Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-25T05:02:24.841Z Has data issue: false hasContentIssue false

Impact of Self-Efficacy and Affective Functioning on Pediatric Concussion Symptom Severity

Published online by Cambridge University Press:  14 January 2021

Kesley A. Ramsey*
Affiliation:
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Christopher Vaughan
Affiliation:
Safe Concussion Outcome Recovery & Education (SCORE) Program, Division of Neuropsychology, Children’s National Hospital, Rockville, MD, USA
Barry M. Wagner
Affiliation:
Department of Psychology, The Catholic University of America, Washington, DC, USA
Joseph F. McGuire
Affiliation:
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Gerard A. Gioia
Affiliation:
Safe Concussion Outcome Recovery & Education (SCORE) Program, Division of Neuropsychology, Children’s National Hospital, Rockville, MD, USA
*
*Correspondence and reprint requests to: Kesley A. Ramsey, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 550 North Broadway, Suite 206, Baltimore, MD 21205, USA. E-mail: [email protected]

Abstract

Objective:

The purpose of this study was to examine whether self-efficacy predicted pediatric concussion symptom severity and explore whether affective mood states (e.g., depression) influenced this relationship.

Method:

Children (8–17 years) who were diagnosed with a concussion within 30 days of injury participated in the study (n = 105). Following a clinical assessment, participants and caregivers completed questionnaires that assessed overall concussion symptom severity and current depression symptoms. Participants also completed ratings capturing self-efficacy for managing concussion recovery.

Results:

Linear regression models revealed that greater levels of self-efficacy predicted lower parent- (R2 = 0.10, p = .001) and youth-rated (R2 = 0.23, p < .001) concussion symptom severity. Interestingly, depression symptoms moderated the relationship between self-efficacy and concussion symptom severity.

Conclusions:

Findings provide initial support for a relationship between self-efficacy and concussion outcomes and highlight the influence of depressive symptoms. Interventions that optimize youth’s self-efficacy have the potential to increase treatment adherence, reduce concussion symptom severity, and improve recovery prognosis.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Armbrust, W., Lelieveld, O.H.T.M., Tuinstra, J., Wulffraat, N.M., Bos, G.J.F.J., Cappon, J., … Hagedoorn, M. (2016). Fatigue in patients with Juvenile Idiopathic Arthritis: relationship to perceived health, physical health, self-efficacy, and participation. Pediatric Rheumatology, 14(1), 19. https://doi.org/10.1186/s12969-016-0125-1 CrossRefGoogle ScholarPubMed
Bandura, A. (1997). Self-Efficacy: The Exercise of Control. New York, NY: Macmillan.Google Scholar
Belanger, H.G., Barwick, F., Silva, M.A., Kretzmer, T., Kip, K.E., & Vanderploeg, R.D. (2015). Web-based psychoeducational intervention for postconcussion symptoms: a randomized trial. Military Medicine, 180(2), 192200. https://doi.org/10.7205/MILMED-D-14-00388 CrossRefGoogle ScholarPubMed
Bryan, M.A., Rowhani-Rahbar, A., Comstock, R.D., Rivara, F., & Seattle Sports Concussion Research Collaborative. (2016). Sports- and recreation-related concussions in US youth. Pediatrics, 138(1), e20154635. https://doi.org/10.1542/peds.2015-4635 CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. (2015). Report to Congress on Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation. Atlanta, GA: National Center for Injury Prevention and Control; Division of Unintentional Injury Prevention.Google Scholar
Centers for Disease Control and Prevention. (2019). Surveillance Report of Traumatic Brain Injury-related Emergency Department Visits, Hospitalizations, and Deaths-- United States, 2014. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.Google Scholar
Chorpita, B., Moffitt, C.E., & Gray, J. (2005). Psychometric properties of the Revised Child Anxiety and Depression Scale in a clinical sample. Behaviour Research and Therapy, 43(3), 309322. https://doi.org/10.1016/j.brat.2004.02.004 CrossRefGoogle Scholar
DeMatteo, C.A., Lin, C.-Y.A., Foster, G., Giglia, L., Thabane, L., Claridge, E., … Connolly, J.F. (2019). Evaluating adherence to return to school and activity protocols in children after concussion. Clinical Journal of Sport Medicine, 18. https://doi.org/10.1097/JSM.0000000000000800 Google Scholar
Ebesutani, C., Bernstein, A., Nakamura, B.J., Chorpita, B.F., Weisz, J.R., & The Research Network on Youth Mental Health (2010). A psychometric analysis of the Revised Child Anxiety and Depression Scale? Parent version in a clinical sample. Journal of Abnormal Child Psychology, 38, 249260.CrossRefGoogle Scholar
Gioia, G.A. (2015). Multimodal evaluation and management of children with concussion: Using our heads and available evidence. Brain Injury, 29(2), 195206. https://doi.org/10.3109/02699052.2014.965210 CrossRefGoogle ScholarPubMed
Gioia, G.A., Vaughan, C.G., & Sady, M.D. (2019). PostConcussion Symptom Inventory-2 (PCSI-2). Lutz, FL: PAR.Google Scholar
Gornall, A., Takagi, M., Clarke, C., Babl, F.E., Davis, G.A., Dunne, K., … Anderson, V. (2019). Behavioral and emotional difficulties after pediatric concussion. Journal of Neurotrauma, 37(1), 163169. https://doi.org/10.1089/neu.2018.6235 CrossRefGoogle ScholarPubMed
Ho, R.A., Hall, G.B., Noseworthy, M.D., & DeMatteo, C. (2020). Post-concussive depression: Evaluating depressive symptoms following concussion in adolescents and its effects on executive function. Brain Injury, 34(4), 520527.CrossRefGoogle ScholarPubMed
Hwang, V., Trickey, A.W., Lormel, C., Bradford, A.N., Griffen, M.M., Lawrence, C.P., … Howell, J.M. (2014). Are pediatric concussion patients compliant with discharge instructions? Journal of Trauma and Acute Care Surgery, 77(1), 117122. https://doi.org/10.1097/TA.0000000000000275 CrossRefGoogle ScholarPubMed
Kavanagh, D.J. (2014). Self-efficacy and depression. In R. Schwarzer (Ed.), Self-efficacy: Thought Control of Action (pp. 177–193). https://psycnet.apa.org/record/1992-97719-008 Google Scholar
Keightley, M.L., Côté, P., Rumney, P., Hung, R., Carroll, L.J., Cancelliere, C., & Cassidy, J.D. (2014). Psychosocial consequences of mild traumatic brain injury in children: results of a systematic review by the International Collaboration on Mild Traumatic Brain Injury Prognosis. Archives of Physical Medicine and Rehabilitation, 95(3 Suppl), S192S200. https://doi.org/10.1016/j.apmr.2013.12.018 CrossRefGoogle ScholarPubMed
Laliliberté Durish, C., Pereverseff, R.S., & Yeates, K.O. (2018). Depression and depressive symptoms in pediatric traumatic brain injury: a scoping review. Journal of Head Trauma Rehabilitation, 33(3), E18E30. https://doi.org/10.1097/HTR.0000000000000343 CrossRefGoogle Scholar
Langlois, J.A., Rutland-Brown, W., & Wald, M.M. (2006). The epidemiology and impact of traumatic brain injury: a brief overview. The Journal of Head Trauma Rehabilitation, 21(5), 375378.CrossRefGoogle ScholarPubMed
Lumba-Brown, A., Yeates, K.O., Sarmiento, K., Breiding, M.J., Haegerich, H., Gioia, G.A., … Timmons, S.D. (2018). Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatrics, 172(11), e182853. https://doi.org/10.1001/jamapediatrics.2018.2853 CrossRefGoogle ScholarPubMed
Maddux, J.E. & Kleiman, E.M. (2016). Self-efficacy: a foundational concept for positive clinical psychology. In Wood, A.M. & Johnson, J. (Eds.), The Wiley Handbook of Positive Clinical Psychology (1st ed., pp. 89101). West Susex, UK: John Wiley & Sons, Ltd.CrossRefGoogle Scholar
Marks, R. & Allegrante, J.P. (2005). A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (Part II). Health Promotion Practice, 6(2), 148156. https://doi.org/10.1177/1524839904266792 CrossRefGoogle Scholar
McCrory, P., Meeuwisse, W., Dvorak, J., Aubry, M., Bailes, J., Broglio, S., … Vos, P.E. (2017). Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. British Journal of Sports Medicine, 51(11), 838847. https://doi.org/10.1136/bjsports-2017-097699 Google Scholar
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Ayton, G., Nelms, R., … Ng, K. (2001). Impact of early intervention on outcome after mild traumatic brain injury in children. Pediatrics, 108(6), 12971303. https://doi.org/10.1542/peds.108.6.1297 CrossRefGoogle ScholarPubMed
Rose, S.C., Weber, K.D., Collen, J.B., & Heyer, G.L. (2015). The diagnosis and management of concussion in children and adolescents. Pediatric Neurology, 53(2), 108118. https://doi.org/10.1016/j.pediatrneurol.2015.04.003 CrossRefGoogle ScholarPubMed
Sady, M.D., Vaughan, C.G., & Gioia, G.A. (2014). Psychometric characteristics of the Postconcussion Symptom Inventory in children and adolescents. Archives of Clinical Neuropsychology, 29(4), 348363. https://doi.org/10.1093/arclin/acu014 CrossRefGoogle ScholarPubMed
Scheenen, M.E., van der Horn, H.J., de Koning, M.E., van der Naalt, J., & Spikman, J.M. (2017). Stability of coping and the role of self-efficacy in the first year following mild traumatic brain injury. Social Science & Medicine (1982), 181, 184190. https://doi.org/10.1016/j.socscimed.2017.03.025 CrossRefGoogle ScholarPubMed
Steele, M.M., Daratha, K.B., Bindler, R.C., & Power, T.G. (2011). The relationship between self-efficacy for behaviors that promote healthy weight and clinical indicators of adiposity in a sample of early adolescents. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 38(6), 596602. https://doi.org/10.1177/1090198110387514 CrossRefGoogle Scholar
Terwilliger, V.K., Pratson, L., Vaughan, C.G., & Gioia, G.A. (2016). Additional post-concussion impact exposure may affect recovery in adolescent athletes. Journal of Neurotrauma, 33(8), 761765. https://doi.org/10.1089/neu.2015.4082 CrossRefGoogle ScholarPubMed
Woodrome, S.E., Yeates, K.O., Taylor, H.G., Rusin, J., Bangert, B., Dietrich, A., … Wright, M. (2011). Coping strategies as a predictor of post-concussive symptoms in children with mild traumatic brain injury versus mild orthopedic injury. Journal of the International Neuropsychological Society: JINS, 17(2), 317326. https://doi.org/10.1017/S1355617710001700 CrossRefGoogle ScholarPubMed
Zebracki, K. & Drotar, D. (2004). Outcome expectancy and self-efficacy in adolescent asthma self-management. Children's Health Care, 33(2), 133149.CrossRefGoogle Scholar
Zemek, R.L., Farion, K.J., Sampson, M., & McGahern, C. (2013). Prognosticators of persistent symptoms following pediatric concussion: a systematic review. JAMA Pediatrics, 167(3), 259265. https://doi.org/10.1001/2013.jamapediatrics.216 CrossRefGoogle ScholarPubMed
Supplementary material: File

Ramsey et al. supplementary material

Table S1

Download Ramsey et al. supplementary material(File)
File 14.2 KB