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73 Sex and Race/Ethnicity in Reporting of Lingering Concussion Symptoms by Adolescents
- Stephen C Bunt, Nyaz Didehbani, Cheryl H Silver, Linda S Hynan, Hannah E Wadsworth, Hudaisa Fatima, Cason Hicks, Mathew Stokes, Shane M Miller, Kathleen Bell, C M Cullum
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 176-177
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- Article
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Objective:
Consideration of individual differences in recovery after concussion has become a focus of concussion research. Sex and racial/ethnic identity as they may affect reporting of concussion symptoms have been studied at single time points but not over time. Our objective was to investigate the factors of self-defined sex and race/ethnicity in reporting of lingering concussion symptoms in a large sample of adolescents.
Participants and Methods:Concussed, symptomatic adolescents (n=849; Female=464, Male=385) aged 13-18 years were evaluated within 30 days of injury at a North Texas Concussion Registry (ConTex) clinic. Participants were grouped by self-defined race/ethnicity into three groups: Non-Hispanic Caucasian (n=570), Hispanic Caucasian (n=157), and African American (n=122). Measures collected at the initial visit included medical history, injury related information, and the Sport Concussion Assessment Tool-5 Symptom Evaluation (SCAT-5SE). At a three-month follow-up, participants completed the SCAT-5SE. Pearson’s Chi-Square analyses examined differences in categorical measures of demographics, medical history, and injury characteristics. Prior to analysis, statistical assumptions were examined, and log base 10 transformations were performed to address issues of unequal group variances and nonnormal distributions. A three-way repeated measures ANOVA (Sex x Race/Ethnicity x Time) was conducted to examine total severity scores on the SCAT-5SE. Bonferroni post-hoc tests were performed to determine specific group differences. SPSS V28 was used for analysis with p<0.05 for significance. Data reported below has been back transformed.
Results:A significant interaction of Time by Race/Ethnicity was found for SCAT-5SE scores reported at initial visit and three-month follow-up (F(2, 843)=7.362, p<0.001). To understand this interaction, at initial visit, Race/Ethnicity groups reported similar levels of severity for concussion symptoms. At three month follow-up, African Americans reported the highest level of severity of lingering symptoms (M= 3.925, 95% CIs [2.938-5.158]) followed by Hispanic Caucasians(M= 2.978, 95% CIs [2.2663.845]) and Non-Hispanic Caucasians who were the lowest(M= 1.915, 95% CIs [1.6262.237]). There were significant main effects for Time, Sex, and Race/Ethnicity. Average symptom levels were higher at initial visit compared to three-month follow-up (F(1, 843)=1531.526, p<0.001). Females had higher average symptom levels compared to males (F(1, 843)=35.58, p<0.001). For Race/Ethnicity (F(2, 843)=9.236, p<0.001), Non-Hispanic Caucasians were significantly different than African Americans (p<0.001) and Hispanic Caucasians (p=0.021) in reported levels of concussion symptom severity.
Conclusions:Data from a large sample of concussed adolescents supported a higher level of reported symptoms by females, but there were no significant differences in symptom reporting between sexes across racial/ethnic groups. Overall, at three-months, the African American and Hispanic Caucasians participants reported a higher level of lingering symptoms than Non-Hispanic Caucasians. In order to improve care, the difference between specific racial/ethnic groups during recovery merits exploration into the factors that may influence symptom reporting.
Chapter 18 - Trust and Lesion Evidence
- from Part V - Neuropathological Level of Trust
- Edited by Frank Krueger, George Mason University, Virginia
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- Book:
- The Neurobiology of Trust
- Published online:
- 09 December 2021
- Print publication:
- 16 December 2021, pp 464-491
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Summary
Understanding when to trust and establishing judgments of trustworthiness are complex processes that are critical and essential for human life. Appropriate judgments in trustworthiness lead to the formation of cooperative, mutually beneficial relationships that facilitate personal success, a sense of achievement, increased well-being, and quality of life. The trust game is an economic decision-making game that was specifically designed to measure trust. It is an important and unique instrument, as it measures the entirety of the trust process. Research investigating brain activation during participation of the trust game has shown many brain regions and networks involved in the processes of trust. Whether some of these regions are necessary for various trust processes has been determined by studying trust game performances in individuals with lesions in specific trust-related brain areas. This chapter reviews lesion studies in patients with damage to the insula, amygdala, and prefrontal cortex, with a focus on how such patients perform on various aspects of the trust game and how the findings have informed our understanding of the neuroanatomical correlates of trust. Additionally, we review briefly some functional neuroimaging research on the involvement of the temporal parietal junction and ventral striatum in the trust process.