有创伤性脑损伤病史的退伍老兵的症状归因和神经心理学结果。

IF 2.4 4区 医学 Q2 CLINICAL NEUROLOGY
Victoria C Merritt, Grace J Goodwin, McKenna S Sakamoto, Laura D Crocker, Amy J Jak
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引用次数: 0

摘要

研究目的在这项横断面研究中,作者旨在考察有创伤性脑损伤(TBI)病史的退伍军人的疾病认知(以症状归因为衡量标准)与神经行为和神经认知结果之间的关系:这项研究包括 55 名寻求治疗的退伍军人(人数=43,并进行了充分的性能效度测试),他们都有远距离创伤性脑损伤病史(80% 为轻度创伤性脑损伤)。退伍军人完成了临床访谈、自我报告问卷和神经心理评估。对神经行为症状量表(NSI)进行了修改,以评估神经行为症状认可度和症状归因。根据标准化认知测试计算综合分数,以评估客观认知功能的具体方面,包括记忆、执行功能、注意力和工作记忆以及处理速度:最常归因于创伤性脑损伤的症状包括健忘、注意力不集中、思维迟缓和头痛。症状归因与总体症状认可度(NSI 总分)(r=0.675)和特定症状领域认可度(NSI 症状领域得分)(r=0.506-0.674)之间存在明显的正相关,表明将更多症状归因于创伤性脑损伤与更多症状认可度相关。此外,线性回归显示,症状归因与客观认知功能显著相关,而症状认可一般不显示这种关系。具体来说,将症状归因于创伤性脑损伤的程度越高,执行功能(β=-0.34)、注意力和工作记忆(β=-0.43)以及处理速度(β=-0.35)就越差:这些研究结果表明,经常将神经行为症状归因于创伤性脑损伤的退伍军人更有可能出现不良的长期结果,包括症状认可度升高和客观认知能力下降。虽然还需要更多的研究来了解疾病认知是如何影响这一人群的结果的,但这些初步结果突显了就创伤性脑损伤后的预期恢复过程进行早期心理教育的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Symptom Attribution and Neuropsychological Outcomes Among Treatment-Seeking Veterans With a History of Traumatic Brain Injury.

Objective: In this cross-sectional study, the authors aimed to examine relationships between illness perception, measured as symptom attribution, and neurobehavioral and neurocognitive outcomes among veterans with a history of traumatic brain injury (TBI).

Methods: This study included 55 treatment-seeking veterans (N=43 with adequate performance validity testing) with a remote history of TBI (80% with mild TBI). Veterans completed a clinical interview, self-report questionnaires, and a neuropsychological assessment. A modified version of the Neurobehavioral Symptom Inventory (NSI) was administered to assess neurobehavioral symptom endorsement and symptom attribution. Composite scores were calculated from standardized cognitive tests to assess specific aspects of objective cognitive functioning, including memory, executive functioning, attention and working memory, and processing speed.

Results: The symptoms most frequently attributed to TBI included forgetfulness, poor concentration, slowed thinking, and headaches. There was a significant positive association between symptom attribution and overall symptom endorsement (NSI total score) (r=0.675) and endorsement of specific symptom domains (NSI symptom domain scores) (r=0.506-0.674), indicating that greater attribution of symptoms to TBI was associated with greater symptom endorsement. Furthermore, linear regressions showed that symptom attribution was significantly associated with objective cognitive functioning, whereas symptom endorsement generally did not show this relationship. Specifically, greater attribution of symptoms to TBI was associated with worse executive functioning (β=-0.34), attention and working memory (β=-0.43), and processing speed (β=-0.35).

Conclusions: These findings suggest that veterans who routinely attribute neurobehavioral symptoms to their TBI are at greater risk of experiencing poor long-term outcomes, including elevated symptom endorsement and worse objective cognition. Although more research is needed to understand how illness perception influences outcomes in this population, these preliminary results highlight the importance of early psychoeducation regarding the anticipated course of recovery following TBI.

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来源期刊
CiteScore
5.30
自引率
3.40%
发文量
67
审稿时长
6-12 weeks
期刊介绍: As the official Journal of the American Neuropsychiatric Association, the premier North American organization of clinicians, scientists, and educators specializing in behavioral neurology & neuropsychiatry, neuropsychology, and the clinical neurosciences, the Journal of Neuropsychiatry and Clinical Neurosciences (JNCN) aims to publish works that advance the science of brain-behavior relationships, the care of persons and families affected by neurodevelopmental, acquired neurological, and neurodegenerative conditions, and education and training in behavioral neurology & neuropsychiatry. JNCN publishes peer-reviewed articles on the cognitive, emotional, and behavioral manifestations of neurological conditions, the structural and functional neuroanatomy of idiopathic psychiatric disorders, and the clinical and educational applications and public health implications of scientific advances in these areas. The Journal features systematic reviews and meta-analyses, narrative reviews, original research articles, scholarly considerations of treatment and educational challenges in behavioral neurology & neuropsychiatry, analyses and commentaries on advances and emerging trends in the field, international perspectives on neuropsychiatry, opinions and introspections, case reports that inform on the structural and functional bases of neuropsychiatric conditions, and classic pieces from the field’s rich history.
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