Relationship between transdiagnostic dimensions of psychopathology and traumatic brain injury (TBI): A TRACK-TBI study.

IF 4.6 1区 心理学 Q1 Medicine
Journal of abnormal psychology Pub Date : 2021-07-01 Epub Date: 2021-06-10 DOI:10.1037/abn0000672
Lindsay D Nelson, Mark D Kramer, Keanan J Joyner, Christopher J Patrick, Murray B Stein, Nancy Temkin, Harvey S Levin, John Whyte, Amy J Markowitz, Joseph Giacino, Geoffrey T Manley
{"title":"Relationship between transdiagnostic dimensions of psychopathology and traumatic brain injury (TBI): A TRACK-TBI study.","authors":"Lindsay D Nelson,&nbsp;Mark D Kramer,&nbsp;Keanan J Joyner,&nbsp;Christopher J Patrick,&nbsp;Murray B Stein,&nbsp;Nancy Temkin,&nbsp;Harvey S Levin,&nbsp;John Whyte,&nbsp;Amy J Markowitz,&nbsp;Joseph Giacino,&nbsp;Geoffrey T Manley","doi":"10.1037/abn0000672","DOIUrl":null,"url":null,"abstract":"<p><p>Neuropsychiatric symptoms are common, comorbid, and often disabling for patients with traumatic brain injury (TBI). Identifying transdiagnostic symptom dimensions post-TBI may help overcome limitations of traditional psychiatric diagnoses and advance treatment development. We characterized the dimensional structure of neuropsychiatric symptoms at 2-weeks postinjury in n = 1,732 TBI patients and n = 238 orthopedic-injured trauma controls (OTC) from the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Symptoms were reported on the Brief Symptom Inventory-18, Patient Health Questionnaire-9 Depression checklist, PTSD Checklist for DSM-5, PROMIS Pain Intensity scale, and Insomnia Severity Index. We established a novel factor model of neuropsychiatric symptoms and evaluated how 3 TBI severity strata and OTC patients differed in symptom severity. The final factor model had 6 first-order factors subsumed by 2 second-order factors: Internalizing (encompassing Depression, Anxiety, and Fear) and Somatic symptoms (Sleep, Physical, Pain). Somatic symptoms fit better as a correlated factor of (vs. a lower-order factor within) Internalizing. All symptom dimensions except for Pain were more severe in 1 or more TBI subgroups, as compared to the OTC group. Milder brain injury was generally associated with more severe symptoms, whereas more general injury severity (higher level of care, e.g., emergency department, intensive care unit) was associated with more pain. The findings indicate a broad factor resembling the internalizing factor of general psychopathology in traumatically injured patients, alongside a distinct somatic symptom factor. Brain injury, especially milder brain injury, may exacerbate liabilities toward these symptoms. These neuropsychiatric dimensions may help advance more precision medicine research for TBI. (PsycInfo Database Record (c) 2021 APA, all rights reserved).</p>","PeriodicalId":14793,"journal":{"name":"Journal of abnormal psychology","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552293/pdf/nihms-1748216.pdf","citationCount":"15","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of abnormal psychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1037/abn0000672","RegionNum":1,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/6/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 15

Abstract

Neuropsychiatric symptoms are common, comorbid, and often disabling for patients with traumatic brain injury (TBI). Identifying transdiagnostic symptom dimensions post-TBI may help overcome limitations of traditional psychiatric diagnoses and advance treatment development. We characterized the dimensional structure of neuropsychiatric symptoms at 2-weeks postinjury in n = 1,732 TBI patients and n = 238 orthopedic-injured trauma controls (OTC) from the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Symptoms were reported on the Brief Symptom Inventory-18, Patient Health Questionnaire-9 Depression checklist, PTSD Checklist for DSM-5, PROMIS Pain Intensity scale, and Insomnia Severity Index. We established a novel factor model of neuropsychiatric symptoms and evaluated how 3 TBI severity strata and OTC patients differed in symptom severity. The final factor model had 6 first-order factors subsumed by 2 second-order factors: Internalizing (encompassing Depression, Anxiety, and Fear) and Somatic symptoms (Sleep, Physical, Pain). Somatic symptoms fit better as a correlated factor of (vs. a lower-order factor within) Internalizing. All symptom dimensions except for Pain were more severe in 1 or more TBI subgroups, as compared to the OTC group. Milder brain injury was generally associated with more severe symptoms, whereas more general injury severity (higher level of care, e.g., emergency department, intensive care unit) was associated with more pain. The findings indicate a broad factor resembling the internalizing factor of general psychopathology in traumatically injured patients, alongside a distinct somatic symptom factor. Brain injury, especially milder brain injury, may exacerbate liabilities toward these symptoms. These neuropsychiatric dimensions may help advance more precision medicine research for TBI. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Abstract Image

Abstract Image

精神病理学跨诊断维度与创伤性脑损伤(TBI)的关系:一项TRACK-TBI研究。
创伤性脑损伤(TBI)患者的神经精神症状是常见的,共病的,并且经常致残。确定创伤性脑损伤后的跨诊断症状维度可能有助于克服传统精神病学诊断的局限性,并促进治疗的发展。我们从TBI的转化研究和临床知识(TRACK-TBI)研究中对n = 1,732名TBI患者和n = 238名骨科损伤创伤对照(OTC)患者在损伤后2周的神经精神症状的维度结构进行了表征。症状以简短症状量表-18、患者健康问卷-9抑郁检查表、DSM-5 PTSD检查表、PROMIS疼痛强度量表和失眠严重程度指数进行报告。我们建立了一种新的神经精神症状因素模型,并评估了3个TBI严重程度层和OTC患者在症状严重程度上的差异。最后的因子模型有6个一级因子被2个二级因子所包含:内化(包括抑郁、焦虑和恐惧)和躯体症状(睡眠、身体、疼痛)。躯体症状更适合作为内化的相关因素(相对于低阶因素)。与OTC组相比,1个或多个TBI亚组中除疼痛外的所有症状维度都更严重。轻度脑损伤通常与更严重的症状相关,而更一般的损伤严重程度(较高的护理水平,例如急诊科、重症监护病房)与更严重的疼痛相关。研究结果表明,在创伤性损伤患者中,有一个广泛的因素类似于一般精神病理的内化因素,同时还有一个明显的躯体症状因素。脑损伤,尤其是轻度脑损伤,可加重这些症状。这些神经精神维度可能有助于推进更精确的创伤性脑损伤医学研究。(PsycInfo Database Record (c) 2021 APA,版权所有)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
期刊介绍: The Journal of Abnormal Psychology® publishes articles on basic research and theory in the broad field of abnormal behavior, its determinants, and its correlates. The following general topics fall within its area of major focus: - psychopathology—its etiology, development, symptomatology, and course; - normal processes in abnormal individuals; - pathological or atypical features of the behavior of normal persons; - experimental studies, with human or animal subjects, relating to disordered emotional behavior or pathology; - sociocultural effects on pathological processes, including the influence of gender and ethnicity; and - tests of hypotheses from psychological theories that relate to abnormal behavior.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信