bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 135 The Relationship between Executive Functioning and Psychological Outcomes Post Mild Traumatic Brain Injury
Authors: Balloun Bailey A , Kent Whitman , Fawcett Maddie , Martin Ethan , Pyykkonen Ben , Han Dan 
Published: October 2023

Abstract

Objective
Cognitive outcomes post mTBI are well-researched, but the relationship between executive functioning and psychiatric outcomes have received much less attention. This study explored emotional outcomes of individuals who sustained a mTBI and the potential relationship to executive functioning. A research study by Zainal & Newman (2021) found that older adults with severe depression and anxiety experienced increased inflammation, which potentially resulted in reduced executive functioning. mTBI is also associated with inflammation – potentially providing a compound effect or interaction. Additional research is needed to clarify the potential compound impact of mTBI and depression and anxiety might have upon cognition.

Method
185 individuals were extracted from an archival clinical database of neuropsychological evaluations of individuals noting deficits following mTBI. Executive functioning was measured using Trail Making Test B (TMT-B). Emotional distress was assessed using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). A Multiple Linear Regression was used to assess the impact of emotional distress (BAI and BDI) upon executive functioning performance (TMT-B) in this population.

Results
Regression analysis identified a relationship between emotional distress upon executive functioning that approached significance (p = 0.057; r^2 = 0.031).

Conclusions
These findings are consistent with previous literature suggesting a modest relationship between emotional distress and executive functioning – this time in a sample with mTBI population. Specific injury, resilience, and other confounding factors to clarify the actual risk and relationship is warranted.
A - 136 Association of Pre-Injury Anxiety and Oculomotor Symptoms Following Concussion among Adolescents
Authors: Burley Chris , Patel Shan , Kegel Nathan , Collins Michael , Kontos Anthony 
Published: October 2023

Abstract

Objective
To investigate the utility of demographic risk factors and post-concussion oculomotor symptoms to identify adolescents with anxiety panic disorder symptoms.

Method
Participants included 124 patients (63 male) aged 10 to 18 (M = 14.4, SD = 2.3) within 2–30 days of injury (M = 9.3, SD = 6.3) who presented to a concussion specialty clinic between 2017–2018. All participants completed the Screening for Child Anxiety Related Disorders (SCARED-C) to evaluate pre-injury anxiety as well as the Vestibular/Ocular Motor Screening (VOMS) as part of standard clinical care. A backward logistic regression (LR) was employed to determine the utility of symptom provocation on oculomotor components of the VOMS (i.e., smooth pursuits, horizontal saccades, vertical saccades, and near point of convergence) and demographic risk factors (i.e., history of anxiety or depression and gender) to identify adolescents with panic disorder symptoms on the SCARED-C.

Results
The LR model was statistically significant (χ2 (6) = 26.8, p &lt; 0.001) and explained 32.0% of the variance. The model correctly classified 84.7% of cases with high specificity = 0.97 but low sensitivity = 0.27. Variables retained in the model included provocation of dizziness during vertical saccades (OR = 1.85, p = 0.016), self-reported history of depression (OR = 7.34, p = 0.032), and sex (i.e., female; OR = 5.45, p = 0.009).

Conclusion
The results indicate that symptom provocation on oculomotor components of the VOMS (i.e., dizziness during vertical saccades), sex, and self-reported history of depression diagnosis are modest predictors of panic disorder symptoms in adolescents. Clinicians should consider these symptoms when interpreting symptoms post-injury.
A - 139 Neurobehavioral Symptoms Are Not Associated with Objective Neuropsychological Test Performance in a Group of Veterans and First Responders Seeking Care for Post-Concussive Symptoms
Authors: Cernasov Paul M , Cole Wesley R , Kane Shawn F , Kanser Robert J , Mihalik Jason P , Sirhal Stephanie R 
Published: October 2023

Abstract

Objective
Subjective post-concussive neurobehavioral symptoms do not often relate to objective cognitive assessment. This archival analysis aimed to characterize the relationship of subjective neurobehavioral symptoms to neuropsychological tests among military veterans and retired first responders with previous mild TBI (mTBI) presenting to an outpatient multidisciplinary program.

Methods
51 patients (88% male; 82% White; 94% veteran), ages 25–68 (M = 43.9, SD = 10.1) underwent neuropsychological evaluation with a flexible battery (M subtests = 29.6; SD = 5.2), through the Transforming Health and Resilience in Veterans (THRIVE) Program at UNC-Chapel Hill. The proportion of below average neuropsychological scores (i.e., ≤ 8th percentile on published norms) was modeled as a function of three subscales (Affective, Cognitive, Somatosensory) on the Neurobehavioral Symptom Inventory (NSI) and estimated premorbid IQ (PIQ) using fractional logit regression with quasi-maximum likelihood estimation and heteroskedasticity consistent “HC1” standard errors. Model diagnostics and sensitivity analyses for overly influential cases (|DFBETAS| ≥ 2/√n) were conducted.

Results
Thirty-eight individuals were included in analyses after removing those with invalid test performance (n = 4) and missing data (n = 9). The mean (median) observed below average scores was 10.9% (5.7%), with the predicted proportion at 8%. No NSI subscale was related to neuropsychological performance. However, upon removal of two overly influential cases, PIQ was inversely associated with rate of low scores - OR: 0.61 (95% CI: 0.36–0.97), SE: 0.14, p = 0.035.

Conclusion
Subjective neurobehavioral symptoms were unrelated to objective neuropsychological tests in veterans and first responders seeking care for TBI-related symptoms.
A - 141 Effects of Posttraumatic Growth on Current and Predicted Future Satisfaction with Recovery in Patients with Moderate/Severe Traumatic Brain Injury and their Families
Authors: Fedio Alison A , Nastea Katerina , Sexton James , Dekarchuk Marina , Dinklocker Brandy , Jackson KaShawn , Rafel Hannah , Okeke Chioma , Jowi Esther , Swartz Allison , Lebedun Alec 
Published: October 2023

Abstract

Objective
This study was designed to assess effects of posttraumatic growth (PTG) on ratings of current and predicted future functioning in adults with moderate–severe traumatic brain injury (mod-sev TBI) and their family members.

Method
Fifteen adults with mod-sev TBI (age 34.5; 4.1 yrs post), and a family member for each, rated current, and predicted 2–3-year future, satisfaction with physical, cognitive, and emotional recovery. All participants also completed the Neurobehavioral Functioning Inventory, and patients completed the Motivation for TBI Rehabilitation Questionnaire. PTG was assessed by raters independently judging the content of brief narratives written by the patients. Results of repeated measures within-subjects contrasts and independent samples t-tests are reported at the p &lt; 0.05 level.

Results
Findings for individuals with (vs without) PTG revealed greater agreement of current and future satisfaction by self and family member, including greater satisfaction with depression and aggression. Families rated less concern across areas of functioning, especially regarding aggression, for individuals with (vs without) PTG. Patients with (vs without) PTG rated poor current satisfaction with memory. Overall, patients with (vs without) PTG were less interested in rehabilitative treatment.

Conclusions
Results align with published findings regarding PTG reflecting acceptance of personal challenges. Benefits to negative emotions are notable. Reasons for patients’ current dissatisfaction with their memory, juxtaposed with satisfaction with their future memory, merits further study but may relate to patients’ noticing memory difficulties while being evaluated. Less interest in rehab may relate to patients with PTG believing they were functioning well overall and therefore being less in need of treatment.
A - 142 The Somatic Factor Drives Elevations on the Beck Depression Inventory-2 in Mild Traumatic Brain Injury
Authors: Glisky Martha L , Caughie Cali , Chu Zoey , Hayden Abigail 
Published: October 2023

Abstract

Objective
The Beck Depression Inventory-2 (BDI-2) is used to identify depression, which is common following a mild traumatic brain injury (mTBI). This study explored the specific type of symptom cluster (Affective, Cognitive and Somatic) most commonly endorsed in mTBI.

Method
A sample of 138 individuals diagnosed with an mTBI completed the BDI-2 during a clinical neuropsychological evaluation. A one-way repeated measures Analysis of Variance (ANOVA) was conducted to examine whether the type of symptoms reported on the BDI-2 differed in our mTBI sample.

Results
The sample included 63% females, with mean age of 46.93 (SD = 13.28) and a mean education level of 15.08 (SD = 2.65).
There was a significant main effect of BDI-2 factors, F (1.74, 238.5) = 199.211, p &lt; 0.001, partial η2 = 0.25. Post-hoc pairwise comparisons (with Bonferroni correction) revealed differences between all three clusters, with significantly more somatic symptoms endorsed (M = 11.07, SD = 4.77, p &lt; 0.001) compared to cognitive symptoms (M = 6.51, SD = 5.44, p &lt; 0.001) and affective symptoms (M = 5.01, SD = 2.81, p &lt; 0.001).

Conclusion
High scores on the BDI-2 were driven primarily by somatic symptoms, followed by cognitive symptoms, and lastly affective symptoms in our mTBI sample. The overlap between the BDI-2 somatic symptoms and post-concussive symptoms raises the question as to whether mTBI patients have higher rates of depression or just higher physical mTBI symptoms elevating the BDI-2. The implications for rates of depression in mTBI, and appropriate treatments will be discussed.
A - 144 Prior Concussions and Symptom Elevation Rates in Collegiate Student-Athletes at Preseason Baseline
Authors: Ingram Eric O , Karr Justin E 
Published: October 2023

Abstract

Objective
Assess how prior concussions are related to baseline symptom endorsement using a four-factor model of post-concussion symptoms (i.e., cognitive, sleep-arousal, physical, and affective).

Method
Athletes from the Concussion Assessment, Research, and Education consortium (N&#3f7,370; 64% Male; 62% White; 36% Freshmen; 15% Football players) with at least one prior concussion were administered the Sport Concussion Assessment Tool-3 Symptom Evaluation at baseline. Subscale and total scores ≥84th percentile were considered elevated based on normative reference data from uninjured participants matched on gender and number of preexisting conditions.

Results
The symptoms of Headache, Pressure in head, Sensitivity to light, and Difficulty remembering were endorsed at a significantly higher rate (ps &lt; 0.001, OR range = 1.35 to 1.40) by those with two or more prior concussions compared to those with one prior concussion. Approximately 22% of athletes had an elevated subscale score without an elevated total score. In contrast, no athletes were elevated on the total score without also being elevated on a subscale score, and 18% of athletes were elevated on both a subscale and the total score. The physical subscale was consistently the most frequent exclusively elevated subscale in the full sample (cognitive = 4%; physical = 10%, sleep-arousal = 6%, affective = 7%).

Conclusion(s)
Prior concussion status is related to item-level symptom endorsement among collegiate athletes at preseason baseline. A multidimensional approach to symptom interpretation identified a sizeable number of athletes (i.e., 22%) with significant symptoms that were not captured by a total score elevation. Most athletes with an elevated subscale score (i.e., 55%) were experiencing physical symptoms.
A - 145 Using a Multidimensional Symptom Model to Identify Persistent Post-Concussion Symptoms in Collegiate Athletes
Authors: Ingram Eric O , Karr Justin E 
Published: October 2023

Abstract

Objective
Determine if a multidimensional (i.e., four-factor model) approach to post-concussion symptoms identifies more participants with persistent post-concussion symptoms after a sport-related concussion than a standard total score approach.

Method
Student-athletes (N = 1097; 61% Male; 59% White; 35% Freshmen; 14% Football athletes) from the Concussion Assessment, Research, and Education consortium completed the Sport Concussion Assessment Tool-3 Symptom Evaluation six months after a concussion. Scores ≥84th percentile compared to normative data were considered elevated. Elevation rates for total and subscale scores were compared to examine the utility of a multidimensional interpretation in identifying persistent symptoms.

Results
Six months after injury, 9.9% of athletes had symptom elevations on the total or subscale score. Overall, 8.1% of athletes were elevated on a subscale (i.e., physical = 3.9%, cognitive = 1.9%, affective = 2.3%, sleep-arousal = 1.7%) but not the total score, whereas just 1.8% were elevated on both a subscale and the total score. No athletes were elevated on the total score without being concurrently elevated on a subscale.

Conclusion(s)
Multidimensional symptom interpretations may aid in identifying cases of persistent post-concussion symptoms, detecting up to 8.1% of athletes with elevated symptoms that would not be detected by focusing on a total score alone. This study did not assess for daily symptoms, which is one of the consensus criteria for persistent post-concussion symptoms. Future research should evaluate whether specific subscale elevations correspond to functional deficits or adverse health outcomes in these athletes.
A - 146 Subjective and Objective Cognitive Functioning in Women Survivors of Intimate Partner Violence with Repetitive Mild Traumatic Brain Injuries
Authors: Karr Justin E , White Agnes E , Leong Sharon E , Logan T K 
Published: October 2023

Abstract

Objective
This study examined subjective and objective cognitive functioning among women survivors of intimate partner violence (IPV) with a history of repetitive mild traumatic brain injury (mTBI), hypothesizing they would have elevated subjective cognitive complaints and lower objective cognitive test performances compared to national norms.

Method
Women were recruited from a domestic violence shelter (N = 16; M = 39.8 ± 7.9 years-old) and completed the Neurological Quality-of-Life Cognitive Function questionnaire (Neuro-QoL-CF), Rey Auditory Verbal Learning Test (RAVLT), NIH Toolbox Cognition Battery (NIHTB-CB), and Delis-Kaplan Executive Function System (D-KEFS) Trail Making and Verbal Fluency tests. One-sample t-tests compared mean scores against national norms for the Neuro-QoL-CF, RAVLT trials 1–5 and delayed recall, NIHTB-CB Crystallized-Fluid difference score, and D-KEFS composite index score.

Results
Nearly all women (81.3%) reported elevated subjective cognitive concerns on the Neuro-QoL-CF, significantly greater than the national average, t = 10.50, p &lt; 0.001, d = 2.62. RAVLT learning, t = 5.41, p &lt; 0.001, d = −1.35, and delayed recall, t = 4.54, p &lt; 0.001, d = −1.28, were significantly lower than the national average. NIHTB-CB difference scores were significantly higher than the national average, t = 5.23, p &lt; 0.001, d = 1.14, indicating worse fluid cognition than anticipated compared to estimated premorbid functioning. Mean D-KEFS composite scores were comparable to national norms, t = 0.73, p = 0.474, d = 0.18.

Conclusions
Women survivors of IPV with repetitive mTBI history had greater subjective cognitive concerns and lower cognitive test performances compared to national norms, indicating cognitive health needs in this population. These findings may be attributable to repetitive mTBI or other neurobehavioral variables that may affect this population, including concurrent physical conditions (e.g., headache), mental illness, chronic pain, substance use, or a combination thereof.
A - 147 Activity Scheduling of Rewarding Activities Is Associated with Decreased Negative Affect and Increased Sense of Accomplishment in a Sample with Anxiety and/or Depression and Traumatic Brain Injury
Authors: Kerr Alissa L , Rabinowitz Amanda R 
Published: October 2023

Abstract

Objective
To determine the effect of activity scheduling as part of a Behavioral Activation (BA) trial on ecological momentary assessment (EMA) of affect and reward in persons with anxiety and/or depression and chronic moderate to severe traumatic brain injury (TBI).

Method
A sample of adults (N = 32) with moderate to severe TBI sustained ≥6 months prior to enrollment, and at least mild depression and/or anxiety were selected from a larger treatment study (N = 60) based on their BA treatment group assignment and EMA response rate. Participants responded to a smartphone app five times daily for approximately 2 weeks prior to and 6 weeks after initiation of activity scheduling (8-week total), while participating in a BA treatment program as part of a randomized controlled trial. The EMA included 0–6 Likert ratings of perceived enjoyment/accomplishment, and the Positive and Negative Affect Scale (PANAS). Average daily scores for positive affect (PA), negative affect (NA), enjoyment, and accomplishment were calculated, and repeated measures general linear modeling was employed to examine the effect of activity scheduling on each outcome.

Results
We found that activity scheduling had a significant impact on reducing NA (F[1,31] = 11.0, p = 0.002) and increasing sense of accomplishment (F[1,31] = 10.46, p = 0.003). We did not detect a significant difference with regards to PA (F[1,31] = 1.41, p = 0.245) or enjoyment (F[1,31] = 2.39, p = 0.132).

Conclusions
Our findings suggest that activity scheduling as part of BA may be helpful for reducing negative affect and increasing a sense of accomplishment in participants with mental health concerns following moderate to severe TBI.
A - 148 Pre-Injury Personality and Engagement in Inpatient Rehabilitation Following TBI
Authors: Krasucki Lauren , Wingfield Roberto , Rabinowitz Amanda 
Published: October 2023

Abstract

Objective
We sought to evaluate the relationship between pre-injury motivational systems and engagement in inpatient rehabilitation (IR) following moderate-to-severe traumatic brain injury (msTBI).

Methods
We recruited 20 individuals, aged 18–80 years, from IR with msTBI as evidenced by a GCS score &lt; 13, loss of consciousness ≥60 minutes, post-traumatic amnesia (PTA) of at least 24 hours, and/or positive findings on neuroimaging. After emergence from PTA, participants reported on their general behavior and personality prior to their injury in a verbal interview, which included the 24-item BIS/BAS Scale. This scale measures the behavioral inhibition system (BIS), which motivates avoidance of aversive outcomes, and the behavioral activation system (BAS), which motivates approach to goal-oriented outcomes. Rehabilitation therapists rated participants’ engagement in each physical (PT), occupational (OT), and speech therapy (ST) session using the Rehabilitation Intensity of Therapy Scale. We assessed the relationship between BIS/BAS scores and average level of engagement in each rehabilitation discipline using Pearson’s correlation.

Results
The sample was 65% male and 65% white with a mean age of 38.95 years (SD = 19.57) and a mean education of 13.45 years (SD = 2.61). Engagement in PT was significantly correlated with BAS Drive, r(18) = −0.55, p = 0.012; BAS Fun-Seeking, r(18) = −0.55, p = 0.013; and BAS Reward Responsiveness, r(18) = −0.56, p = 0.010. There were no significant correlations between the BIS/BAS subscales and engagement in OT or ST.

Conclusion
Pre-injury motivation to approach goal-oriented outcomes predicts engagement in inpatient PT following msTBI, which may impact treatment benefit and subsequent functioning.
A - 151 Assessing the Role of Executive Function in the Memory Performances of Retired National Football League Players
Authors: Lopez Hernandez Daniel W , Cantu Robert , Guskiewicz Kevin M , Kelly Daniel F , Swerdloff Ronald , Woo Ellen , Wright Matthew J 
Published: October 2023

Abstract

Objective
We evaluated the relationship between retired National Football League players executive functioning (EF) abilities on verbal memory performance and subprocesses.

Method
Fifty-eight participants were divided into two groups: intact executive functioning (IEF) and deficit executive functioning (DEF). Participants completed the California Verbal Learning Test, Second Edition (CVLT-II) to evaluate verbal memory performance. Additionally, the Item Specific Deficit Approach (ISDA) was applied to the CVLT-II to quantify verbal memory subprocesses (i.e., encoding, consolidation, & retrieval). Next, we determined which ISDA indices predicted long-delayed free recall (LDFR) for both groups. We then computed hierarchal regressions to determine which ISDA indices were predictive of LDFR for each group. Next, we retained significant predictors from the ISDA and correlated them with measures of executive function in both groups with and without partialling out cognitive reserve (CR).

Results
We found the IEF group outperformed the DEF group on the CVLT-II learning trials and LDFR, and demonstrated better encoding abilities. Hierarchical regression revealed that the ISDA was predictive of LDFR in both groups. The DEF group LDFR issues were only predicted by encoding problems. In contrast, LDFR deficits in the IEF were primarily driven by consolidation problems. The ISDA encoding index correlated with Trail Making Test part B and Phonemic Fluency Test. However, after partialling out the variance accounted for by CR, the associations between the encoding index and executive function were nonsignificant.

Conclusions
Our results suggest that greater executive function results in better memory performances in retired football players. Lastly, improved executive function is related to greater CR.
A - 155 Southern African Parents’ Concussion Knowledge and Intention to Report Youth Athletes
Authors: Lonsdale Louise C , Ernst William , Fetterman Joshua , Kneavel Meredith 
Published: October 2023

Abstract

Objective
To determine Southern African parents’ concussion knowledge and intention to report in youth athletes.

Method
A diverse sample of 48 Southern African parents of youth athletes ages 5–18 completed an online survey. Recruitment included: 1) contacting school administrations to forward the survey to parents and 2) a social media post. The Concussion Knowledge Checklist (CKC) consists of 27 items, 19 true and eight false symptoms, with a score range of 0–54. The Intention to Report Scale consists of seven questions on a Likert scale, with a score range of 7–49. Higher scores indicate greater knowledge and intention to report, respectively.

Results
CKC score (M = 37.24; SD = 7.1) indicates a moderate degree of concussion knowledge. Certain symptoms (i.e., blurred vision) were accurately endorsed at a high rate (83%). Conversely, affective symptoms, such as more emotional, were accurately endorsed at a low rate (25%). The Intention to Report Scale score (M = 40.98; SD = 5.97) suggests a moderate to strong degree of participants’ intention to report.

Conclusions
Participants indicated a moderate degree of concussion knowledge. However, variability was evidenced by some symptoms (e.g., blurred vision) endorsed at a high rate and others, for example, more emotional, at a low rate. These findings have possible implications for concussion education. The Intention to Report Scale indicated a moderate to strong degree of parents’ intention to report their children with a suspected concussion.