Sport-Related Concussions: A Review of Epidemiology, Challenges in Diagnosis, and Potential Risk Factors

Sport-related concussion (SRC) is a common mild traumatic brain injury among young, active individuals, affecting approximately 300,000 young American adults annually. In this review of the epidemiology of SRC, we describe the challenges in identifying concussion occurrence and review the studies describing concussion incidence in various sports. In high risk contact sports, American football, soccer (European football), hockey, lacrosse, and basketball athletes experience concussion unintentionally during the course of play. Among these, football concussion incidence is reviewed in greatest detail because it has the highest incidence among the contact sports, and some studies have shown long-term neurophysiologic and neurodegenerative outcomes. Mechanisms of injury differ significantly by sport and can be potential targets for concussion risk mitigation. Despite the apparent high incidence of SRC, risk factors determining initial concussion, recovery periods, recurrence, and long-term outcomes remain poorly understood and warrant further study exploring the influence of age, sex, genetics, and athletic factors.     

Perspectives on Healthcare Provider Well-Being: Looking Back,Moving Forward

Recognizing the impact of healthcare professional (HCP) burnout has led to vigorous interest from organizations and individuals regarding how to most effectively promote HCP well-being. The present paper reviews the literature on HCP well-being and describes factors that impact well-being at various levels (i.e., system, institution, program, interpersonal, and individual). We propose that change must occur at all levels to have the greatest impact. Further, we highlight opportunities to advance research on HCP well-being (e.g., being more inclusive regarding study populations and designing longitudinal intervention studies).     

Governing sporting brains: concussion,neuroscience, and the biopolitical regulation of sport

Abstract

Drawing on the recent concussion litigation from the United States’ National Football League (NFL), the paper examines the emergence of neuroscience knowledge as part of a defining rationale for the justification and rationalization of the lawsuit. The paper argues that neuroscience knowledge is best understood as a regulatory discourse that is attached to larger social, political, and economic realities that bring it into being as a legitimate type of knowledge. This larger socio-political governance logic is one that scholars call ‘biopolitical’ which emphasizes the protection of individual life over and above other ways of being. Risk discourses that frame risk-taking practices as immoral thus emerge within this biopolitical regime of governance that frame morality in terms of public health that individual citizens ought to pursue. With this in mind neuroscience knowledge plays an important role in concussion litigation. It emerges as a technology of biopolitical governance in that it is used to justify legal decisions on concussion. This is despite the fact that neuroscience knowledge remains nascent and even scientifically uncertain. Because of this, the paper argues that scholars ought to not only consider neuroscience research skeptically, but also ought to be aware of the dangers of neuroscience’s emergence as an ‘anticipatory discourse’ that has the potential to reduce human behavior to matters of the brain that thus transforms our very ontology of ourselves and the practices we perceive as ‘good’.     

How Perceptions Impact Recovery from Concussion in Childhood and Adolescence: a Systematic Review

Neuropsychology Review - Perceptions about the causes and consequences of concussion, and individual representations and interpretations of these factors, can influence the post-concussive recovery...     

Sports Media Representations of Concussions in the National Rugby League

Objective

Concussion is poorly understood by the general public who are regularly exposed to this type of injury via televised sports such as the National Rugby League (NRL). This study investigated media representations of concussion by examining the terminology used by the commentators during the 2010 and 2011 NRL seasons.

Method

Data was obtained through a surveillance design where commentary statements were recorded for each observable concussion.

Results

Dramatic terminology was the most frequently used followed by entertaining and humorous terminology. Commentators often portrayed the way the incident had occurred and the player's reaction to being concussed. However, information about a player sustaining an injury that required medical attention was rarely conveyed.

Conclusion

Media tend to trivialise concussion and this may have an impact on the public's knowledge of, and influence their response to, concussion.     

Mental illness disclosure in organizations: defining and predicting (un)supportive responses

Employees with a mental illness regularly encounter situations where they must make decisions regarding the extent to which they discuss their stigma. Past research has found links between positive disclosure experiences and positive well-being and job-related outcomes for the individual disclosing. However, research on stigma disclosure has not yet defined what differentiates a supportive response from an unsupportive one, and there is evidence to suggest that people are unsure of how to best respond to a disclosure. In a series of three studies, we sought to develop a better understanding of mental illness disclosure at work. First, we created a typology of supportive and unsupportive responses to disclosure via critical incidents gathered from working adults with a mental illness. Second, we surveyed working adults with and without a mental illness to examine if they perceive the supportiveness of responses differently. Third, in an experimental study, we examined which methods of disclosure are most effective in eliciting a supportive response. This work identifies several types of supportive (e.g., providing emotional support) and unsupportive (e.g., denial of symptoms) responses to mental illness disclosure and finds that individuals without a mental illness have a reasonable understanding of what an individual with a mental illness would also identify as supportive/unsupportive responses. We also find that downplaying one’s mental illness will likely lead to a less supportive response.

     

Introducing the Expectations and Preference Scales for Couple Therapy (EPSCT): Development,Psychometric Evaluation,and Suggested Use in Practice and Research

While it is known that client factors account for the largest proportion of outcome variance across treatment modalities, little is known about how clients’ characteristics affect the process and effectiveness of couple therapy. To further knowledge in this area, we created a brief, practice‐friendly measure, the Expectation and Preference Scales for Couple Therapy (EPSCT). Three self‐report scales assess clients’ Outcome expectations (e.g., I expect our relationship to improve as a result of couple therapy) and role expectations for Self (e.g., I expect to listen to my partner's concerns) and Partner (e.g., I expect my partner to blame me). Three Cognitive‐Behavioral, Emotionally Focused, and Family Systems preference scales use a forced‐choice format to measure the comparative strength of respondents’ preferences for interventions broadly reflective of each approach. A large item pool was developed from relevant literature and clinical experience and refined based on face and content analyses with two panels of experienced couple therapists and researchers. Across four studies with 1,175 participants, the scales’ internal consistency reliabilities were similar and their construct validity was supported with confirmatory factor analyses and significant correlations with several established measures, including expectation measures developed for individual psychotherapy and measures of attitudes toward professional help seeking and valuing personal growth. Across all studies, participants had stronger role expectations for themselves than their partners, although gender effects differed by sample. We discuss how to use the 15‐item EPSCT in clinical practice and in future research as a predictor of couple therapy processes and outcomes.     

Exploring the Enigmatic Link between Religion and Anti‐Black Attitudes

This review explores social psychological perspectives on the complex relationship between religion and anti‐Black prejudice in the United States. We examine the different ways in which religiosity has been conceptualized by behavioral scientists. We consider the methodological limitations of previous research, as well as how the advent of priming research introduces new empirical questions regarding religiosity and anti‐Black prejudice, such as whether activation of different religious conceptions (e.g., God versus religion) or priming via different types of stimuli (e.g., words versus images) produces different outcomes. Finally, we discuss the lack of diverse samples in the present literature and highlight the need for additional research with Black American respondents. Conclusions consider the real world implications of links between religion and anti‐Blackness for both White individuals (e.g., intergroup relations) and Black individuals (e.g., psychological functioning).     

心理学视角下的道德损伤

道德损伤是指个体实施、未能阻止、目睹或听闻违背自身深层的道德信念和期望的行为, 对心理、生理、精神、行为和社会的持久影响。道德损伤作为一个跨学科概念, 自2009年Litz从心理学角度对其重新做出界定以来, 在心理学、伦理学、精神病学、社会学等领域引起了广泛关注。目前研究者已经编制出多个多维度量表来对道德损伤的事件或症状进行测量, 运用认知行为疗法、认知加工疗法和针对道德损伤研发的适当暴露疗法等措施来进行干预。未来的研究可以继续深入探究道德损伤的发生发展机制, 确立道德损伤的诊断标准, 推广道德损伤的适用范围, 丰富道德损伤的内涵, 从而拓展道德损伤研究的广度和深度。     

THE PERVERSITY OF INANIMATE OBJECTS: STIMULUS CONTROL BY INCIDENTAL MUSICAL NOTATION

Social cognition research suggests that incidental, environmental stimuli (e.g., business suits) can nonconsciously influence the degree to which behavioral dispositions (e.g., competitiveness) are expressed. Similarly, cognitive research suggests that incidental action-related objects (e.g., hammers) can prime action plans that then affect the speed with which a concurrent, intended action (e.g., power grip) is executed. However, whether incidental stimuli can instigate actions that run counter to one's current goals has yet to be determined. Moving beyond indirect effects, we show that such stimuli can directly cause the expression of undesired actions: Incidental stimuli resembling musical notation caused the systematic expression of unintended key presses in musicians, but not in nonmusicians. Moreover, the effect was found even when targets and distracters bore no apparent perceptual or semantic relation. We discuss the implications of these findings for models of action production and for social-cognitive concepts (e.g., applicability) regarding the limits of nonconscious processing.     

老年人医疗语篇理解的影响因素和补偿模型

医疗语篇理解是老年人实现自我照护的关键因素,改善老年人医疗语篇理解有助于提高其生存质量并节约医疗成本。本文整理了老年人医疗语篇理解的影响因素,包括加工能力等老年人个体因素和可读性等语篇设计因素,并在此基础上提出了老年人医疗语篇理解补偿模型。该模型尝试阐述上述各影响因素中,那些随龄衰退的因素(如加工能力),如何从别的因素中得到补偿(如医疗知识),从而支撑老年人的医疗语篇理解。补偿模型有利于干预研究的设计,但也还有待更多的实证研究。     

Victim and Perpetrator Groups’ Divergent Perspectives on Collective Violence: Implications for Intergroup Relations

Groups in conflict develop strikingly different construals of the same violent events. These clashing perceptions of past violence can have detrimental consequences for intergroup relations and might provoke new hostilities. In this article, we integrate and juxtapose what we know about construals of collective violence by delineating the different dimensions along which these construals differ between victim and perpetrator groups: regarding the question of who is the victim, who is responsible for the harm doing, what the perpetrator’s intent was, how severe the violence was, and when it took place. Then, we discuss the individual‐ and group‐level factors (e.g., collective narratives, social identities) that shape these construals, as well as their implications for attitudes regarding the conflict and support for relevant policies. We distinguish two different core motives that drive construals and their outcomes among victim and perpetrator groups: Perpetrator groups try to cope with moral identity threats and preserve a positive image of the ingroup, while victim groups try to protect their ingroup from future harm doing and desire acknowledgment of their group’s experiences. Lastly, we discuss implications for strategies and interventions to address victim and perpetrator groups’ divergent perspectives of collective violence.     

Is early identification of children of alcoholics necessary for preventive intervention? Reaction to Havey and Dodd

Havey and Dodd (1995, this issue) address the question of how to best identify early adolescents who are at risk for later substance abuse, with a particular focus on children of alcoholics (COAs). They conclude that stressful family events are preferable to COA status as an at-risk indicator. In addition, they question the well-substantiated at-risk status of COAs, claiming support for the null hypothesis regarding individual and family differences between COAs and non-COAs. This article addresses both conceptual and methodological concerns about identification and intervention for COAs in general, and about the Havey and Dodd study in particular. I first discuss a theoretically-empirically based approach to identification and risk prevention that supports a more complex, less parsimonious, model than that suggested by Havey and Dodd. Second, I present research to support the at-risk status of COAs. Third, I discuss issues related to identification of COAs and question the validity of Havey and Dodd's identification techniques. On the basis of conceptual and methodological arguments, I contend that Havey and Dodd's conclusions are not well-founded in their own or others' research and that the at-risk status of COAs cannot be dismissed on the basis of their research. I also contend that early identification may not be necessary for intervention with COAs or other at-risk groups. Alternatively, primary prevention programs provide the context for both service delivery and identification of individuals who might not otherwise be easily identified, particularly those at risk for developing mental health problems because of family environment factors (e.g., family alcoholism or conflict), or those currently experiencing mild or internalized (e.g., depression) adjustment difficulties.     

Preschoolers' use of spatiotemporal history, appearance, and proper name in determining individual identity

Humans construe their environment as composed largely of discrete individuals, which are also members of kinds (e.g., trees, cars, and people). On what basis do young children determine individual identity? How important are featural properties (e.g., physical appearance, name) relative to spatiotemporal history? Two studies examined the relative importance of these factors in preschoolers' and adults' identity judgments. Participants were shown pairs of individuals who looked identical but differed in their spatiotemporal history (e.g., two physically distinct but identical Winnie-the-Pooh dolls), and were asked whether both members in the pair would have access to knowledge that had been supplied to only one of the pairs. The results provide clear support for spatiotemporal history as the primary basis of identity judgments in both preschoolers and adults, and further place issues of identity within the broader cognitive framework of psychological essentialism.     

Effects of Situational Cues on Aggressive Behavior

Numerous situational factors are known to increase the likelihood that a person will behave aggressively. The current review addresses what is currently understood about the relationship between three theoretically relevant situational variables (the presence of weapons, alcohol cues, and exposure to media violence) and aggressive behavior. Theoretical models of aggression generally propose heightened accessibility of aggressive cognitions (i.e., priming) as a common mechanism to explain effects of these variables on aggression but differ in terms of factors that modulate whether and how activated mental content will influence behavior. Here, we discuss these factors and suggest ways in which models of priming might be integrated. We also underscore that, although aggression has been the focus of considerable research for decades, much more research is needed to better understand the psychological and biological processes that mediate effects of situational cues on aggression in humans.     

Taxonomic and thematic organisation of proper name conceptual knowledge

We report the investigation of the organisation of proper names in two aphasic patients (NBC and FBI). The performance of both patients on spoken word to written word matching tasks was inconsistent, affected by presentation rate and semantic relatedness of the competing responses, all hallmarks of a refractory semantic access dysphasia. In a series of experiments we explored the semantic relatedness effects within their proper name vocabulary, including brand names and person names. First we demonstrated the interaction between very fine grain organisation and personal experience, with one patient with a special interest in the cinema demonstrating higher error rates when identifying the names of actors working in a similar film genre (e.g., action movies: Arnold Schwarzenegger, Bruce Willis, Sylvester Stallone, Mel Gibson) than those working in different genres (e.g., Arnold Schwarzenegger, Gregory Peck, Robin Williams, Gene Kelly). Second we compared directly two potential principles of semantic organisation - taxonomic and thematic. Furthermore we considered these principles of organisation in the context of the individuals' personal knowledge base. We selected topics matching the interests and experience of each patient, namely cinema and literature (NBC) and naval history (FBI). The stimulus items were arranged in taxonomic arrays (e.g., Jane Austen, Emily Bronte, Agatha Christie), thematic arrays (e.g., Jane Austen, Pride and Prejudice, Mr Darcy), and unrelated arrays (e.g., Jane Austen, Wuthering Heights, Hercule Poirot). We documented that different patterns of taxonomic and thematic organisation were constrained by whether the individual has limited knowledge, moderate knowledge or detailed knowledge of a particular vocabulary. It is suggested that moderate proper name knowledge is primarily organised by taxonomy whereas extensive experience results in a more detailed knowledge base in which theme is a powerful organising principle.     

Explaining use of information in public policymaking

In recent years, scholars have attempted to understand the role of information in policymaking by developing several models of information utilization and have tested them empirically, at both national and state levels. This paper has called into question past studies as they relate to describing and explaining use of information. This paper tests an integrated model of information utilization that contains four sets of primary variables: decision makers’ environments (i.e., nature of policy issues), organization, individual characteristics, and characteristics of information. Based on the conceptual framework, a path model is built and tested against data about knowledge utilization and policy change in two areas of mental health policy (i.e., service and financing). The findings of the study have demonstrated that decision makers’ behavior does not conform to the assumptions put forward by either the organizational interest (e.g., information source or content of information) or the communications perspective (e.g., decision makers’ attitudes toward social science research). Instead, we have shown that information utilization is affected directly and indirectly by a variety of factors and their linkage, and not dominated by one set of factors that is defined by a singe perspective. The most important paths in the model are those between factors associated with information (e.g., the amount of information received or information source) and the use of information. Interestingly, these factors also play the role of major intervening mechanisms for linking other factors to decision makers’ use of information. More importantly, the general pattern of the findings indicates that policy areas make a difference in the process of information utilization.     

Individual differences in current events knowledge: Contributions of ability,personality, and interests

What accounts for individual differences in the sort of knowledge that people may draw on in everyday cognitive tasks, such as deciding whom to vote for in a presidential election, how to invest money in the stock market, or what team to bet on in a friendly wager? In a large sample of undergraduate students, we investigated correlates of individual differences in recently acquired knowledge of current events in domains such as politics, business, and sports. Structural equation modeling revealed two predictive pathways: one involving cognitive ability factors and the other involving two major nonability factors (personality and interests). The results of this study add to what is known about the sources of individual differences in knowledge and are interpreted in the context of theoretical conceptions of adult intelligence that emphasize the centrality and importance of knowledge (e.g., Ackerman, 1996; Cattell, 1971).     

Can Psychotherapy Research Serve as a Guide for Research About Executive Coaching? An Agenda for the Next Decade

Although there are important differences between psychotherapy and executive coaching, both seek to bring about behavior change and both involve a relationship between a professional (e.g., therapist, coach) and a client (e.g., patient, executive). Numerous meta-analyses conducted over the past 30 years have established the efficacy of psychotherapy, but research on the efficacy of executive coaching is scarce at best. Based on a review of meta-analyses of psychotherapy, I present eight questions to guide research concerning executive coaching. For each question, I present the results of psychotherapy meta-analyses and discuss the implications for executive coaching research and practice. The voluminous history of psychotherapy research points to important questions and methodological issues that should guide future research about the impact and practice of executive coaching.     

Multifactorial processes in recovery from aphasia: developing the foundations for a multileveled framework

This paper develops the foundations for a framework of recovery from aphasia which attempts to integrate knowledge from several domains to form a basis for an approach to treatment as managed recovery. We still have a mainly operational appreciation of recovery derived from atheoretical group investigations using psychometric batteries and generic definitions of aphasia and a lack of clarity in the use of the terms restoration, compensation, and reorganization. There is a failure to appreciate the interrelation of different levels (e.g., neural, cognitive, behavioral) and the importance of different perceptions (e.g., patient, relative, clinician) in individual recovery. The multileveled framework may improve understanding of what underlies individual recovery and form a framework for mapping interactions between levels as a basis for intervention.