Indexing
All Issues
Submission
Author Guidelines
Reviewers
Editorial Members
Publication Fee
Vol.5 , No. 2, Publication Date: Apr. 16, 2019, Page: 49-52
. The present study focussed only on the posttraumatic neuropsychological symptoms and evaluated which components (i.e., symptom groupings) within the spectrum of post-concussion and whiplash symptoms can be detected via factor analysis. Method: The principal component analysis was carried out on 6 initial symptoms of cerebral concussion, on all 16 items of the Rivermead post-concussion scale, and on 8 other post-accident neurological symptoms (hand tremor, tingling, numbness, or loss of feeling in the limbs, impaired bladder or bowel control, impaired muscular control over upper or lower limbs). The analysis included data from 90 adult survivors of car accidents (mean age 42.0 years, SD=13.6; 33 males, 57 females) interviewed at 2 to 33 months after their accident. Only component loadings above .450 were included in the interpretations. Results: The first factor explained 25.9% of the variance and primarily consisted of classical signs of the post-concussion syndrome (cognitive and visual impairments, headaches, dizziness, nausea, and restlessness). The second factor explained 9.4% of the total variance and consisted solely of paresthesia in the limbs (tingling or numbness). Discussion: This study did not include measures of pain and of PTSD which are also an important part of the post-accident spectrum of symptoms. Factor-analytic or inter-correlational studies on all elements of Lew’s Polytrauma Clinical Triad would be of interest in further research.&picture=http://www.aascit.org/aascit/decorators/img/journal/929.jpg)
| [1] | Zack Cernovsky, Department of Psychiatry, University of Western Ontario (also Known as Western University), London, Canada. |
| [2] | Larry Litman, Department of Psychiatry, University of Western Ontario (also Known as Western University), London, Canada. |
| [3] | James Mendonca, Department of Psychiatry, University of Western Ontario (also Known as Western University), London, Canada. |
| [4] | Yves Bureau, Department of Psychiatry, University of Western Ontario (also Known as Western University), London, Canada. |
| [5] | Paul Istasy, Departments of Physiology, Pharmacology, and Psychology, University of Western Ontario, London, Canada. |
Background and Objective: Recent studies by neuropathologists such as Omalu showed that cerebral concussions can occur even without visible head injuries and without a full loss of consciousness or loss of ability to perform simple tasks. Undiagnosed concussions remain a major public health problem, especially in patients who experience a complete Lew’s Polytrauma Clinical Triad (persistent post-concussion syndrome, pain, and PTSD). The present study focussed only on the posttraumatic neuropsychological symptoms and evaluated which components (i.e., symptom groupings) within the spectrum of post-concussion and whiplash symptoms can be detected via factor analysis. Method: The principal component analysis was carried out on 6 initial symptoms of cerebral concussion, on all 16 items of the Rivermead post-concussion scale, and on 8 other post-accident neurological symptoms (hand tremor, tingling, numbness, or loss of feeling in the limbs, impaired bladder or bowel control, impaired muscular control over upper or lower limbs). The analysis included data from 90 adult survivors of car accidents (mean age 42.0 years, SD=13.6; 33 males, 57 females) interviewed at 2 to 33 months after their accident. Only component loadings above .450 were included in the interpretations. Results: The first factor explained 25.9% of the variance and primarily consisted of classical signs of the post-concussion syndrome (cognitive and visual impairments, headaches, dizziness, nausea, and restlessness). The second factor explained 9.4% of the total variance and consisted solely of paresthesia in the limbs (tingling or numbness). Discussion: This study did not include measures of pain and of PTSD which are also an important part of the post-accident spectrum of symptoms. Factor-analytic or inter-correlational studies on all elements of Lew’s Polytrauma Clinical Triad would be of interest in further research.
Keywords
Cerebral Concussion, Post-Concussion Syndrome, Whiplash, Polytrauma Clinical Triad, Spinal Injury, Axonal Shearing, Car Accidents
Reference
| [01] | Omalu BI, DeKosky ST, Minster RL, et al. (2005). Chronic traumatic encephalopathy in a National Football League player. Neurosurgery, 57, 128–34. |
| [02] | Omalu BI, DeKosky ST, Hamilton RL, et al. (2006). Chronic traumatic encephalopathy in a National Football League player: Part II. Neurosurgery, 59, 1086-92. |
| [03] | Mez J, Daneshvar DH, Kiernan PT, et al. (2017). Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football. Journal of the American Medical Association - JAMA, 318, 360-70. |
| [04] | Cernovsky Z., Istasy P., Bureau Y., & Chiu S. (2018). Scale for retrospective assessment of immediate concussion symptoms. Mental Illness, 10 (2), 70-71 and multilingual Appendix (2 pages). https://doi.org/10.4081/mi.2018.7901 |
| [05] | Lew HL, Otis JD, Tun C, Kerns RD, Clark ME, Cifu DX. (2009). Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: polytrauma clinical triad. Journal of Rehabilitation Research and Development, 46 (6), 697-702. |
| [06] | Peixoto C, Hyland L, Buchanan DM, Langille E, Nahas R. (2018). The polytrauma clinical triad in patients with chronic pain after motor vehicle collision. Journal of Pain Research, 11, 1927–1936. |
| [07] | Eyres S, Carey A, Gilworth G, et al. (2005). Construct validity and reliability of the Rivermead Post-Concussion Symptoms Questionnaire. Clinical Rehabilitation, 19, 878-87. |
| [08] | Cernovsky Z., Istasy P., Bureau Y., & Chiu S. (2018). Quantifying post-accident neurological symptoms other than concussion. Paper presented in the Congress of the World Psychiatric Association, Mexico City, Mexico, September 27-30, 2018. |
| [09] | Cernovsky ZZ, Istasy PVF, Hernández-Aguilar ME, Mateos-Moreno A, Bureau Y, Chiu S. (2019). Quantifying Post-Accident Neurological Symptoms Other than Concussion. Archives of Psychiatry and Behavioral Science, 2 (1), 50-54. |
| [10] | Barker-Collo S, Theadom A, Starkey NJ, Kahan M, Jones K, Feigin V. (2019). Long-term factor structure of the Rivermead Post-Concussion Symptom Questionnaire in mild traumatic brain injury and normative sample. Brain Injury, 33 (5), 618-622. doi: 10.1080/02699052.2019.1570339. |
| [11] | Smith GP and Burger GK. (1997). Detection of malingering: Validation of the Structured Inventory of Malingered Symptomatology (SIMS). Journal of the American Academy on Psychiatry and Law, 25, 180-183. |
| [12] | Widows MR and Smith GP. (2005). Structured Inventory of Malingered Symptomatology - Professional Manual. Lutz, FL: PAR Inc. |
| [13] | Cernovsky Z, Ferrari J, Mendonca J. (2019). Deceptive Clinical Diagnosing of Malingering via Structured Inventory of Malingered Symptomatology. Archives of Psychiatry and Behavioral Sciences, 2 (1), 44-49. |
| [14] | VanImpelen A, Merckelbach H, Jelicic M, Merten T. (2014). The Structured Inventory of Malingered Symptomatology (SIMS): a systematic review and meta-analysis. The Clinical Neuropsychologist, 28 (8), 1336-65. doi: 10.1080/13854046.2014.984763. |
| [15] | American Educational Research Association, American Psychological Association, National Council on Measurement in Education (2014). The Standards for Educational and Psychological Testing. AERA Publications, Washington, DC. |
