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  • 1
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    Online Resource
    Perceived cognitive impairment in high school students in the United States
    Frontiers Media SA ; 2022
    In:  Frontiers in Psychology Vol. 13 ( 2022-10-4)
    Details
    In: Frontiers in Psychology, Frontiers Media SA, Vol. 13 ( 2022-10-4)
    Abstract: Some youth experience cognitive difficulties that interfere with their ability to learn and function well in a school environment. We examined correlates of perceived cognitive impairment among high school students who completed a national survey conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019. Methods Participants were high school students (grades 9–12) who completed the Youth Risk Behavior Survey (YRBS) in 2019. The CDC uses this survey to monitor risk behaviors. Students answered the following question ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ as either ‘yes’ or ‘no.’ Student responses to this question were analyzed in relation to demographic variables and variables pertaining to adversity, mental health problems, and drug use. Results The sample included 8,349 students between the ages of 14 and 18, with 4,093 boys (49%) and 4,256 girls (51%). A large proportion reported having serious difficulty concentrating, remembering, or making decisions due to physical, mental, or emotional problems (38%). A significantly larger proportion of girls (45%) than boys (30%) reported experiencing cognitive impairment [ χ 2 (1) = 212.23, p   & lt; 0.001; Odds Ratio = 1.95, 95% confidence interval = 1.78–2.13]. Youth who exercised regularly were significantly less likely to report cognitive impairment. Binary logistic regression was used to examine the associations between perceived cognitive impairment and adversity, mental health, and lifestyle variables separately for boys [ χ 2 (11) = 569.158, p   & lt; 0.001; Nagelkerke R 2  = 0.212] and girls [ χ 2 (11) = 1,026.189, p   & lt; 0.001; Nagelkerke R 2  = 0.321]. Being bullied, feeling unsafe or threatened at school, getting very low grades, insufficient sleep, and using illicit drugs were independently associated with perceived cognitive impairment in both boys and girls—after controlling for associations with depression and suicidality. Youth who denied mental health problems, psychosocial adversities, and using illicit drugs reported much lower rates of perceived cognitive impairment (boys = 13%, girls = 15%). Conclusion A remarkably large proportion of high school students in the United States reported experiencing serious difficulty with their cognitive functioning over the past year. Girls were significantly more likely to endorse perceived cognitive difficulties compared to boys. There was a strong association between perceived cognitive impairment and the experience of psychosocial adversity.
    Type of Medium: Online Resource
    ISSN: 1664-1078
    URL: Article
    DOI: 10.3389/fpsyg.2022.1019159
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2563826-9
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  • 2
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    Adverse childhood experiences are associated with perceived cognitive difficulties among high school students in the United States
    Frontiers Media SA ; 2024
    In:  Frontiers in Psychology Vol. 15 ( 2024-2-5)
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    In: Frontiers in Psychology, Frontiers Media SA, Vol. 15 ( 2024-2-5)
    Abstract: Adverse childhood experiences (ACEs) are associated with mental health and cognitive problems, and mental health problems are associated with perceived cognitive difficulties among adolescents. The unique contribution of ACEs to cognitive difficulties after adjusting for poor mental health is not well understood and represents the purpose of this study. Methods The Adolescent Behaviors and Experiences Survey was conducted in 2021 with high school students in the United States. Cognitive difficulty was assessed with: ‘Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?’ Four ACEs were examined: sexual violence (lifetime and past 12 months), parental emotional abuse, and parental physical abuse. Students were asked about feeling sad or hopeless (past year), considering suicide (past year), and having poor mental health (past month). Binary logistic regressions examined the association between ACEs and cognitive problems, adjusting for mental health. Results Participants were 6,945 students. Students reporting poor mental health were very likely to endorse difficulty concentrating, remembering, or making decisions (girls = 81% and boys = 67%). Cognitive difficulty was uncommon among students who denied poor mental health (girls = 17% and boys = 12%). For boys [ p & lt; 0.001; R 2 = 0.22] and girls [ p & lt; 0.001; R 2 = 0.31], after adjusting for mental health problems, independent predictors of cognitive difficulties included parental verbal abuse and physical abuse. For girls, lifetime forced sexual intercourse and sexual violence during the past year were also independently associated. Conclusion ACEs are associated with perceived cognitive difficulty in both adolescent girls and boys, even after adjusting for poor mental health.
    Type of Medium: Online Resource
    ISSN: 1664-1078
    URL: Article
    DOI: 10.3389/fpsyg.2024.1293013
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2024
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  • 3
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    Suicide in Older Adult Men Is Not Related to a Personal History of Participation in Football
    Frontiers Media SA ; 2021
    In:  Frontiers in Neurology Vol. 12 ( 2021-11-26)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2021-11-26)
    Abstract: Introduction: It is reasonable to estimate that tens of millions of men in the United States played high school football. There is societal concern that participation in football confers risk for later-in-life mental health problems. The purpose of this study is to examine whether there is an association between a personal history of playing high school football and death by suicide. Methods: The subjects were obtained from the Lieber Institute for Brain Development (LIBD) brain donation program in collaboration with the Office of the Medical Examiner at Western Michigan University Homer Stryker MD School of Medicine. Donor history was documented via medical records, mental health records, and telephone interviews with the next-of-kin. Results: The sample included 198 men aged 50 or older (median = 65.0 years, interquartile range = 57–75). There were 34.8% who participated in contact sports during high school (including football), and 29.8% participated in high school football. Approximately one-third of the sample had suicide as their manner of death (34.8%). There was no statistically significant difference in the proportions of suicide as a manner of death among those men with a personal history of playing football compared to men who did not play football or who did not play sports ( p = 0.070, Odds Ratio, OR = 0.537). Those who played football were significantly less likely to have a lifetime history of a suicide attempt ( p = 0.012, OR = 0.352). Men with mood disorders ( p & lt; 0.001, OR = 10.712), substance use disorders ( p & lt; 0.020, OR = 2.075), and those with a history of suicide ideation ( p & lt; 0.001, OR = 8.038) or attempts ( p & lt; 0.001, OR = 40.634) were more likely to have suicide as a manner of death. Moreover, those men with a family history of suicide were more likely to have prior suicide attempts ( p = 0.031, OR = 2.153) and to have completed suicide ( p = 0.001, OR = 2.927). Discussion: Suicide was related to well-established risk factors such as a personal history of a mood disorder, substance abuse disorder, prior suicide ideation, suicide attempts, and a family history of suicide attempts. This study adds to a steadily growing body of evidence suggesting that playing high school football is not associated with increased risk for suicidality or suicide during adulthood.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2021.745824
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
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  • 4
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    Online Resource
    Data_Sheet_1.pdf
    Frontiers Media SA ; 2023
    In:  Frontiers in Neurology Vol. 14 ( 2023-6-19)
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    In: Frontiers in Neurology, Frontiers Media SA, Vol. 14 ( 2023-6-19)
    Abstract: We examined postmortem brain tissue from men, over the age of 50, for chronic traumatic encephalopathy neuropathologic change (CTE-NC). We hypothesized that (i) a small percentage would have CTE-NC, (ii) those who played American football during their youth would be more likely to have CTE-NC than those who did not play contact or collision sports, and (iii) there would be no association between CTE-NC and suicide as a manner of death. Methods Brain tissue from 186 men and accompanying clinical information were obtained from the Lieber Institute for Brain Development. Manner of death was determined by a board-certified forensic pathologist. Information was obtained from next of kin telephone interviews, including medical, social, demographic, family, and psychiatric history. The 2016 and 2021 consensus definitions were used for CTE-NC. Two authors screened all cases, using liberal criteria for identifying “possible” CTE-NC, and five authors examined the 15 selected cases. Results The median age at the time of death was 65 years (interquartile range = 57–75; range = 50–96). There were 25.8% with a history of playing American football and 36.0% who had suicide as their manner of death. No case was rated as definitively having “features” of CTE-NC by all five authors. Ten cases were rated as having features of CTE-NC by three or more authors (5.4% of the sample), including 8.3% of those with a personal history of playing American football and 3.9% of those who did not play contact or collision sports. Of those with mood disorders during life, 5.5% had features of CTE-NC compared to 6.0% of those who did not have a reported mood disorder. Of those with suicide as a manner of death, 6.0% had features of CTE-NC compared to 5.0% of those who did not have suicide as a manner of death. Discussion We did not identify a single definitive case of CTE-NC, from the perspective of all raters, and only 5.4% of cases were identified as having possible features of CTE-NC by some raters. CTE-NC was very uncommon in men who played amateur American football, those with mood disorders during life, and those with suicide as a manner of death.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    URL: Article
    DOI: 10.3389/fneur.2023.1143882
    DOI: 10.3389/fneur.2023.1143882.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
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  • 5
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    Serotonergic Antidepressants and Risk for Traumatic Intracranial Bleeding
    Frontiers Media SA ; 2021
    In:  Frontiers in Neurology Vol. 12 ( 2021-10-28)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2021-10-28)
    Abstract: Background: Serotonergic antidepressants may predispose to bleeding but the effect on traumatic intracranial bleeding is unknown. Methods: The rate of intracranial bleeding in patients with antidepressant medication was compared to patients not antidepressants in a cohort of patients with acute head injury. This association was examined by using a consecutive cohort of head trauma patients from a Finnish tertiary center emergency department (Tampere University Hospital, Tampere, Finland). All consecutive (2010–2012) adult patients ( n = 2,890; median age = 58; male = 56%, CT-positive = 22%, antithrombotic medication users = 25%, antidepressant users = 10%) who underwent head CT due to head trauma in the emergency department were included. Results: Male gender, GCS & lt;15, older age, and anticoagulation were associated with an increased risk for traumatic intracranial bleeding. There were 17.8% of patients not taking antidepressants and 18.3% of patients on an antidepressant who had traumatic intracranial bleeding ( p = 0.830). Among patients who were taking antithrombotic medication, 16.6% of the patients not taking antidepressant medication, and 22.5% of the patients taking antidepressant medication, had bleeding ( p = 0.239). In a regression analysis, traumatic intracranial hemorrhage was not associated with antidepressant use. Conclusions: Serotonergic antidepressant use was not associated with an increased risk of traumatic intracranial hemorrhage.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2021.758707
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
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  • 6
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    Online Resource
    Examining Test-Retest Reliability and Reliable Change for Cognition Endpoints for the CENTER-TBI Neuropsychological Test Battery
    Frontiers Media SA ; 2020
    In:  Frontiers in Neurology Vol. 11 ( 2020-10-20)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 11 ( 2020-10-20)
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2020.541533
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
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  • 7
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    Improving the Methodology for Identifying Mild Cognitive Impairment in Intellectually High-Functioning Adults Using the NIH Toolbox Cognition Battery
    Frontiers Media SA ; 2021
    In:  Frontiers in Psychology Vol. 12 ( 2021-9-8)
    Details
    In: Frontiers in Psychology, Frontiers Media SA, Vol. 12 ( 2021-9-8)
    Abstract: Objective: Low scores on neuropsychological tests are considered objective evidence of mild cognitive impairment. In clinical practice and research, it can be challenging to identify a cognitive deficit or mild cognitive impairment in high-functioning people because they are much less likely to obtain low test scores. This study was designed to improve the methodology for identifying mild cognitive impairment in adults who have above average or superior intellectual abilities. Method: Participants completed the National Institutes of Health Toolbox for the Assessment of Neurological and Behavioral Function Cognition Battery (NIHTB-CB). The sample included 384 adults between the ages of 20 and 85 who had completed either a 4-year college degree or who scored in the above average, superior, or very superior range on a measure of intellectual functioning, the Crystallized Composite score. Algorithms were developed, based on the absence of high scores and the presence of low scores, for identifying mild cognitive impairment. Results: Base rate tables for the presence of low scores and the absence of high scores are provided. The base rate for people with high average crystalized ability obtaining any one of the following, 5 scores & lt;63rd percentile, or 4+ scores & lt;50th percentile, or 3+ scores ≤ 25th percentile, or 2+ scores ≤ 16th percentile, is 15.5%. Conclusions: Algorithms were developed for identifying cognitive weakness or impairment in high-functioning people. Research is needed to test them in clinical groups, and to assess their association with clinical risk factors for cognitive decline and biomarkers of acquired neurological or neurodegenerative diseases.
    Type of Medium: Online Resource
    ISSN: 1664-1078
    URL: Article
    DOI: 10.3389/fpsyg.2021.724888
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
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  • 8
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    Online Resource
    High School Football and Risk for Depression and Suicidality in Adulthood: Findings From a National Longitudinal Study
    Frontiers Media SA ; 2022
    In:  Frontiers in Neurology Vol. 12 ( 2022-2-9)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2022-2-9)
    Abstract: There is growing public concern regarding the potential long-term effects of playing football on brain health, specifically that playing football before and during high school might cause damage to the brain that manifests years or decades later as depression or suicidality. This study examined if playing high school football was associated with increased lifetime risk for depression, suicidality over the past year, or depressed mood in the past week in men aged between their middle 30 s to early 40 s. Methods Publicly available data from the National Longitudinal Study of Adolescent to Adult Health were analyzed. This longitudinal, prospective cohort study sampled nationally representative U.S. youth starting in 1994–1995 (Wave I) and most recently in 2016–2018 (Wave V). A total of 3,147 boys participated in Wave I (median age = 15), of whom 1,805 were re-assessed during Wave V (median age = 38). Results Of the 1,762 men included in the study, 307 (17.4%) men reported being diagnosed with depression and 275 (15.6%) reported being diagnosed with an anxiety disorder or panic disorder at some point in their life. When comparing men who played high school football to those who did not, there were no differences in the proportions of the sample who had a lifetime diagnosis of depression, lifetime diagnosis of anxiety/panic disorders, suicidal ideation in the past year, psychological counseling in the past year, or current depressed mood. However, men who received psychological counseling and/or experienced suicidal ideation during adolescence were significantly more likely to report a lifetime history of depression, suicidal ideation in the past year, and current depressed mood. Conclusion Individuals who reported playing football during adolescence did not have an increased risk of depression or suicidal ideation when they were in their middle 30 s to early 40 s, but mental health problems during adolescence were associated with an increased risk for psychological health difficulties more than 20 years later.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    DOI: 10.3389/fneur.2021.812604
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2564214-5
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  • 9
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    Online Resource
    Data_Sheet_1.PDF
    Frontiers Media SA ; 2022
    In:  Frontiers in Neurology Vol. 13 ( 2022-11-22)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 13 ( 2022-11-22)
    Abstract: Blood-based biomarkers have been increasingly studied for diagnostic and prognostic purposes in patients with mild traumatic brain injury (MTBI). Biomarker levels in blood have been shown to vary throughout age groups. Our aim was to study four blood biomarkers, glial fibrillary acidic protein (GFAP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), neurofilament light (NF-L), and total tau (t-tau), in older adult patients with MTBI. The study sample was collected in the emergency department in Tampere University Hospital, Finland, between November 2015 and November 2016. All consecutive adult patients with head injury were eligible for inclusion. Serum samples were collected from the enrolled patients, which were frozen and later sent for biomarker analyses. Patients aged 60 years or older with MTBI, head computed tomography (CT) imaging, and available biomarker levels were eligible for this study. A total of 83 patients (mean age = 79.0, SD = 9.58, range = 60–100; 41.0% men) were included in the analysis. GFAP was the only biomarker to show statistically significant differentiation between patients with and without acute head CT abnormalities [U (83) = 280, p & lt; 0.001, r = 0.44; area under the curve (AUC) = 0.79, 95% CI = 0.67–0.91]. The median UCH-L1 values were modestly greater in the abnormal head CT group vs. normal head CT group [U (83) = 492, p = 0.065, r = 0.20; AUC = 0.63, 95% CI = 0.49–0.77]. Older age was associated with biomarker levels in the normal head CT group, with the most prominent age associations being with NF-L ( r = 0.56) and GFAP ( r = 0.54). The results support the use of GFAP in detecting abnormal head CT findings in older adults with MTBIs. However, small sample sizes run the risk for producing non-replicable findings that may not generalize to the population and do not translate well to clinical use. Further studies should consider the potential effect of age on biomarker levels when establishing clinical cut-off values for detecting head CT abnormalities.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    URL: Article
    DOI: 10.3389/fneur.2022.960741
    DOI: 10.3389/fneur.2022.960741.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
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  • 10
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    Online Resource
    Data_Sheet_1.PDF
    Frontiers Media SA ; 2023
    In:  Frontiers in Neurology Vol. 14 ( 2023-7-21)
    Details
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 14 ( 2023-7-21)
    Abstract: Some ultra-high exposure boxers from the 20th century suffered from neurological problems characterized by slurred speech, personality changes (e.g., childishness or aggressiveness), and frank gait and coordination problems, with some noted to have progressive Parkinsonian-like signs. Varying degrees of cognitive impairment were also described, with some experiencing moderate to severe dementia. The onset of the neurological problems often began while they were young men and still actively fighting. More recently, traumatic encephalopathy syndrome (TES) has been proposed to be present in athletes who have a history of contact (e.g., soccer) and collision sport participation (e.g., American-style football). The characterization of TES has incorporated a much broader description than the neurological problems described in boxers from the 20th century. Some have considered TES to include depression, suicidality, anxiety, and substance abuse. Purpose We carefully re-examined the published clinical literature of boxing cases from the 20th century to determine whether there is evidence to support conceptualizing psychiatric problems as being diagnostic clinical features of TES. Methods We reviewed clinical descriptions from 155 current and former boxers described in 21 articles published between 1928 and 1999. Results More than one third of cases (34.8%) had a psychiatric, neuropsychiatric, or neurobehavioral problem described in their case histories. However, only 6.5% of the cases were described as primarily psychiatric or neuropsychiatric in nature. The percentages documented as having specific psychiatric problems were as follows: depression = 11.0%, suicidality = 0.6%, anxiety = 3.9%, anger control problems = 20.0%, paranoia/suspiciousness = 11.6%, and personality change = 25.2%. Discussion We conclude that depression, suicidality (i.e., suicidal ideation, intent, or planning), and anxiety were not considered to be clinical features of TES during the 20th century. The present review supports the decision of the consensus group to remove mood and anxiety disorders, and suicidality, from the new 2021 consensus core diagnostic criteria for TES. More research is needed to determine if anger dyscontrol is a core feature of TES with a clear clinicopathological association. The present findings, combined with a recently published large clinicopathological association study, suggest that mood and anxiety disorders are not characteristic of TES and they are not associated with chronic traumatic encephalopathy neuropathologic change.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    URL: Article
    URL: Article
    DOI: 10.3389/fneur.2023.1214814
    DOI: 10.3389/fneur.2023.1214814.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
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