, NY: Cornell University Press.Google Scholar
Woodrome, S.E., Yeates, K.O., Taylor, H.G., Rusin, J., Bangert, B., Dietrich, A., &Wright, M. (2011). Coping strategies as a predictor of post-concussive symptoms in children with mild traumatic brain injury versus mild orthopedic injury. Journal of the International Neuropsychological Society, 17(2), 317326.Google Scholar
Zemek, R., Barrowman, N., Freedman, S.B., Gravel, J., Gagnon, I., McGahem, C., . . . Pediatric Emergency Research Canada (PERC) Concussion Team. (2016). Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED. JAMA, 315(10), 10141025.Google Scholar
Zemek, R.L., Farion, K.J., Sampson, M., & McGahern, C. (2013). Prognostic indicators of persistent symptoms following pediatric concussion: A systematic review. JAMA Pediatrics, 167(3), 259265.Google Scholar