British Columbia Postconcussion Symptom Inventory

Last updated
British Columbia Postconcussion Symptom Inventory
Purposemeasure of the ICD-10 criteria for Post concussion syndrome

The British Columbia Postconcussion Symptom Inventory (BC-PSI), is a 16 item self-report inventory designed to measure both the frequency, and intensity of the ICD-10 criteria for Post concussion syndrome, which is a common occurrence in cases of mild traumatic brain injury. The (BC-PSI) asks the respondent to rate the severity of 13 symptoms rated on a six-point Likert-type rating scale that measures the frequency and intensity of each symptom in the past two weeks.

The two ratings are multiplied (how often × how bad) to create a single score for each item. These product-based scores are then converted to item scores that reflect both the frequency and intensity of symptom endorsement (range = 0–4). Item product scores convert to item total scores:
0–1 = 0, 2–3 = 1, 4–6 = 2, 8–12 = 3, and 15+ = 4.

Item scores of 3> reflect moderate to severe symptom endorsement, Item scores from 1 - 2 reflect mild endorsement of the symptom

BC-PSI items

[1] [2]

Validity

For most patients with MTBI the cognitive, psychological, and psychosocial symptoms do not last longer than three to six months.(Belanger & Vanderploeg, 2005); [3] (Carroll et al., 2004). Those in which the symptoms persist longer may be diagnosed with postconcussion syndrome (Ruff, 2005). PCS is recognised in International Classification of Diseases, 10th edition (ICD-10;(World Health Organization, 1992) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV;(American Psychiatric Association, 2000). PCS symptoms may include headaches, dizziness, light and noise sensitivity, nausea, fatigue, sleep disturbance, irritability, temper problems, emotional problems, poor concentration, and memory impairment.

Some research has indicated that healthy controls and those seen for psychological services also endorse many of the items on the BC-PSI (Meares et al.., 2008) [4] .

The results of a comparison study (Iverson GL. et al. 2010) between a clinician conducted open-ended interview and the self-report (BC-PSI), conducted among patients following a mild traumatic brain injury showed patients endorsed all 13 items on the (BC-PSI) at significantly higher rates.

CONCLUSIONS: Clinicians need to be cautious when interpreting questionnaires and be aware of the possibility of nonspecific symptom endorsement, symptom overendorsement, symptom expectations influencing symptom endorsement, and the nocebo effect. [5]

Related Research Articles

Head injury Serious trauma to the cranium

A head injury is any injury that results in trauma to the skull or brain. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries.

Premenstrual syndrome (PMS) refers to emotional and physical symptoms that regularly occur in the one to two weeks before the start of each menstrual period. Symptoms resolve around the start of bleeding. Different women experience different symptoms. The common emotional symptoms include irritability and mood changes while the common physical symptoms include acne, tender breasts, bloating, and feeling tired; these are also seen in women without PMS. Often symptoms are present for around six days. An individual's pattern of symptoms may change over time. Symptoms do not occur during pregnancy or following menopause.

Brain damage Destruction or degeneration of brain cells

Neurotrauma, brain damage or brain injury (BI) is the destruction or degeneration of brain cells. Brain injuries occur due to a wide range of internal and external factors. In general, brain damage refers to significant, undiscriminating trauma-induced damage, while neurotoxicity typically refers to selective, chemically induced neuron damage.

Concussion Type of traumatic brain injury

Concussion, also known as mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness (LOC); memory loss; headaches; difficulty with thinking, concentration or balance; nausea; blurred vision; sleep disturbances; and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.

Drug withdrawal, drug withdrawal syndrome, or substance withdrawal syndrome, is the group of symptoms that occur upon the abrupt discontinuation or decrease in the intake of medicational or recreational drugs.

Alexithymia

Alexithymia is a personality trait characterized by the subclinical inability to identify and describe emotions experienced by one's self or others. The core characteristic of alexithymia is marked dysfunction in emotional awareness, social attachment, and interpersonal relation. Furthermore, people with alexithymia have difficulty distinguishing and appreciating the emotions of others, which is thought to lead to unempathic and ineffective emotional responses. Alexithymia occurs in approximately 10% of the population and can occur with a number of psychiatric conditions as well as any neurodevelopmental disorder.

Traumatic brain injury Injury of the brain from an external source

A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity, mechanism, or other features. Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional and behavioral symptoms, and outcomes can range from complete recovery to permanent disability or death.

Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive impairment in young people. Overall, closed-head injuries and other forms of mild traumatic brain injury account for about 75% of the estimated 1.7 million brain injuries that occur annually in the United States. Brain injuries such as closed-head injuries may result in lifelong physical, cognitive, or psychological impairment and, thus, are of utmost concern with regards to public health.

The Beck Depression Inventory, created by Aaron T. Beck, is a 21-question multiple-choice self-report inventory, one of the most widely used psychometric tests for measuring the severity of depression. Its development marked a shift among mental health professionals, who had until then, viewed depression from a psychodynamic perspective, instead of it being rooted in the patient's own thoughts.

Post-concussion syndrome (PCS) is a set of symptoms that may continue for weeks, months, or a year or more after a concussion – a mild form of traumatic brain injury (TBI). About 15% of individuals with a history of a single concussion develop persistent symptoms associated with the injury.

Chronic traumatic encephalopathy Neurodegenerative disease caused by repeated head injuries

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease which can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia. It is unclear if the risk of suicide is altered.

Second-impact syndrome (SIS) occurs when the brain swells rapidly, and catastrophically, after a person suffers a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days or weeks after an initial concussion, and even the mildest grade of concussion can lead to SIS. The condition is often fatal, and almost everyone who is not killed is severely disabled. The cause of SIS is uncertain, but it is thought that the brain's arterioles lose their ability to regulate their diameter, and therefore lose control over cerebral blood flow, causing massive cerebral edema.

Concussion grading systems are sets of criteria used in sports medicine to determine the severity, or grade, of a concussion, the mildest form of traumatic brain injury. At least 16 such systems exist, and there is little agreement among professionals about which is the best to use. Several of the systems use loss of consciousness and amnesia as the primary determinants of the severity of the concussion.

Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. The person may be unable to state their name, where they are, and what time it is. When continuous memory returns, PTA is considered to have resolved. While PTA lasts, new events cannot be stored in the memory. About a third of patients with mild head injury are reported to have "islands of memory", in which the patient can recall only some events. During PTA, the patient's consciousness is "clouded". Because PTA involves confusion in addition to the memory loss typical of amnesia, the term "post-traumatic confusional state" has been proposed as an alternative.

The Rivermead Post-Concussion Symptoms Questionnaire, abbreviated RPQ, is a questionnaire that can be administered to someone who sustains a concussion or other form of traumatic brain injury to measure the severity of symptoms. The RPQ is used to determine the presence and severity of post-concussion syndrome (PCS), a set of somatic, cognitive, and emotional symptoms following traumatic brain injury that may persist anywhere from a week, to months, or even more than six months.

Traumatic brain injury can cause a variety of complications, health effects that are not TBI themselves but that result from it. The risk of complications increases with the severity of the trauma; however even mild traumatic brain injury can result in disabilities that interfere with social interactions, employment, and everyday living. TBI can cause a variety of problems including physical, cognitive, emotional, and behavioral complications.

Reversible cerebral vasoconstriction syndrome is a disease characterized by a weeks-long course of thunderclap headaches, sometimes focal neurologic signs, and occasionally seizures. Symptoms are thought to arise from transient abnormalities in the blood vessels of the brain. In some cases, it may be associated with childbirth, vasoactive or illicit drug use, or complications of pregnancy. If it occurs after delivery it may be referred to as postpartum cerebral angiopathy.

A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, these sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, roller blading, skateboarding, skiing or snowboarding.

Concussions in rugby union

Concussions in England's professional rugby union are the most common injury received. Concussion can occur where an individual experiences an impact to the head. Commonly occurring in high contact sporting activities; American football, boxing, mma, rugby, and soccer. It can also occur in recreational activities like horse riding, jumping, cycling, and skiing. The reason being that it doesn't have to be something to strike you in the proximity of your brain, but can also be caused by rapid change of movement, giving the skull not enough time to move with your body, causing your brain to press against your skull. With rugby being such a contact and fast moving sport, it is no wonder why there is concussion and other head injuries occurring. With the development of equipment and training methods, these will help benefit the players on the field know what could happen and how they can help with preventing it.

Organic personality disorder (OPD) is not included in the wide variety of group of personality disorders. For this reason, the symptoms and diagnostic criteria of the organic personality disorder are different from those of the mental health disorders, which are included in this various group of personality disorders. According to the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems ICD-10, it defines the organic personality disorder as the personality change, which can be caused by traumatic brain injury (TBI) that means there are specific brain areas of patients, which have been injured after a very strong accident. Moreover, according to the ICD-10, the organic personality disorder is associated with a "significant alteration of the habitual patterns of premorbid behaviour". Furthermore, organic personality disorder is associated with "personality change due to general medical condition". There are crucial influences on emotions, impulses and personal needs because of this disorder. Thus, all these definitions about the organic personality disorder support that this type of disorder is associated with changes in personality and behaviour.

References

  1. Iverson, GL; Lange, RT (2003). "Examination of "postconcussion-like" symptoms in a healthy sample". Appl Neuropsychol. 10 (3): 137–44. doi:10.1207/S15324826AN1003_02. PMID   12890639.
  2. Brain injury medicine: principles and practice p. 377 By Nathan D. Zasler, Douglas I. Katz, Ross D. Zafonte Publisher: Demos Medical Publishing; 1 edition (October 15, 2006) Language: English ISBN   1-888799-93-5
  3. Belanger, HG; Vanderploeg, RD (Jul 2005). "The neuropsychological impact of sports-related concussion: a meta-analysis". J Int Neuropsychol Soc. 11 (4): 345–57. PMID   16209414.
  4. Meares, S.; et al. (Mar 2008). "Mild traumatic brain injury does not predict acute postconcussion syndrome". J Neurol Neurosurg Psychiatry. 79 (3): 300–6. doi:10.1136/jnnp.2007.126565. PMID   17702772.
  5. Iverson, GL; Brooks, BL; Ashton, VL; Lange, RT (Jan 2010). "Interview versus questionnaire symptom reporting in people with the postconcussion syndrome". J Head Trauma Rehabil. 25 (1): 23–30. doi:10.1097/HTR.0b013e3181b4b6ab. PMID   19680134.