Psychological resilience plays an important role in recovery from concussion, and this relationship may be mediated by anxiety and depressive symptoms.
Effects of animal-assisted therapy on social behaviour in patients with acquired brain injury: a randomised controlled trial.
Karin Hediger, Stefan Thommen, Cora Wagner, Jens Gaab & Margret Hund-Georgiadis. Nature: Scientific Reports, volume 9, Published: 09 April 2019.
https://www.nature.com/articles/s41598-019-42280-0
Abstract
Animal-assisted therapy (AAT) is increasingly used to address impaired social competence in patients with acquired brain injury. However, the efficacy of AAT has not been tested in these patients. We used a randomised, controlled within subject trial to determine the effects of AAT on social competence in patients undergoing stationary neurorehabilitation. Participants received both AAT sessions and paralleled conventional therapy sessions. The patients’ social behaviour was systematically coded on the basis of video recordings of therapy sessions. Moreover, mood, treatment motivation and satisfaction was measured during each therapy session. We analysed 222 AAT and 219 control sessions of 19 patients with linear mixed models. Patients showed a significantly higher amount of social behaviour during AAT. Furthermore, patients’ positive emotions, verbal and non-verbal communication, mood, treatment motivation and satisfaction were increased in the presence of an animal. Neutral emotions were reduced but no effect was found regarding negative emotions. Our results show that AAT increases aspects of social competence and leads to higher emotional involvement of patients with acquired brain injury, reflected in higher social engagement, motivation and satisfaction during a therapeutic session.
Risk of Posttraumatic Stress Disorder and Major Depression in Civilian Patients After Mild Traumatic Brain Injury A TRACK-TBI Study.
Stein, Sonia Jain, Giacino et al. JAMA Psychiatry. 2019; 76(3):249-258.
https://doi.org/10.1001/jamapsychiatry.2018.4288
Published online: January 30, 2019
Importance Traumatic brain injury (TBI) has been associated with adverse mental health outcomes, such as posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), but little is known about factors that modify risk for these psychiatric sequelae, particularly in the civilian sector.
Objective To ascertain prevalence of and risk factors for PTSD and MDD among patients evaluated in the emergency department for mild TBI (mTBI).
Design, Setting, and Participants Prospective longitudinal cohort study (February 2014 to May 2018). Posttraumatic stress disorder and MDD symptoms were assessed using the PTSD Checklist for DSM-5 and the Patient Health Questionnaire-9 Item. Risk factors evaluated included preinjury and injury characteristics. Propensity score weights-adjusted multivariable logistic regression models were performed to assess associations with PTSD and MDD. A total of 1155 patients with mTBI (Glasgow Coma Scale score, 13-15) and 230 patients with nonhead orthopedic trauma injuries 17 years and older seen in 11 US hospitals with level 1 trauma centers were included in this study.
Main Outcomes and Measures Probable PTSD (PTSD Checklist for DSM-5 score, ≥33) and MDD (Patient Health Questionnaire-9 Item score, ≥15) at 3, 6, and 12 months postinjury.
Results Participants were 1155 patients (752 men [65.1%]; mean [SD] age, 40.5 [17.2] years) with mTBI and 230 patients (155 men [67.4%]; mean [SD] age, 40.4 [15.6] years) with nonhead orthopedic trauma injuries. Weights-adjusted prevalence of PTSD and/or MDD in the mTBI vs orthopedic trauma comparison groups at 3 months was 20.0% (SE, 1.4%) vs 8.7% (SE, 2.2%) (P < .001) and at 6 months was 21.2% (SE, 1.5%) vs 12.1% (SE, 3.2%) (P = .03). Risk factors for probable PTSD at 6 months after mTBI included less education (adjusted odds ratio, 0.89; 95% CI, 0.82-0.97 per year), being black (adjusted odds ratio, 5.11; 95% CI, 2.89-9.05), self-reported psychiatric history (adjusted odds ratio, 3.57; 95% CI, 2.09-6.09), and injury resulting from assault or other violence (adjusted odds ratio, 3.43; 95% CI, 1.56-7.54). Risk factors for probable MDD after mTBI were similar with the exception that cause of injury was not associated with increased risk.
Conclusions and Relevance After mTBI, some individuals, on the basis of education, race/ethnicity, history of mental health problems, and cause of injury were at substantially increased risk of PTSD and/or MDD. These findings should influence recognition of at-risk individuals and inform efforts at surveillance, follow-up, and intervention.
Sport-related Concussion Clinical Profiles: Clinical Characteristics, Targeted Treatments, and Preliminary Evidence.
Kontos, Sufrinko, Sandel, Emami, Collins. Curr Sports Med Rep. 2019 Mar;18(3):82-92.
www.doi.org/10.1249/JSR.0000000000000573
Abstract
Sport-related concussion (SRC) is a heterogeneous injury that involves varied symptoms and impairment that presents a significant clinical challenge to sports medicine professionals.
In response to this challenge, clinical researchers have proposed clinical profiles or subtype models for assessing and treating athletes with SRC. One such model emphasizes five concussion clinical profiles including cognitive/fatigue, vestibular, ocular, migraine, and anxiety/mood. Sleep is a common modifier that co-occurs across these clinical profiles. A combination of medical history, risk factors, injury information, clinical characteristics, and assessment outcomes can inform each clinical profile.
Preliminary data involving 236 patients from a concussion specialty clinic indicate that the migraine (26%) and anxiety/mood (24%) profiles are the most common, with vestibular and ocular profiles combined representing more than one third (35%) of clinical profiles.
Findings also support several relationships among different clinical profiles including vestibular and migraine, suggesting that many athletes present with multiple clinical profiles. Targeted, active treatments for each profile are discussed.
Special Issue – Therapeutic Benefits of Physical Activity for Mood: A Systematic Review on the Effects of Exercise Intensity, Duration, and Modality.
John S. Y. Chan, Guanmin Liu, Danxia Liang, Kanfeng Deng, Jiamin Wu & Jin H. Yan.
Published online: 15 Oct 2018 The Journal of Psychology: Interdisciplinary and Applied.
Abstract
In contemporary society, people experience considerable stress in their daily lives. Therefore, developing effective approaches and convenient means to cope with their mood problems is important nowadays. Physical activity has been consistently reported as a cost-effective way to improve physical fitness, prevent mental illnesses, and alleviate mood problems. In this systematic review, the effects of exercise intensity, duration, and modality on mood change are discussed.
Results show that moderate-intensity anaerobic exercise is associated with greater mood improvements. The relationship between exercise duration and mood change is non-linear; A regime of 10- to 30-minute exercise is sufficient for mood improvements. For exercise modality, anaerobic exercise improves mood, but the efficacy of aerobic and mindfulness-related exercises remains to be further examined.
In addition to the systematic review of potential moderators, a narrative review of psychological and neurophysiological theories of exercise effects on mood is provided; we have highlighted the central role of neuroplasticity in integrating the two classes of theories. An adoption of neuroimaging techniques in future research is critical to reveal the mechanisms underpinning the therapeutic influence of physical activity on affective responses. Some future research directions are also raised.
https://doi.org/10.1080/00223980.2018.1470487
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