Development and preliminary validation of the Paediatric Awareness Questionnaire for children and adolescents with traumatic brain injury

There is a lack of validated measures for assessing self-awareness of deficits after pediatric traumatic brain injury (TBI). The current study aimed to develop and examine the psychometric properties of the Paediatric Awareness Questionnaire (PAQ), and investigate factors related to self-awareness. The PAQ was administered to 32 children aged 8–16 years with mild to severe TBI (72% male, M age = 11.75, SD = 2.9), their parents, and treating clinicians, and to 32 age- and gender-matched typically developing controls and their parents. Children with TBI and their parents also completed the Knowledge of Injury Checklist (KIC), and parents completed the Depression Anxiety and Stress Scale 21. The PAQ was found to have fair to excellent (α = .79–.97) internal consistency for all versions across both groups and good concordance between parent and clinician total scores (ICC = .78). There was also evidence of convergent validity between the PAQ and KIC for both child (r = ?.45, p < .05) and parent ratings (r = ?.66, p < .001). Poorer self-awareness was significantly related to younger age at injury for the TBI group and lower parental education for the total sample. ANCOVA identified that children with TBI demonstrated significantly poorer awareness than controls after controlling for parental education. Children with TBI typically overestimated their functioning compared to their parents, whereas typically developing children tended to rate their functioning lower than their parents. These findings provide preliminary support for the reliability and validity of the PAQ for assessing self-awareness after pediatric TBI.     

Women’s Perspectives Related to Occupational Performance Following Participation in Substance Use Recovery Programs

Very little research has examined how substance abuse programs affect occupational performance. The progression of addiction and its etiology for women are still under-reported. This study aimed to explore perceived effects of substance use and participation in peer-based programs on women’s occupational performance. Qualitative semi-structured interviews were completed with seven women. Four themes were identified: (1) substance use did not markedly inhibit participation in daily life; (2) recovery was supported by replacing substance related occupations with non-substance related occupations; (3) perceived value of shared perspectives and experiences with others; and (4) the embracing of new perspectives as part of recovery.     

Attentional bias toward emotional stimuli in accidentally injured Chinese patients with different posttraumatic growth levels

Extensive evidence has been obtained that supports an association between an attentional bias (AB) toward negative stimuli and vulnerability to stress-related psychopathology, little is known regarding the characteristics of individual AB in different posttraumatic growth (PTG) levels. The current study used a modified dot-probe task to investigate if individual differences in AB towards either positive or negative emotional stimuli, are related to self-reported PTG. A sample of 202 patients completed the experiment. Patients with low levels of PTG did not exhibit AB toward negative or positive stimuli, patients with medium levels of PTG had difficulty disengaging attention from negative stimuli, patients with high levels of PTG had difficulty disengaging attention from positive stimuli. And the AB towards positive stimuli was only predictive for PTG. An implication of this finding is that there are different characteristics of implicit cognitive processing in patients with different levels of PTG, suggesting the necessity of psychological intervention on the accidentally injured patients.     

Does multitasking mediate the relationships between episodic memory,attention, executive functions and apathetic manifestations in traumatic brain injury?

Apathy is frequently described in patients with traumatic brain injury (TBI); its negative consequences particularly affect functional independence. Among apathetic manifestations, lack of initiative and lack of interest have mainly been associated with cognitive impairments. However, few studies have been conducted to precisely identify the underlying cognitive processes. Our aims were (1) to determine the best predictor of apathy from among several cognitive processes, including episodic memory and attention/executive mechanisms and multitasking, and (2) to examine to what extent multitasking could mediate the relationships between specific cognitive processes and lack of initiative/interest. Seventy participants (34 patients with TBI matched with 36 control participants) were given a questionnaire to assess anxio‐depressive symptoms, four tasks to assess specific cognitive processes, and one task to assess real‐life multitasking. Participants’ relatives completed an apathy questionnaire. Multitasking, as assessed by the number of goals not achieved, was the only significant predictor of apathetic manifestations. In addition, the mediation analyses revealed that multitasking performance mediated the relationships between verbal episodic memory and lack of initiative/interest, whereas executive and attentional functions were only indirectly related to lack of initiative/interest due to their significant impacts on multitasking. These results shed new light on the aetiology of apathetic manifestations in patients with TBI, indicating how specific cognitive deficits are expressed in real‐life multitasking, and consequently, how they may lead to the development and/or maintenance of apathetic manifestations.     

非目标工作记忆表征下颜色关联和抽象关联的注意捕获和抑制

采用工作记忆—视觉搜索双任务范式,探讨在非目标工作记忆表征下,颜色关联和抽象关联干扰子的注意捕获和抑制现象。实验1结果发现,颜色关联干扰子在快速反应阶段捕获注意,随后被成功抑制;抽象关联干扰子仍能捕获注意。实验2消除知觉凸显后,结果发现颜色关联条件的抑制消失,干扰子重新捕获注意。结果表明,有效抑制策略受不同关联干扰子加工先后顺序的影响,选择性抑制颜色关联干扰子,而颜色特征的凸显有助于抑制策略形成。     

Neurocognitive functioning in patients with conversion disorder/functional neurological disorder

Neurocognitive symptoms are common in individuals with somatic symptom and related disorders (SSRD), but little is known about the specific impairments in neurocognitive domains in patients with conversion disorder (CD)/functional neurological disorder (FND). This study examines neurocognitive functioning in patients with CD/FND compared to patients with other SSRD. The sample consisted of 318 patients. Twenty-nine patients were diagnosed with CD/FND, mean age 42.4, standard deviation (SD) = 13.8 years, 79.3% women, and 289 patients had other SSRD (mean age 42.1, SD = 13.3, 60.2% women). Patients completed a neuropsychological test battery that addressed a broad range of neurocognitive domains, including information processing speed, attention and executive functioning. Patients with CD/FND had clinically significant neurocognitive deficits in all neurocognitive domains based on normative data comparison. Patients with CD/FND also performed significantly worse than patients with other SSRD on information processing speed (Digit Symbol Substitution Test (V = .115, p = .035), Stroop Color–Word Test (SCWT) card 1 (V = .190, p = .006), and SCWT card 2 (V = .244, p < .001). No CD/FND vs. other SSRD differences were observed in other neurocognitive domains. These findings indicate the patients with CD/FND perform worse on information processing speed tests compared to patients with other SSRD.     

High- compared to low-arched athletes exhibit smaller knee abduction moments in walking and running

High- (HA) and low-arched athletes (LA) experience distinct injury patterns. These injuries are the result of the interaction of structure and biomechanics. A suggested mechanism of patellofemoral pain pertains to frontal plane knee moments which may be exaggerated in LA athletes. We hypothesize that LA athletes will exhibit greater peak knee abduction moments than high-arched athletes.MethodsTwenty healthy female recreational athletes (10 HA and 10 LA) performed five over-ground barefoot walking and five barefoot running trials at a self-selected velocity while three-dimensional kinematics and ground reaction forces were recorded. Peak knee abduction moments and time-to-peak knee abduction moments were calculated using Visual 3D.ResultsHigh-arched athletes had smaller peak knee abduction moments compared to low-arched athletes during walking (KAM1: p = 0.019; KAM2: p = 0.015) and running (p = 0.010). No differences were observed in time-to-peak knee abduction moment during walking (KAM1: p = 0.360; KAM2: p = 0.085) or running (p = 0.359).ConclusionsThese findings demonstrate that foot type is associated with altered frontal plane knee kinetics which may contribute to patellofemoral pain. Future research should address the efficacy of clinical interventions including orthotics and rehabilitation programs in these athletes.     

Brain drawings following traumatic brain injury (TBI) and links to illness perceptions and health outcomes – Findings from a population-based study

Objective: Individuals’ illness perceptions predict health behaviours and influence functional outcomes. This study examined associations between a novel assessment of illness perceptions, in the form of adult’s brain drawings after traumatic brain injury (TBI) and questionnaire measures of illness perceptions, quality of life and post-concussive symptoms.

Design: Population-based, prospective longitudinal study examining 245 adults with predominantly mild TBI with high risk of complications.

Main outcome measures: Participants were asked to draw pictures of what they thought their brain looked like before injury and at baseline and one month post-injury. Drawing characteristics (height, width and percentage damage at one month) were examined in relation to each outcome of interest at six months.

Results: Greater damage at one month was associated with more negative illness perceptions (rs = .23), poorer mental health (rs = ?.21), and more total post-concussive symptoms (rs = .27 to r = .35) at six months. The extent of damage depicted reduced over time (p < .001). No associations were found between the amount of damage drawn and injury severity, nor the height or width of drawings and injury severity or illness perceptions.

Conclusion: Drawings post-TBI offer a simple, cost- and time-effective way to begin discussions and improve understanding of peoples’ illness perceptions.     

Public health consequences of road traffic injuries – Estimation of seriously injured persons based on risk for permanent medical impairment

Despite the fact, that Sweden has one of the safest traffic environments in the world, a large number of people are still injured in road traffic accidents in Sweden. The core concept of the Vision Zero that was adopted by the Swedish parliament in 1997 is to decrease the number of deaths and serious injuries caused by traffic. The vision has been followed-up in terms of decreased mortality, but there was not a consensus on how the concept “seriously injured” should be measured at that time. The aim of this paper is to describe how to develop a measure to estimate the number of seriously injured people in Sweden. The results show that it is possible to estimate the health impact of road traffic accidents based on the definition of medical impairment. According to the results, 8389 people were seriously injured (permanently medical impaired more then 1%) in the road transport area in Sweden in 2013. If the number of people who had slipped or fallen down without any vehicle being involved is excluded, the number of seriously injured was around 4700. The result of the study has been included in the road safety goal for Sweden with the aim to have 25% less seriously injured people in 2020 than the average for the years 2006–2008. The results also showed that 91% of the seriously injured were transported by car, bike or by foot. The relatively high proportion of pedestrian fall accidents happening within the transport system irrespective of whether a vehicle was moving or not raises the question whether these types of accidents should be included in the reporting of formal road traffic accidents.     

PREGNANT WOMEN'S RECOLLECTIONS OF EARLY MATERNAL BONDING: ASSOCIATIONS WITH MATERNAL–FETAL ATTACHMENT AND BIRTH CHOICES

Recollections of own maternal care measured by parental bonding were found to be important in the pregnant woman's construction of herself as a mother. Although these recollections were studied with regard to various variables, there is a dearth of studies associated with pregnancy and childbirth. In this cross‐sectional study, 341 pregnant women were recruited. Measures included a Sociodemographics–Obstetric History Questionnaire; the Childbirth Choices Questionnaire (H. Preis, M. Gozlan, U. Dan, & Y. Benyamini, 2018); the Parental Bonding Instrument (G. Parker, H. Tupling, & L.B. Brown, 1979); a question regarding the planned presence of the woman's mother at delivery; and the Maternal‐Fetal Attachment Scale (M.S. Cranley, 1981). Parental recollections of Care were associated with fewer natural birth choices (hence, a more “medicalized” delivery), lower maternal–fetal attachment, and a wish for the mother's mother to be present at the birth. Parental recollections of Encouragement of Behavioral Freedom in childhood were associated with more natural choices regarding childbirth. In addition, women with higher scores on the parental bonding Denial of Autonomy factor reported stronger maternal–fetal attachment. Thus, early recollections of experiences with caregivers as manifested in parental bonding may be a possible influence on the transition to motherhood, and working through possible difficulties associated with these recollections may improve adjustment to motherhood.